Intrauterine contraceptive device

An intrauterine contraceptive device (IUD) works by preventing fertilisation of the egg. The copper or hormone stops sperm moving through the uterus towards the egg. If your egg does receive the sperm, the IUD stops your egg from implanting in the wall of your uterus.

• The copper IUD is 99% effective in preventing pregnancy. Only 1 person out of 100 will get pregnant each year.
• Mirena is 99.5% effective in preventing pregnancy.

Most women are able to use an IUD including teens and women who have not had tamariki.

Mirena is particularly suitable for women who get heavy periods.

You will need to use a different method of contraception if you:

• have a blood disorder
• are on blood-thinning medication
• have a heart murmur or rheumatic heart disease.

There are many advantages to an intrauterine contraceptive device (IUD) which include:

• they can stay in place for 5 years or more
• it is possible to get pregnant as soon as the IUD is taken out
• they do not interfere with sex
• they can be inserted up to 48 hours after giving birth
• they are safe to use if you are breastfeeding
• it is safe to use if you cannot take a contraceptive pill
• you do not need to think about taking a pill everyday
• most people have lighter periods and less period pain with Mirena — some have no periods at all
• the copper IUD has no hormonal side effects.

There are some disadvantages to an intrauterine contraceptive device (IUD).

• You have to have the IUD inserted. This is usually a simple, safe procedure. It is done by a doctor or nurse who is experienced at inserting IUDs. It takes about 5 to 10 minutes.
• Most people have some cramps, like period cramps, at the time of insertion. Some people feel pain and may feel faint when the IUD is put in or taken out.
• Cooper IUDs may cause heavier periods or cramping with your periods.
• IUDs do not protect against sexually transmitted infections (STIs).

About 5% of the time, an IUD can come out by itself. You should check the strings are still in place after each period. It is also a good idea to do this 1 week after your IUD has been put in.

Contact your healthcare provider if you can feel the hard plastic of the IUD or if you cannot feel the string.

If you are not sure what to do call Healthline on 0800 611 116

There are some risks from having an intrauterine contraceptive device (IUD) put in:

• there may be a small chance of infection (about 1%) when an IUD is put in
• there is a very small risk of damage or perforation of the uterus (about 1 in 1,000)
• you may get pregnant with an IUD in place — but this is rare
• any pregnancy can be ectopic (in the tubes) — this risk is less than in people not using any contraception
• a copper IUD may cause more bleeding and cramping during periods
• the copper IUD can very rarely cause an allergic reaction
• Mirena may cause irregular, light bleeding for more days than usual when it is first put in.

Visit the Medsafe website for more information about Mirena's side effects.

Mirena — Medsafe (PDF 284KB)external linkPDF

You can have an IUD inserted by your healthcare provider or at a Sexual Wellbeing Aotearoa clinic.

The IUD is put into your uterus through your cervix. The procedure takes a few minutes and may be painful.

Before your appointment

It is a good idea to take some pain relief 1 to 2 hours before your appointment. Paracetamol or an anti-inflammatory such as ibuprofen are suitable.

Take a sanitary pad with you to your appointment.

You should arrange to have someone you can call to come and collect you in case you feel too unwell to drive, although this is very unlikely. You might like to arrange a support person to come with you.

During the appointment

1. The doctor or nurse will check the size and position of your uterus. They will do this by gently placing 2 fingers in your vagina, then placing their other hand on the lower part of your tummy.
2. They will insert an duck-bill shaped device called a speculum into your vagina
3. The doctor or nurse will place a holder on your cervix to keep it steady while they move a thin instrument through your cervix into your uterus. This measures the length of your uterus and opens the cervix so the IUD can be inserted.
4. The IUD is inserted. You may feel some cramping while this is happening.

A few women feel light-headed and may feel like throwing up (nauseous) after they have an IUD inserted. If this happens, it normally only lasts a short time. That is why it is important to organise someone who can collect you if you do not feel well enough to drive.

After the IUD is inserted

You may have some cramps for a couple of hours and some spot bleeding. The spotting could last up to 2 weeks.

To reduce the risk of infection after the insertion:

• you should use sanitary pads (not tampons or a menstrual cup) for the first 48 hours
• do not have sex in the first 48 hours.

If you have a copper IUD you may have heavy periods after your IUD is inserted. This is not as common with the hormone type of IUD (Mirena).

Copper IUDs protect you against pregnancy as soon as they are fitted.

A Mirena or Jaydess IUD does not work as a contraceptive until 7 days after it is put in (unless it is fitted within 7 days of the start of your period).

Follow up

You may have a follow-up visit 6 weeks after the procedure with your healthcare provider or the provider who performed the procedure. This is to check the strings from the IUD or IUS and discuss any concerns you might have about the device.

The best time to fit an IUD is:

• during or just after a menstrual period
• 4 to 6 weeks after your pēpi is born
• immediately after a surgical abortion (during the same procedure).

You should wait to have an IUD inserted if you:

• have pelvic pain or unusual vaginal discharge
• have a sexually transmitted infection
• are unwell with a fever on the day you plan to have the IUD inserted.

After giving birth

You may be able to get an IUD fitted immediately after the birth of your pēpi and up to 48 hours afterwards. Talk to your midwife or doctor.

Emergency contraception

A copper IUD can be used as emergency contraception up to 5 days after unprotected sex.

If you think you might be pregnant, see your healthcare provider to get your intrauterine contraceptive device (IUD) removed as soon as possible. There is an increased chance of miscarriage if the IUD is left in while you are pregnant.

If you decide you want your IUD removed, the best time is during your period. Your healthcare provider will remove the IUD by pulling the threads. This may be painful for a few seconds.

For more information, contact your healthcare provider or Sexual Wellbeing Aotearoa clinic.

Intrauterine device — Sexual Wellbeing Aotearoaexternal link