Long-acting, immediately reversible, and highly effective (99.2–99.8%), the intrauterine device (IUD) is recommended as a first-line method of contraception. It is an excellent option for youth, adolescents, adults, immediate postpartum use, and later reproductive years, including peri-menopausal women experiencing abnormal periods.
Hormonal IUDs are also commonly used for cycle control in women struggling with heavy or painful periods, and they provide endometrial protection in women using menopause hormone therapy (MHT).
One of the greatest benefits of an IUD is that its effectiveness does not depend on daily or routine action by the user. Once placed, you can simply forget about it — it is discreet, reliable, and cost-effective.IUDs can also serve as emergency contraception when inserted within seven days of unprotected intercourse.
Since many family physicians do not provide IUD insertions, we are here to offer expert care and support throughout the process.
The IUD is a small, soft T-shaped device that is inserted into your uterus, also known as your womb, to prevent pregnancy.
Some IUDs contain a hormone (Mirena and Kyleena LNG IUS) called progesterone which can reduce menstrual bleeding or stop menstruation altogether.
Whereas , Copper IUDs , are hormone free and the top choice for women who want to avoid hormones.
Let’s sit down and see what best suits your lifestyle.
An IUD is one of the most effective contraception methods – it is 99% effective and lasts between 3 to 8 years, depending on the type.
There are two styles of IUDs available in Canada.
Hormonal IUDs:
Mirena® and Kyleena® are hormonal (progesterone-based) IUDs that are completely free of estrogen.
Mirena® provides contraception for up to 8 years and is also approved for the management of heavy or painful periods.
Kyleena® lasts for 5 years and is used primarily for birth control.
Both IUDs release a small, steady amount of levonorgestrel, a hormone similar to progesterone which your body naturally makes. This works by:
Thickening the cervical mucus to block sperm.
Thinning the uterine lining, which makes periods lighter or may even stop them completely.
Because of these effects, hormonal IUDs are often a great choice for women with heavy or painful periods, athletes, or anyone who prefers to avoid monthly bleeding.
IUD's can be removed at any time, are safe to use while breastfeeding, and do not affect future fertility—your ability to become pregnant returns quickly after removal.
2. Copper IUD is the only form of birth control that is completely hormone-free, making it an excellent option for any women who prefer to avoid hormones. This includes breastfeeding mothers or women with depression or anxiety who wish to avoid hormonal effects on mood.
Copper IUDs are available with a lifespan of 3, 5, or 10 years, depending on the style. The device consists of a small, flexible piece of plastic shaped like a “T,” with copper wrapped around it — which is why it is called a copper IUD.
The copper is released into the uterine cavity, preventing pregnancy by stopping sperm from fertilizing an egg and reducing sperm movement. It also thickens the cervical mucus, forming a barrier that prevents sperm from entering the uterus.
Because copper IUDs may make periods longer, heavier, or more painful, particularly during the first few cycles. In most cases, this settles over time, but if heavier or painful bleeding persists beyond six months, it is unlikely to change after that and you should speak to your healthcare provider as heavy periods can lead to iron deficiency and anemia
For women who have never been pregnant, scheduling the IUD insertion during or just after your period can make the procedure easier and more comfortable, although Dr. Gerber can insert an IUD at any time during your cycle.
To help ensure your comfort, a local anesthetic ( cervical block) is used to numb the cervix during the procedure.
For patients who may need additional support, we also offer oral sedation (Ativan/lorazepam) or inhaled anesthesia (Penthrox/methoxyflurane, commonly called the “green whistle”) in select cases to help manage anxiety and pain. If you think you may need these methods, a phone consultation is required before your appointment.
The IUD insertion procedure typically takes less than five minutes.
Dr. Gerber uses breathing techniques to help make the process easier, and local numbing or freezing . The IUD is inserted into the uterus using sterile instruments.
Pain experience varies from person to person. Some patients feel only a mild pinch or cramping similar to menstrual discomfort, while others may experience more intense cramping .
Most patients find the procedure " not as bad as they were expecting."
To help ensure the procedure goes smoothly, arrive well prepared: take Naproxen 440 mg when you arrive at the clinic, be well hydrated, and have eaten something light. If you anticipate you might be sensitive to procedures, it is recommended to arrange for a ride home afterward.
It is important to be cautious about information on social media. Many patients who have positive experiences do not share them, while negative or exaggerated stories are often more visible. Most patients manage the procedure well with Naproxen and local anesthetic (cervical block), and social media posts may not accurately reflect the typical experience.
Using social media as a reference often creates unnecessary anxiety and misinformation.
Most women are able to return to work immediately after the procedure. At our clinic, we recommend that for the first 24 hours following an IUD insertion , you avoid placing anything inside the vagina to reduce the risk of infection. During this time, use pads or panty liners and take showers rather than baths. After the first 24 hours, you can resume all normal activities, including swimming, using hot tubs, and inserting menstrual cups or tampons.
MIRENA or KYLEENA IUDs become effective 7 days after insertion. If you weren't using birth control prior to the procedure, we recommend using condoms or avoiding sex during the first week. If you were using the pill, patch, or ring, continue using that method for 7 days or refrain from sex during the first week.
Copper IUDs Copper IUDs are effective immediately after insertion and do not require an overlap with other forms of contraception, such as condoms.
If you experienc low grade cramping after the procedure take Ibuprofen or Tylenol or use a heating pad.
IUD STRING CHECKS: Checking your IUD threads is optional but can provide reassurance that your IUD is in place and functioning properly. To check, gently insert your middle finger into the vagina until you reach the cervix, which feels firm and rubbery. The IUD threads should be coming out of the cervix.
Many women find it difficult to feel the strings at first, so some practice may be needed. You can try different positions or ask your partner to help feel for the strings.
If you are concerned, use condoms, take a pregnancy test, and contact your doctor or a walk-in clinic for a string check.
Never pull on your IUD strings, as this can cause the IUD to shift or fall out. Regularly checking the strings is optional, but it can help detect if your IUD has moved. IUDs may shift during the first few months after insertion or during a menstrual period. If the strings feel longer or shorter than usual, or if you feel the hard part of the IUD against your cervix, the IUD may have shifted. In this case, use condoms and contact your healthcare provider.
When you choose to change contraception methods, plan a pregnancy, replace your expiring IUD or simply discontinue use, the IUD can be easily removed at our clinic.
To prevent any chance of pregnancy, you should either abstain from vaginal intercourse or use condoms for at least one week before IUD removal.
If you plan to switch to another contraceptive method, such as the pill, patch, or ring, it is ideal to start your new method seven days before your IUD removal appointment.I
IUD removal is generally a straightforward procedure that typically involves only mild cramping. Sterile instruments are used to grasp the threads and gently slide the IUD out of the uterus.
If the IUD threads cannot be seen, the removal may be more complicated and require additional instruments and local numbing or freezing to locate the IUD. In rare cases, if the IUD cannot be removed in the office, a referral to a gynecologist may be necessary, and minor surgery may be required to remove the device.
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