Intra-Uterine Device (IUD)

What is an intra-uterine device (IUD) - hormonal and non-hormonal?

IUDs are methods of birth control inserted inside the uterus (intra-uterine). The non-hormonal IUD is a small T-shaped plastic device with copper wire around it. The hormonal IUD contains one hormone called progestin. IUDs must be inserted by a health care professional (HCP), are at least 99% effective in preventing pregnancy and protect for three to five years. The copper IUD can also be used for emergency contraception if inserted within 7 days of unprotected sex.

How does a hormonal IUD work?

The hormonal IUD thickens the cerical mucus, making it harder for sperm to enter the uterus, thins the lining of the uterus and impairs implantation in the uterus.

How does a non-hormonal IUD work?

The copper IUD primarily inhibits sperm from reaching an egg and impairs implantation in the uterus.

Who can use an IUD (hormonal or non-hormonal)?

All women who are seeking a reliable, effective, private, and reversible method of birth control that requires little attention. Also, the IUD (hormonal or non-hormonal) may be a good option for women who are unable to take estrogen or who are breastfeeding.

How do I use IUD (hormonal or non-hormonal)?

All IUDs must be inserted by a HCP:

• An interview and internal exam are needed before the insertion to assess the size and position of the uterus and to detect genital infections or abnormalities. A prescription for the hormonal IUD is given to you to take to a pharmacy. A copper IUD can be purchased at the clinic.
• IUDs can be inserted any time during your cycle provided pregnancy is ruled out.
• The copper IUD is effective immediately. The hormonal IUD is effective 7 days after insertion, unless the IUD was inserted during your period.
• Check the IUD strings before sex and after each period. If you feel the plastic part of the IUD or if the strings are absent, use another method of birth control and seek medical attention.
• A follow-up visit is required 4 to 6 weeks after insertion to assess for any infection or complications. Seek care sooner if you experience:
  • late period or no period
  • abdominal pain 
  • fever, chills
  • increased or foul smelling discharge
  • spotting, heavy bleeding or clots with your period
• If you have a hormonal IUD, you may notice that your period decreases over time and may stop all together. This is a normal side effect. If an abrupt change to your period occurs, see your HCP.
• Never attempt to remove an IUD yourself.

What are the advantages, possible side effects, and complications of IUDs?

Non-hormonal IUD:

Advantages:

• Long-lasting, discreet, and forgettable birth control
• Does not affect breastfeeding
• Reduces the risk of endometrial cancer

Side effects

• Pain and bleeding after insertion
• Heavier menstrual flow and cramping (up to 50%)

Hormonal IUD:

Advantages

• Long-lasting, discreet, and forgettable birth control
• Does not affect breastfeeding
• Reduces menstrual flow and painful periods
• May reduce the risk of endometrial cancer with high risk individuals

Side effects

• Cramping and irregular bleeding for 3-6 months after insertion
• Minimal hormonal effects – headaches, sore breasts, mood changes, acne

Possible complications for hormonal or non-hormonal IUDs:

• Pain and increased bleeding
• Perforation of (poking a hole in) the uterus (less than 1 in 1,000)
• Expulsion (falling out) of the IUD
• Infection within 20 days post insertion (less than 1 in 100)
• Pregnancy (less than 1 in 100/year). If this happens, there is a higher risk of ectopic (tubal) pregnancy.

Remember

• IUDs do not protect against STBBIs or HIV. Use condoms to lower your risk.
• Call the Sexual Health Infoline Ontario at 1-800-668-2437 if you have questions or need help.
• For more information on IUDs, please visit: www.sexandu.ca.
• To find out if this birth control method is right for you, click here for an interactive quiz! 

Note: Insertion of IUDs available at the main sexual health clinic located at 179 Clarence Street. To book an appointment call 613-234-4641.