Copper Intrauterine Device (IUD)

WHAT IS A COPPER IUD?

An intrauterine device (IUD) is a small plastic device inserted into the uterus (womb) by a doctor or nurse and is used to prevent pregnancy. IUDs are a highly effective long-acting reversible contraceptive. There are two different types of IUDs- hormonal and copper. The copper IUD is an IUD that has copper wrapped around its stem and arms. It does not contain any hormones.

HOW DOES IT WORK?

The copper IUD works mainly by preventing fertilisation. It does this by being toxic to the egg and sperm and by interfering with sperm movement. It also prevents the implantation of a fertilised egg. It does not affect ovulation.

HOW EFFECTIVE IS IT?

The copper IUD is 99.5% effective.

HOW LONG DOES IT LAST

The copper IUD lasts either 5 or 10 years, depending on the type.

HOW IS AN IUD INSERTED?

iud insertion

An IUD is inserted by a doctor or nurse who is specially trained to do this. The procedure involves inserting a speculum into the vagina, then using a special IUD inserting tube to place the IUD into the uterus. Local anaesthetic is often used to numb the cervix and make the insertion more comfortable. This procedure is usually done when you are awake; however anxiety reducing medication can be taken before the procedure, or you can have insertion at a clinic that provides sedation if needed.

HOW IS AN IUD REMOVED?

Removal of an IUD is done by a doctor or nurse who is specially trained to do this. It is a relatively quick and straightforward procedure and can be done at any time. IUDs have very fine nylon threads attached to them that extend through the cervix to make it easy to check if they are still in place and make it easy for a doctor or nurse to remove. If you do not want to get pregnant, make sure that you use condoms or abstain from sexual intercourse for 7 days before the IUD is removed. Sperm can live for up to 7 days in the uterus, and there is a risk of pregnancy if an IUD is removed within this time.

WHAT ARE THE ADVANTAGES OF A COPPER IUD?

It is a highly effective contraceptive (99.5%)
It does not require any day-to-day action on your part.
It is long-acting (up to 10 years, depending on the type).
The effect is rapidly reversible after removal.
It can be used when breastfeeding
While there is an upfront cost for the device and insertion, it is a relatively inexpensive method over time.
It is a suitable method for people who cannot use or do not wish to use hormonal contraception.

WHAT ARE THE DISADVANTAGES?

It must be inserted and removed by a health professional who is specially trained.
As with any procedure, there is always a small risk of complications.
The insertion procedure can be uncomfortable.
It provides no protection against sexually transmissible infections.
Some people may have factors in the uterus structure that prevent IUD insertion, and this may not be apparent until insertion is attempted.

WHO CAN USE A COPPER IUD?

The Copper IUD is suitable if you are looking for a very effective, long-acting, reversible contraceptive method. It is suitable regardless of whether or not you have had children. The Copper IUD is a suitable method if you cannot use or would rather not use a method that contains hormones. As with most contraception, it is suitable for use when breastfeeding.

WHO MAY NOT BE ABLE TO USE A COPPER IUD?

There are some situations where you may not be able to use a Copper IUD; these include:

If you may already be pregnant.
If you have unexplained vaginal bleeding.
If you have recently had pelvic inflammatory disease (an infection of the uterus and tubes)
If you have Wilson’s disease or an allergy to copper.

Some other situations may also make a Copper IUD unsuitable for you. You would need to discuss these with your doctor. These include:

Very heavy or painful periods.
Anaemia due to heavy periods.
Problems with IUDs in the past.
Conditions that may make the insertion difficult, such as fibroids or the shape of your uterus.

WHAT ARE THE POSSIBLE PROBLEMS WHICH MAY OCCUR WITH A COPPER IUD?

Periods may become heavier, longer, and more painful with the copper IUD. This is manageable for most people, but can be a problem if your periods are already heavy and painful.
There is a small risk of pregnancy occurring with an IUD (less than 1 in 100). If pregnancy does occur, there is a slightly increased risk of it occurring in the fallopian tube.
Infection: There is a small risk of infection at the time of insertion (about 1 in 500).
Expulsion: In about 5% of cases, the uterus will expel the device. It is essential to check that the IUD is still in place by feeling for the IUD string after each period. If the string is not present, this may indicate that the IUD has moved or been expelled.
Perforation: This is a rare event (approximately 2 in 1000 insertions) when the IUD passes through the uterus wall into the pelvic area. This will require minor surgery under a general anaesthetic to remove.

WHERE DO I GO FOR AN IUD INSERTION?

IUDs are only inserted by doctors or nurses who have done specialised IUD training.

The clinic at SHFPACT provides IUD insertion services with doctors. Some GPs and most gynaecologists also offer this service.

WHAT HAPPENS IN THE IUD INSERTION PROCESS AT SHFPACT?

INITIAL CONSULTATION APPOINTMENT

There will be an initial consultation with a doctor to see if a copper IUD is a suitable option for you. The method and the insertion procedure will be explained, cervical screening will be done if due, and swabs may also be done. It is best to ask any questions or raise concerns at this point.
Copper IUDs need to be inserted on days 1 to 10 of your cycle (Day one being the first day of your period). Following your initial consultation, you will need to make an appointment for the insertion within this timeframe.

IUD INSERTION APPOINTMENT

You will be encouraged to arrange to be driven home and rest up after the procedure for the remainder of the day. You may need to organise care for young children, time off work, etc. You will probably be fine to return to normal activities the following day.
You will be at the clinic from 1 to 1 ½ hours. If parking, please ensure you leave enough time.
The doctor will talk with you about the procedure and make sure the process is clear.
An uncomplicated insertion procedure takes about 15 mins. You will be asked to stay at the clinic for a minimum of 20 minutes following the procedure. If you are not feeling well, you will be asked to remain until the staff caring for you think that you are well enough to leave.
The copper IUD will be provided to you on the day of the insertion appointment; the cost will be included in the fee charged on the day.

AFTER YOUR IUD INSERTION

There may be cramping and/or bleeding in the first few days afterwards.
We advise that nothing should enter the vagina for 72 hours afterwards to reduce infection risk– no tampons, no sex, no water (showering is ok).
There is no further appointment needed unless you are experiencing problems. Your doctor will discuss this with you at the time of your insertion.

You should contact the doctor if:

You suspect you might be pregnant.
You experience excessive pelvic pain or tenderness, fever or chills, offensive discharge, or deep pain with intercourse.
You can’t feel the string or can feel the plastic of the device.

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References:
Contraception: An Australian clinical practice handbook 4th Edition
Contraception – Intrauterine Devices/ Family Planning QLD
The copper IUD Fact sheet/ Family Planning NSW
Guillebaud, J & MacGregor, A 2013. Contraception: Your questions answered. 6th ed. Churchill Livingstone