An IUD or intra-uterine device is small, plastic T-shaped device placed inside the uterus to prevent pregnancy. There are two main types of IUDs - hormonal and copper. Mona Vale Doctors offers insertion of hormonal IUDs - Mirena and Kyleena. Both contain the synthetic form of the hormone progesterone levonorgestrol. The Kyleena IUD is slightly smaller and has a lower level of levonorgestrol. With the Kyleena, you are also most likely to have a period (though usually lighter than before) whereas with a Mirena, having no period (or a lighter period) is more common. The Mirena has contraceptive effect for 8 years and the Kyleena has contraceptive effect for 5 years.

Its release of levonorgestrol provides contraceptive effect in three main ways:

1. Thickening of cervical mucous, which makes it harder for sperm to enter the uterus;

2. Thinning of endometrium (inner lining of the uterus), making it less suitable to implantation;

3. Partially suppressing ovulation (monthly release of an egg from the ovary).

Yes, most women are suitable candidates for an IUD. IUDs are a safe and effective option for a wide range of individuals, including those who:

• Cannot take oestrogen due to medical contraindications such as migraines with aura or a history of deep vein thrombosis (DVT).

• Prefer to avoid oestrogen-based contraception due to side effects or personal choice.

• Struggle with daily pill adherence, making a long-acting method more practical.

• Want a more reliable contraceptive than condoms or the withdrawal method.

• Seek a low-maintenance, cost-effective, reversible, and long-term solution for contraception.

• Wish to space out pregnancies.

• Use the Mirena IUD as part of menopausal hormone therapy (MHT) for its progesterone component.

• Experience heavy menstrual bleeding (HMB) and are looking for symptom relief.

Yes, you can. Many women who haven’t had children choose the smaller Kyleena IUD, which is designed to be more comfortable for those who haven’t given birth. However, the Mirena IUD is also suitable, especially if you're using it to manage heavy menstrual bleeding (HMB) or as the progesterone component of menopausal hormone therapy (MHT) - uses for which Kyleena is not approved.

We usually recommend to wait 9 weeks after you have had a vaginal birth and 12 weeks if you have had a caesarean section. There is a higher risk of the IUD being pushed out (expelled) or damaging the uterine wall (perforation) if it is inserted earlier.

Yes, you can. Hormonal IUDs are safe to use while breastfeeding and do not affect your milk supply.

However, research shows that the risk of uterine perforation - where the IUD may puncture the uterine wall - is slightly higher in breastfeeding women, particularly if the IUD is inserted within 36 weeks postpartum. While the risk is about six times higher compared to non-breastfeeding women, it remains very low overall, estimated at up to 12 cases per 1,000 insertions.

Your doctor will assess the best timing for insertion to minimise risks and ensure safe placement.

No, IUDs do not offer protection against STIs. To reduce the risk of sexually transmitted infections, it’s important to use condoms.

Yes, while IUDs are safe and effective for most women, there are certain medical conditions where they may not be recommended. These include:

• Current breast cancer (for hormonal IUDs only)

• Active pelvic infection, such as pelvic inflammatory disease (PID)

• Unexplained vaginal bleeding that has not been investigated

• Severe liver disease (for hormonal IUDs)

• Uterine abnormalities, such as fibroids that distort the shape of the uterine cavity

It’s important to speak with your doctor to determine whether an IUD is appropriate for your individual health needs and circumstances.

Like any medical procedure, IUD insertion carries some risks and potential side effects. These include:

• Cramping or discomfort during and shortly after insertion - this usually settles within a few days.

• Failure to prevent pregnancy, although rare (less than 1 in 100 women per year).

• Expulsion, where the IUD is pushed out of the uterus - this occurs in about 1 in 20 cases, most commonly within the first year.

• Uterine perforation, where the IUD punctures the uterine wall - this is very rare, occurring in approximately 2 in 1,000 insertions.

• Infection, typically within the first 20 days after insertion - affects fewer than 1 in 300 women.

• Irregular bleeding or spotting, especially in the first few months after insertion.

• Hormonal side effects (with hormonal IUDs like Mirena), which may include acne, headaches, or mood changes.

Your doctor will discuss these risks with you and help determine whether an IUD is the right option based on your health and preferences.

To get started, call our reception to book a consultation with one of our doctors. During this appointment, you can discuss whether an IUD is suitable for your needs and preferences.

If you decide to proceed, the IUD insertion will be performed by Dr Michelle Penm at a follow-up appointment.