IUDs (intrauterine devices)

Copper-bearing IUDs

Intrauterine devices are small devices which are inserted by a doctor to fit inside the uterus (womb). They are plastic with copper wound around the stem. They have fine threads which can be felt protruding from the cervix. They can be fitted at any time including during a surgical termination or within a week of a medical termination. Depending on the type of device they can be left in place for 5 - 10 years or even longer for women over the age of 25 who have had a child. There is only a small risk of pregnancy, about 1-2 for every 100 women using the method over a year. They do not cause ectopic pregnancies (in the fallopian tube) but if a pregnancy does occur there is a small chance that it may be ectopic. As with all methods care should be taken to protect against STIs, to avoid any infection and to preserve future fertility. Sometimes periods may be heavier than normal but this is not usually a big problem.

Mirena

This is hormone-releasing intrauterine system. Instead of having copper wound around the stem, there is a special membrane which releases a small amount of progestogen, a hormone which affects the lining of the womb making it rare for a fertilised egg to implant. If women are anaemic through heavy menstrual bleeding Mirena can be provided free, otherwise it costs about $400. It lasts for 5 years. It is a very effective contraceptive with less than 1 pregnancy for every 100 women using the method over a year It is also used in older women as part of hormone replacement therapy for menopausal symptoms. Many women with Mirena lose their periods altogether and this is medically safe.