Intra Uterine Contraceptive Device
We specialise in the management of Intra Uterine Contraceptive Devices (IUCD). These are sometimes called “Coils”. They can be used by any woman but they are ideal for the mother who has already had children and seeks a low maintenance approach to contraception and family planning. Once inserted they can stay in place for more than five years. On removal conception can be immediate if required. Insertion and removal is generally done as an out patient procedure. These devices are highly reliable in the prevention of pregnancy when they are correctly placed. It should be noted that they do not prevent ectopic pregnancy.
Type of Device
There are two devices: the traditional Copper T and the more modern Mirena. The Copper T is a plastic T with some copper in a very small filament around the stalk. The Mirena is a plastic T with some progesterone hormone embedded in it. The Copper T is less costly. The Copper T is associated with heavier menstruation at least for a few months after insertion and will exacerbate this bleeding in a woman who already has heavy periods. In women with heavy periods the Mirena should reduce them and often results in the stopping of menstrual bleeding each month. Mirena is used for the treatment of heavy periods irrespective of contraceptive requirements. There is a small incidence of hormonal side effects with a Mirena.
This is done in the few days following the end of menstrual bleeding. The cervix may be more pliable at this point and there is less risk of an already existing pregnancy. A consultation for insertion lasts about half an hour. The actual insertion takes less than 5 minutes. If the woman has never been pregnant or has had planned caesarean sections without labour it may be more difficult because the cervix is less pliable. A small dose of sedative by mouth may be appropriate before the procedure. We always perform an ultrasound scan at the beginning of the procedure to assess uterine condition and position.
While the woman is still on the ultrasound couch the device is inserted through the vagina and cervix. There can be some pain or discomfort at this time. An ultrasound scan is performed immediately after insertion to ensure the device is correctly placed. The attached thread is then trimmed at the cervix. This thread is used for later visualization and removal. Usually the woman can leave the clinic within 10 minutes. For a few days later there may be some pelvic discomfort but generally no pain. The sexual partner should not be able to feel the thread but if it causes discomfort it can be trimmed shorter.
It is recommended that the woman should be seen for a brief check with a tummy ultrasound scan in 6-8 weeks (this is included in our price). There should be further checks when cervical smears are done every 18-24 months.
A local clinic or other doctor may have had difficulty inserting a device. We are happy to assess the situation and try ourselves. With our expertise and scanning guidance it may be successful.
Sometimes there is difficulty removing a device previously inserted. The thread may be short or have disappeared. Again we have an expertise in such cases and are happy to see and assess.
If a woman has had particular pain during or after insertion and an ultrasound scan has not been done then this should be arranged. This may indicate that the device has been misplaced and will be at greater risk of failure with a consequent unplanned pregnancy.
We provide short notice appointments for advice about IUCDs.