MIRENA/KYLEENA IUD

What is an IUD?

An intrauterine device (IUD) is a small plastic loop with a nylon string at the end that's put inside the womb (uterus) by a doctor. It is a convenient, affordable and highly effective method of preventing pregnancy.

What types of IUD are available?

Broadly speaking, there are 2 types of IUD; the hormonal IUD (Mirena or Kyleena) or the copper IUD.

What are the benefits of an IUD?

You won’t have to remember to take something for contraception every day
The hormonal IUD will make your periods lighter
Medications and natural remedies won’t stop the IUD from working
It can work for up to 5 years
Quickly reversible: it can be easily taken out by a doctor if you don’t want it any more

What are the down-sides of an IUD?

The copper IUD can make periods heavier and more painful
There is a small risk of infection around the time the copper or hormonal IUD is inserted
Neither IUD will prevent STI’s

How can I have an IUD removed?

Removal of an IUD is usually a straightforward and quick procedure. We can do this for you in a standard appointment.

Which doctor can perform an IUD insertion?

Dr Jamie Mackay

IUD insertions are performed at Diamond Valley Clinic by Dr Jamie Mackay. He has had extensive experience in women’s health, including completing his Diploma of Obstetrics and Gynaecology at Eastern Health.

How can I arrange to get an IUD?

You can call us on 9438 3888 to book an appointment with Dr Jamie Mackay. Please let our reception staff know that you would like to discuss getting an IUD at the time of booking.

During your initial appointment, the doctor will discuss the requirements and risks involved with IUD use, and determine if it is the best contraceptive option for you. A subsequent second appointment will then be required to insert the IUD. You will also need to see the doctor 6 weeks after the procedure to check the IUD’s position and make sure that everything is working as expected.

We can also offer advice on other contraceptive methods such as the contraceptive pill, vasectomy, Implanon and more.

Hormone-releasing IUD (Mirena/Kyleena)

What Is The Hormone-Releasing IUD?

The are 2 hormone-releasing intrauterine devices (IUD) available in Australia these are the Mirena® and Kyleena®. It is a small plastic device in the shape of a 'T' with a hormone called levonorgestrel in its stem. It is placed inside the uterus (womb) to prevent pregnancy. The IUD has a fine nylon string attached to it. When the IUD is in place, the string comes out through the cervix (the neck of the uterus) into the top end of the vagina. If you feel high up inside your vagina with your finger, you can check that the string is there and know the IUD is still in place. The string also makes it easy for a doctor to remove the IUD.

The hormone-releasing IUD can stay in place for up to 5 years.

How Does The Hormone-Releasing IUD Work?

The hormone makes the mucus in the cervix thicker so that sperm cannot get into the uterus. It also affects the ability of the sperm and egg to move through the uterus and fallopian tubes, which reduces the chance of an egg being fertilised. It also changes the lining of the uterus, making it less suitable for a pregnancy. It can also sometimes stop your ovaries from releasing an egg.

How Effective Is the Hormone-Releasing IUD?

The hormone-releasing IUD is at least 99% effective. This means that on average, if 100 women use an IUD for one year, it is possible that one of them could become pregnant.

Who Can Use the Hormone-Releasing IUD?

Most women who want a reliable, long term contraceptive can use it. Women who have completed their families, those who are spacing their pregnancies as well as women who have not had a pregnancy can all potentially use a hormone-releasing IUD.

Women who are breastfeeding can use a hormone-releasing IUD.

Women who have heavy periods will benefit from having lighter periods with this IUD.

Who Should Not Use This Type of IUD?

You should not use a hormone-releasing IUD if:

you could be pregnant
you have a current pelvic infection – this is called pelvic inflammatory disease (PID)
you have abnormal bleeding from your vagina, that has not been diagnosed
you are waiting for treatment for cervical cancer or cervical changes

Situations That Require Further Consideration Before Choosing an IUD

If any of these apply to you, you will need to talk them over with your doctor before deciding to use a hormone-releasing IUD:

you have had a recent sexually transmitted infection (STI)
you have a congenital heart or valve disease
you have fibroids or other conditions that change the shape of your uterus or cervix; or your uterus is fairly large or small (the doctor will be able to tell you when you are examined)
you have already had previous problems with an IUD (for instance the IUD has come out by itself)
you are unable to have a follow-up check after insertion

Benefits With Using a Hormone-Releasing IUD

It is more than 99% effective at preventing pregnancy
It is long acting and can stay in place and protect against pregnancy for up to five years
Although the initial cost of an IUD is more than for other methods it is relatively inexpensive over the five or ten years of use. The Mirena® is listed on the PBS, which means that if you have a Medicare card it is subsidised by the government. If you have a Healthcare card you just pay the standard fee for a script at the pharmacy.
For women who have heavy periods, the hormone-releasing IUD can be a very good choice as it usually makes bleeding much lighter and sometimes stops periods all together
It is immediately reversible so when it is removed you return to your usual level of fertility

Possible Problems With Using a Hormone-Releasing IUD

If you haven’t had children or if you have only had caesarean deliveries, the IUD may be more difficult to insert
Women may have irregular bleeding and spotting in the first few months after the hormone-releasing IUD is inserted. Bleeding usually settles down and periods become shorter and lighter. Up to 65% of women end up with no bleeding at all after 12 months of use
Some women may experience hormonal side effects, such as bloating or skin changes, but this is uncommon because the dose of hormone is so small
There is a small chance of getting a pelvic infection (PID) at the time of the IUD insertion. It occurs in about one in every 500 insertions and usually happens in the first 3 weeks after insertion. PID may rarely lead to reduced fertility and problems falling pregnant in some women
Very rarely the wall of the uterus can be damaged by the process of inserting an IUD, or by the IUD itself, usually at the time of theinsertion. It occurs in about one in every thousand insertions, although the risk of this may be slightly increased in women who are breastfeeding, who have given birth in the past 6 months, or had a previous caesarean section
The IUD may be pushed out of the uterus into the vagina and can occasionally fall out, without you noticing. This is called ‘expulsion’ and happens in about five out of every 100 women with an IUD. It is most common in the few months after the insertion procedure
Occasionally a woman becomes pregnant with an IUD in place. This happens in fewer than one in 100 women who have an IUD. The IUD is usually removed although this is associated with a small chance of miscarriage
If you fall pregnant with an IUD in place there is a small risk that the pregnancy is outside the uterus in the fallopian tubes. This is called an ectopic pregnancy. This is an uncommon complication and less common than amongst women who are not using any contraception

How Do You Get the Hormone-Releasing IUD?

You are usually asked to make two visits. On the first visit the doctor will ask you questions about your general and reproductive health. You may need to have a vaginal/pelvic examination, and if necessary a Pap test and possibly a test for infections. You will probably also be given a script to get the hormone-releasing IUD from a pharmacy before your insertion visit.

On the second visit you will have the IUD inserted. The procedure takes about 10 minutes and some women may find the experience uncomfortable while others may find it quite painful. It is a good idea to take some analgesia just prior to the procedure. Occasionally, some women feel faint during or after the insertion. You should allow about an hour to be at the clinic.

What to Expect After an IUD Insertion

You may have period-like cramps and bleeding or spotting in the first few days after the IUD is inserted. Taking paracetamol and holding a hot water bottle on your abdomen may help to relieve any discomfort. If cramps, spotting or pain last more than a few days, see your doctor. You should avoid vaginal sex, tampons, swimming and baths for two days, to reduce the risk of infection.

You will need to go back to the doctor for a check-up, four to six weeks after the IUD insertion. After that you will need a check-up every two years with your regular Pap test.

Remember, women may have irregular bleeding and spotting in the first few months after the hormone-releasing IUD is inserted. Bleeding usually settles down and periods become shorter and lighter.

How Is the Hormone-Releasing IUD Taken Out?

The IUD can stay in place for five years. If you want to get pregnant or you decide that you do not want to have the IUD for other reasons, it can be removed earlier. You need to see your doctor to have it taken out. The doctor uses a special instrument to remove the IUD by gently pulling on the string. This only takes a couple of minutes. Some women find it a little uncomfortable and some don't feel much at all.

Things To Remember If You Choose a Hormone-Releasing IUD

Learn to check the string each month after your period to make sure the IUD is still in the right place
If you have any unusual symptoms including a discharge from your vagina, pain low in your abdomen or deep pain during intercourse, see your doctor straight away
If you are concerned that you could be pregnant, see your doctor or clinic for a pregnancy test. But remember, you can miss periods with the hormone-releasing IUD
If you, or your partner, ever have casual sex, or if you have a new sexual partner, use a condom every time until you both have been checked for sexually transmissible infections (STIs)
Keep a record of the date for replacement because an IUD should not stay in for longer than the recommended time