About IUDs
Willow Clinic offers insertions, removals, and replacements of all IUDs. We offer ultrasound guided insertions and removals and we have many options for pain management including inhaled analgesia, oral analgesia and local anaesthetic.
Intrauterine devices (IUDs) are part of a group of birth control options called long-acting reversible contraception (LARCs). They are very effective at preventing pregnancy and do not rely on remembering to take a pill, change a patch or ring, or get an injection regularly. They are all good for several years after insertion, though they can be removed or changed at any time if you decide you want a pregnancy or you want to try something else.
There are two kinds of IUD available in Canada – progesterone-based IUDs (Mirena and Kyleena) and copper IUDs. They are placed into the cavity of your uterus and work by releasing the progesterone or copper locally and changing the environment in your uterus and vagina (lining of the uterus, acidity, etc) to make it less likely that sperm will live and get close to an egg. They can but do not always prevent ovulation.
Overall, these methods are as effective at preventing pregnancy as surgical sterilization (vasectomy or tubal ligation), but once removed fertility returns to normal very quickly. If 1000 people use one of these methods for a year, we expect about 2 – 8 to get pregnant.
These methods of birth control can be an excellent choice for people who have had side effects from the birth control pill in the past, or who have been told they cannot use the birth control pill for a medical reason. This is because the IUDs and implant do not contain estrogen, and have much lower hormone levels than birth control pills.
To help you decide which type of IUD is right for you there is also excellent information on these and other forms of birth control at the website sexandu.ca. Our doctors are also happy to help you make your decision.
Which IUD should you choose?
Mirena – Can last up to 8 years – Only 2/1000 patients per year will get pregnant on Mirena and periods tend to be lighter and easier. The amount of hormone in a Mirena is much less than in the birth control pill, patch, ring or shot so there are very few hormonal side effects. 12.9% of people will get the IUD removed for hormonal side effects such as weight gain, mood changes or acne. Most people get some spotting and cramping in the first month or two after their Mirena has been inserted.
Kyleena – Can last 5 years – These are smaller and have less hormone than Mirena. They are a good choice for people who just want contraception and do not have very heavy painful periods. Risk for pregnancy is also 2/1000.
Copper IUD – Can last 5 or 10 years – Many patients choose copper IUDs because they have no hormones in them. They are very effective with about 8 in 1000 people getting pregnant in a year. They usually make periods heavier, longer and more painful. There are no effects from a copper IUD outside the uterus: no weight gain, mood changes, nausea, sore breasts, etc. The copper IUD is also very effective as emergency contraception.
If you have decided that you would like a IUD or implant, call us at 604-709-5611 to schedule your appointment or have your regular care provider send us a referral.
Virtual Assessment Visit: In most cases, you will first be scheduled for a phone call with a doctor who will go over your individual needs and medical history, help guide you to choose the best option for you, and provide a prescription for your IUD if you don’t already have one. They will also discuss the insertion procedure, discuss all the pain management options we have available and give you some instructions.
Pain Management: At Willow Clinic we are committed to making your experience as comfortable and respectful as possible. Although IUD insertions can be uncomfortable and can be painful, we have a number of options which can make the experience easier. These options include inhaled medications, oral medications, and local anaesthetic. Talk to your doctor at your consultation appointment to decide what approach is best for you.
Your Appointment: On the day of your insertion appointment you will need to make sure you bring the IUD or implant to the clinic with you. When you arrive you will be asked to fill in some forms and provide a urine sample. You can expect to be at the clinic for about an hour, though the actual insertion should take only 5-10 minutes.
Insertion: The doctor uses an ultrasound machine to check the position of your uterus. They will then put a speculum into your vagina so they can see your cervix. We can do your cervical screening or PAP test at this time also. We usually use freezing with a local anesthetic. Most patients feel a pinching feeling and then a sharp cramping pain which lasts a few minutes when the IUD is inserted. Taking naproxen or ibuprofen an hour before helps the cramps. The best time to put in an IUD is during or just after a period but they can be put in any time as long as we know you are not pregnant.
DUE TO OUR HIGH VOLUME OF WEB FORMS WE HAVE HAD TO TEMPORARILY CLOSE DOWN OUR ONLINE BOOKING FORM. PLEASE CALL US DIRECTLY @ 604-709-5611 TO SCHEDULE AN APPOINTMENT
FAQs About IUDs
Please read the section above, “Which IUD should you choose?”
You will likely feel a strong cramp at the time of the insertion. We use a local anesthetic on your cervix and recommend that you take naproxen (eg. Aleve) 1 hour before your appointment to help with the cramping. At our clinic we also offer inhaled and oral pain medications. Talk to one of our doctors for more information. After insertion most patients feel fine. Some people do find that the cramps remain strong and may be given a stronger pain killer if needed.
Expect that copper IUDs will make your first periods quite heavy and that they will get better by the fourth or fifth period after insertion. If they remain very heavy, make sure you eat well or take iron supplements so that you do not become anemic.
The hormonal IUDs tend to make your periods longer and lighter for the first few months. Sometimes it can feel like you are spotting all the time. This will get better with time but if you are not happy with your bleeding pattern by 6 months book an appointment with us so we can discuss options for management.
Copper IUDs tend to make cramps worse and hormonal IUDs tend to make cramps better. Taking naproxen (eg. Aleve) or ibuprofen (eg. Advil) short term works well for cramps but if you cannot take these medications you can use acetaminophen (eg. Tylenol). Heat from a hot water bottle or heating pad work very well also.
If you get a fever, unmanageable steady pain abnormal discharge, or very heavy bleeding please give us a call. We are available 24 hours a day at 604-709-5611.
Yes. When using your cup, just make sure you break the suction and ensure you are not accidentally pulling on your IUD string before removing it.
The copper IUD works right away so you can have sex immediately as long as you are comfortable to do so. The hormonal IUDs take one week to work but if you are using another form of birth control it is safe to have sex right away. You may notice some moments of discomfort with a new IUD during sex however, this should go away over time. Make sure you use condoms if there is risk of sexually transmitted diseases.
Occasionally, you may feel a twinge of pain particularly in the first months of having it, but it should go away. About 5% of people with a penis say they can feel the strings, but it usually doesn’t bother them. If it does bother your partner, we can shorten or tuck the string up out of the way.
You only need to get checked if you have any concerns or if our doctor asked to come back for a check up. After your first period or in about one month, check to see if you can feel the string by putting your finger inside, to the top of your vagina. If you can’t feel the string, don’t worry but make sure you cannot feel any hard plastic. If you do feel hard plastic, check with a doctor right away. If you don’t feel the string but your period is still altered your IUD is likely still in good position however, you can book an appointment with your regular doctor or with us if you would like us to confirm it is in good position.
Don’t panic. Your IUD moves naturally during your cycle and when it moves down the string will feel closer to the entrance of your vagina. If the string is coming out of your vagina, is very long or you can feel the plastic of the IUD, your IUD may be coming out and you need a check in clinic.
Many people will never feel the strings. You might ask your partner to try. If you are worried that it has come out, you can get a doctor to check.
Significant complications that affect fertility are very rare. After the IUD has been removed, your fertility will return to normal.
If you get pregnant with an IUD, check with a doctor immediately to make sure it is a normal pregnancy. The IUD should be removed if possible. If it is a normal pregnancy, you can decide whether you would like to continue the pregnancy or not.
Yes. It is best not to take a break between IUDs, because if you do, you will have to go through the same adjustment reaction (cramps and bleeding) as the first time. If you have a new IUD inserted at the same appointment that you get one removed, you tend to have less ongoing bleeding and pain then the first time an IUD is inserted.
You can get pregnant right away. Some people prefer to wait until they have had one period after removal before they start trying.
Yes – Neither the hormonal or copper IUDs will interfere with an MRI.
FAQs About Your Appointment
Our wait times can vary from a week or two to over a month for an appointment. Call our office to find out the latest wait times and you can ask to be on our cancellation list.
Usually you will have a consultation by phone with one of our doctors prior to your insertion. This appointment usually lasts around 10 miniutes. For your insertion appointment you can expect to be at our office for approximately 1 hour. You will fill out forms when you come in and do a urine sample. You will then see the doctor for the insertion. After the insertion we will ask you to rest in our recovery area for about 10 minutes for us to make sure you are feeling OK before you go.
The doctor will do a vaginal ultrasound before the insertion to check your uterus and then again after the insertion to make sure the IUD is in correct position.
If you are a BC resident and you have a valid MSP card, the cost of the device is covered by the government. If you do not have valid medical coverage in BC the approximate cost is: Mirena – $425.00, Kyleena – $425, Copper – $90.00. There will be an office visit charge of $325.00 for anyone who does not have a BC Care Card. If you have medical coverage from another province we can give you a receipt to send in and you may get a full refund, or a portion of the fee from them.
Most patients feel well enough to continue their normal activities that day and are able to control any cramps with medication. Some people do have very strong cramps and need to rest.
You may have some bleeding at the time of and after the insertion so we ask you to bring menstrual protection (pad, pantiliner, tampon, period underwear) with you. The bleeding may last for a few days, weeks or even months depending on how your body adjusts to the IUD. You may have spotting on and off or a day or two of heavy bleeding. This is normal and should settle down over the first few months.
No, anytime in your cycle is fine as long as you are not pregnant.
After having a baby you can book your appointment with us anytime 6 weeks after birth as long as you did not have an active postpartum infection in your uterus. If you did have significant postpartum infection please call us to book a consultation.