Intrauterine Device-IUD

An IUD is best inserted between Day 3- Day 15 of your menstrual cycle. Your cervix is naturally more open during this time, which makes for an easier insertion. At Integrated Health Clinic, an endovaginal ultrasound is done prior to insertion to locate and visualize the shape of your uterus. This also ensures that you don’t have any structural abnormality which would exclude you as a candidate for an IUD. After that, a speculum is inserted, much like the beginning of a Pap test. Some freezing is applied to your cervix and then the depth of your uterus is measured. You will likely experience a little pinching and cramping at this time and during the insertion to follow. It generally takes less than 15 minutes from beginning to end. It is advisable that you take 400mg of Ibuprofen 1 hour prior to the appointment to minimize your discomfort. After the IUD is inserted, another ultrasound is preformed to ensure the IUD is in correct placement within your uterus. You will be asked to remain in the clinic for 20-30 minutes post insertion.

The initial side effects are cramping and spotting. The spotting usually lasts 3 to 14 days. Cramping is usually strongest the day of insertion, and tapers off within 24-48 hours. Infection is a potential side effect, that it minimized by treating higher risk women with one dose of antibiotics right after the insertion. If you are at higher risk for infection (i.e. several sexual partners within the past year, +/- history if STI), than a one time dose of antibiotics will be given after your insertion. Infection will present with fever, abdominal pain and foul smelling discharge within 2 weeks after insertion. Perforation of the uterus happens in 1/1600 people. This is most common in post part women. This would be detected on your post procedure ultrasound, and a referral to your local hospital would be necessary to remove the IUD. The uterus would heal itself within a few weeks, with no impairment to future fertility.

Copper IUD’s: can cause 30-50% heavier periods, 5% of women will expel the IUD within the first year.  Copper IUD’s traditionally have a nickel core, which can cause local irritation in those women with nickel sensitivity. In 2019, a copper IUD with a silver core was approved by Health Canada. It is hypothesized that the silver core IUD may cause less inflammation and bleeding in those nickel sensitive women. Integrated Health Clinic offers the choice of silver core copper IUD and the standard nickel core copper IUD.

Kyleena IUD’s: little to no hormonal side effects. Most women maintain ovulation, with very light periods.

Mirena  IUD’s: 5-10% of women will have some hormonal side effects (weight gain, acne, depression, breast tenderness) however most women will stop ovulating and lose their menstrual cycle.

As of April, 2024, all contraception is free in British Columbia (BC) , for BC residents. This incudes all types of IUDs. A prescription will be issued during the IUD screening visit, and the IUD can be picked up from your local pharmacy.

For non- BC residents, costs are listed below:

• Copper IUD’s – $75.00 (provided in clinic)
• Kyleena and Mirena IUDs are prescriptions (pick up at pharmacy) and cost around $400.00.

*Often times the Kyleena and Mirena IUDs are covered under drug plans, but you need to check with your insurance provider.

For ALL patients, IUD appointment fees are as follows:

• IUD screening (pre-assessment -virtual/ 10 min) – $40.00
• IUD insertion fee (30 min)- $115.00
• IUD insertion fee (training day) – $50.00
• IUD removal (15 min) – $65.00
• IUD removal (training day) – $40.00
• IUD removal and insertion (30 min) – $150
• IUD removal and insertion (training day) – $75
• IUD follow-up visit (15 min) – $65.00

* screening pap tests and STI testing is available at visits for no additional charge

There are several Health Canada Approved IUD’s. The following chart lists those approved IUD’s that are offered and inserted at IHC.

Copper IUDs:

Liberte, FlexiT, Monalisa, NovaT

Copper IUDs are less expensive and have no hormones. They are very effective with about 1 in 100 people getting pregnant in a year. They usually make periods heavier, longer and sometimes more painful. There are no systemic side effects from a copper IUD, such as weight gain, mood changes, nausea, sore breasts, etc. Copper IUDs can have nickel cores or silver cores. It is estimated that 10-20% of women may have sensitivities to nickel, and is suggested a silver core copper IUD may not cause such dramatic increases in bleeding and cramping in those women.

Levonorgestrel hormonal IUDs:

Kyleena (19.5mg levonorgestrel) – 5yrs

Mirena (50mg levonorgestrel) – 5yrs

Kyleena 19.5mg – low dose levonorgestrel (progesterone releasing).  Most women will continue to have regular periods, but they are very light to perhaps just spotting. In studies, most people who use this dosage continue to ovulate, and have normal ovarian function. There are few systemic side effects, as the hormone dose is low and mostly contained to uterus.

Mirena 50mg – higher dose levonorgestrel (pregesterone releasing) About 10% of people will get the IUD removed for hormone side effects such as weight gain, mood changes or acne. Most people get some spotting in the first month or two after their Mirena has been inserted, but then period usually disappears for remainder of the 5 years. Often will inhibit ovulation completely.