What is an IUD?
An intrauterine device (IUD) is a small contraceptive device that is put into the uterus (womb) to prevent pregnancy. The two types available in Australia are the copper IUD and the hormonal IUD (Mirena™ and Kyleena™). The copper IUD is designed to stay in place for up to 10 years and the hormonal IUD (Mirena and Kyleena) for five years. Both can easily be removed sooner, if needed. IUDs are known as long acting reversible methods of contraception.
The copper IUD is a small, T-shaped, plastic and copper device. It constantly releases a small amount of copper into the uterus. The copper IUD can also be used for emergency contraception instead of the emergency contraceptive pill (‘morning after pill’).
Hormonal IUDs are small, T-shaped, plastic devices, inserted into a woman’s uterus to provide contraception. They slowly release a hormone (progestogen) into your uterus. Progestogen is like the hormone produced by the ovaries.
The Mirena™ hormonal IUD has been available in Australia for many years.
Kyleena™ is a smaller low dose version of Mirena. It became available in March 2020 and is listed on the Pharmaceutical Benefits Scheme.
Kyleena® appears to be as safe and nearly as effective as Mirena. It is smaller in size and has a lower dose of hormone, 19.5 mg of levonorgestrel over 5 years (Mirena has 52 mg levonorgestrel).
How effective are IUDs?
Both copper and the Mirena hormonal IUDs are more than 99% effective at preventing pregnancy. Copper IUDs are 99.5% effective, Mirena is 99.9% effective and Kyleena is 99.7% effective.
How do I use an IUD?
Your doctor or nurse practitioner will write you a script and you can get the IUD from your pharmacy. Sometimes you can buy a copper IUD from the clinic providing the IUD insertion.
The IUD is inserted inside your uterus by a trained doctor or nurse. It has a fine nylon thread attached to it which comes out through the cervix (opening to the uterus). If you feel high up inside your vagina, you can check that the thread is there and know the IUD is still in place. Because it is high up in the vagina the thread cannot be seen.
It’s good to make a record of the date when you had the IUD inserted. You will need to make sure it’s taken out before it expires (5 or 10 years, depending on the type, after being inserted).
Your partner might be able to feel the IUD string during sex, but it rarely hurts them.
How much does an IUD cost?
The hormonal IUD prescriptions (Mirena™ and Kyleena™) are covered by a Health Care Card in Australia. They cost around $6.60 if you’re a Health Care Card holder and around $41.00 if you’re not.
The copper IUD is not covered by a Health Care Card and may cost around $70 to $120 outside a public hospital setting.
The overall cost of the procedure will vary depending on whether you attend a private or public provider. If you don't have a Medicare card, it will be more expensive.
Advantages of IUDs
Advantages of copper or hormonal IUDs include:
- They are more than 99% effective in preventing pregnancy.
- They last for a long time – Mirena can last for five years, and the copper IUD can last for 10 years.
- They are safe to use if you are breastfeeding.
- No medications stop them from working.
- They provide another contraceptive choice if you have difficulty taking the hormone oestrogen. (The combined pill and the vaginal ring contain both oestrogen and progestogen.) The hormonal IUD only contains progestogen and the copper IUD has no hormones.
- Once they have been put in, you don’t need to do anything more apart from checking the thread each month after your period to ensure it has not moved out of the correct position.
- The device can be taken out at any time by an appropriately trained doctor or nurse.
- Your chance of getting pregnant will go back to normal as soon as the copper or hormonal IUD has been taken out.
Advantages of hormonal IUDs include:
- Most users have no vaginal bleeding at all, or a light regular period.
- Periods may be less painful.
Advantages of copper IUDs include:
- They are a choice for those who do not want to use hormonal contraception.
- They are a very effective method of emergency contraception.
Are there any side effects from using the hormonal IUD?
Possible side effects when using the hormonal IUD include:
- When it’s first inserted some users have period-type cramping that usually settles after a few days.
- Sometimes the IUD can come out. This is more common in the first three months of it being inserted.
- Your period will change. Spotting or frequent bleeding is common in the first three to six months. By six months around 95% of users will have a light regular period or no bleeding at all (this is not harmful to the body).
You may experience tender breasts, headaches, skin changes and mood changes. These side effects nearly always settle with time. The hormonal IUD has not been shown to cause weight gain.
Kyleena™ has a lower hormone dose than Mirena. Studies are needed to show whether it has fewer hormone related symptoms.
Are there any side effects from using the copper IUD?
Possible side effects when using the copper IUD include:
- Spotting or frequent bleeding in the first three months. This nearly always settles with time and your regular bleeding pattern will return.
- Heavier periods.
Can the IUD cause any serious health problems?
In about 1 in 500 users, a small hole in the wall of the uterus (womb) may be created while the IUD is being inserted. The IUD can move through the hole and sit in the wrong place. If this happens, keyhole surgery is required to have the IUD removed.
Around 1 in 300 users get an infection when the IUD is first inserted. This is usually successfully treated with antibiotics.
It’s very unlikely to get pregnant when using an IUD. If you do get pregnant with an IUD in place, there is a higher chance of ectopic pregnancy. This means that the pregnancy may settle in the fallopian tubes (pathway of the egg to uterus).
When is an IUD not a good option?
An IUD might not be a good option for you if you have:
The hormonal IUD might not be a good option for you if you have:
The copper IUD might not be a good option for you if you have:
What happens if I get pregnant while I’m using an IUD?
If you become pregnant while you are using an IUD it’s important that you see a doctor or nurse as soon as possible and have the IUD removed. The doctor or nurse will also need to rule out a pregnancy in your fallopian tubes (ectopic pregnancy).
If the IUD is removed, there will be no harm to the pregnancy and you can choose to continue or terminate the pregnancy (have an abortion). If the IUD is not removed and you continue with the pregnancy, there’s a high risk of losing the pregnancy or delivering the pregnancy early.
Can I use an IUD after I’ve had a baby?
You can have an IUD inserted straight after you give birth. If it’s not inserted straight after you give birth, then you need to wait at least four weeks. IUDs are safe to use if you are breastfeeding.
What if I’m using an IUD and I want to become pregnant?
An IUD can be removed at any time by a doctor or a nurse. Your fertility will quickly return.
Other types of contraception
There are many contraceptive methods available in Australia. When choosing the method of contraception that best suits you, it can help to talk to a doctor or nurse about your options. Different methods may suit you at different times in your life.
A doctor or nurse can give you information about:
- the benefits and risks of using various methods of contraception
- how well each method works
- the possible side effects
- how easy it is to use
- how much it costs
- how each method meets your current and future needs.
Other methods include the contraceptive implant or injection, the vaginal ring or the combined oral contraceptive pill.
IUDs do not give protection from STIs
Neither type of IUD gives protection from sexually transmissible infections (STIs). It’s important to practise safer sex, as well as to prevent an unintended pregnancy.
The best way to lessen the risk of STIs is to use barrier methods such as condoms for oral, vaginal and anal sex with all new sexual partners. Condoms can be used with IUDs.
Where to get help
This page has been produced in consultation with and approved by:
Family Planning Victoria
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