Mirenas and More
Dr Sarah McDonnell
The Mirena is an intrauterine device (IUD) which provides very reliable contraception and can also be used to treat heavy periods and as part of menopausal hormone therapy. A smaller, lower hormone dose version called the Kyleena is also available, but this can only be used for contraception, not for period control or hormone therapy. Both are suitable for women who cannot tolerate or use oestrogens.
How are IUDs inserted and how do they work?
Both are small plastic devices that are inserted into the womb (uterus) through the natural opening in the cervix. Specialised training is required to become an IUD inserter and Dr Sarah Mc Donnell and Dr Louisa Gilles have both been certified in IUD insertion.
Most women find the procedure uncomfortable or mildly painful, with very few experiencing stronger cramps or pain. Insertion is well tolerated by most women, and we always provide advice on pain relief to take beforehand, as well as using local anaesthetic gel if needed. The procedure can be performed in our dedicated consult room, with aid of our experienced nurses.
What benefits do IUDs provide?
The benefits of IUDs include:
- Highly effective contraception for women who don't want to have to remember to take a pill every day. Mirena is 99.8 % effective as a contraceptive and Kyleena is about 98% effective at preventing pregnancy over 3 years .
- Long lasting contraception and/or period control: both last for up to 5 years (longer if inserted over the age of 45).
- Although there can be a few months of irregular spotting or bleeding, periods with the Mirena becomes light in most cases and can disappear completely in up to 20% of women.
- Both are suitable for women who have never been pregnant or given birth, as well as those who have had children. They can be used from the teen years right through to menopause.
- They are quickly reversible, usually easily removed and with immediate return to fertility.
The hormone progesterone is directly released into the womb by the IUD, thickening the cervical mucus to prevent sperm from reaching the egg. The lining of the uterus also changes over time, preventing implantation of a pregnancy on the wall. They work locally so less hormones are needed than with oral medications or contraceptive implants.
Are there non hormonal options?
Copper IUDs are also available for those who cannot or prefer not to use hormonal methods of contraception. Unlike Mirena, copper IUDs do not treat heavy periods and can be associated with heavier menstrual bleeding in 50% of cases.
Copper IUDs can be used as emergency contraception up to 5 days after unprotected sex has occurred. An “all in one” assessment and insertion appointment may be appropriate if seeking emergency contraception. Please phone reception for details.
Do I have to see a GP before arranging my IUD insertion?
The usual process at Neighbourhood Medical is book an assessment appointment so that the GP can discuss the pros and cons of an IUD/ Mirena with you, and make sure that it is safe to go ahead before booking an insertion. This is best done face to face, but can be done via Telehealth (video) for new and existing patients.
We realise it can be difficult to coordinate multiple appointments in our busy lives. In certain circumstances, the GPs consulting at Neighbourhood Meducal can undertake assessment and IUD insertion/replacement on the same day. Please contact reception by email or phone if you need more information on this option.
How much does the device and insertion process cost?
The Mirena and Kyleena devices costs around $40 with a Medicare card or $6 with a concession card. Copper IUDs vary in price and cost around $75.
The initial assessment appointment usually requires a long consultation and is generally billed as per the usual GP fees schedule. Telehealth appointments to discuss issues relating to reproductive and sexual health attract Medicare rebates for new patients, so you don’t have to have attended the clinic in person previously to make a video appointment to discuss an IUD or other contraceptive options.
The current fee for the insertion procedure and associated visits are available online and here and at reception. A small additional fee for a pregnancy test may also be required.
For more advice on your contraceptive options see here and for detailed information on IUDs see here.
