Insertion of an intrauterine device (IUD)

IUS insertion

The IUS, which releases the hormone levonorgestrel, is a highly effective and long-lasting method of contraception. Its contraceptive efficacy is maintained, depending on the model, for up to 3 or 6 years.

The choice of model depends, among others, on the structure of the uterus and the history of past births.

The method involves the insertion of a flexible hormone-releasing device, made of plastic and commonly referred to as a coil, into the uterus.

The contraceptive effect of the IUS relies on the interaction of several factors:

• increasing the density of cervical mucus, which reduces sperm motility;
• reducing the thickness of the endometrium;
• minor, sterile (i.e. without the presence of bacteria) inflammation of the uterus, which is combated by leukocytes with a spermicidal effect

Scientific reports indicate that the use of IUS reduces the risk of developing endometrial cancer. In addition to preventing pregnancy, hormonal IUS can also be used to treat painful menstrual bleeding with heavy blood loss.

The choice of this method of contraception and the appropriate IUS model should always be consulted with a doctor who, on the basis of an in-depth patient interview as well as a physical examination, can rule out contraindications to IUS insertion.

Therefore, a thorough gynaecological examination, supplemented by cervical smear and a gynaecological ultrasound scan, should be carried out before IUS insertion.

Contraindications to the use of hormone-releasing IUS include:

• suspected pregnancy,
• frequent inflammation of the appendages,
• infection in the pelvic region,
• genital tract bleeding of unknown cause,
• allergy to insert components,
• malformations of the uterus or myomas distorting the uterine cavity,
• cancer of the breasts, reproductive organs or liver,
• an interval of less than 6 weeks since delivery or miscarriage.

How is the IUS inserted?

• During the procedure, the gynaecologist uses a special applicator to insert the IUS through the vagina and cervix into the uterine cavity; once the applicator is removed, the IUS expands, taking its proper shape and position.
• After the procedure, the doctor performs an ultrasound examination to verify that the IUS is correctly positioned in the uterine cavity.

After the period of time indicated by the doctor, a follow-up appointment should be made to check the position of the IUS and assess how the patient feels.

How do I prepare for IUS insertion?

The IUS is best inserted during menstrual bleeding (within 7 days after the start of menstrual bleeding), when the cervix is slightly open, then the procedure is less uncomfortable for the patient.

However, about 20% of patients experience discomfort or even pain during the IUS insertion procedure. In general, anaesthetics are not used.

IUS insertion is performed after a prior gynaecological consultation.

The IUS starts to work as soon as it is inserted. However, like any contraceptive method, it does not guarantee 100% protection against unplanned pregnancy and does not protect against HIV (AIDS) and other sexually transmitted diseases.

The IUS insertion service does not include the price of the IUS itself. The IUS (coil) is provided by the patient. Coils are available in pharmacies with prescription.

During the IUS insertion visit, the doctor performs a gynaecological examination. On that basis, the doctor may refuse to perform the procedure on medical grounds. In this situation, the patient bears the cost of the consultation and should submit a claim to the shop for reimbursement for the non-performed IUS insertion service.