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Implanon and IUD/Mirena Insertion and Removal

Implanon

Implanon NXT

  • Over 99.95 % Effective
  • No STI Protection
  • 3 years

What is the implant?

The contraceptive implant (Implanon NXT®) is a soft plastic stick about 4 cm long. The implant slowly releases a hormone, progestogen, into your body. Progestogen is similar to the hormone produced by the ovaries.

How effective is the implant?

It is more than 99% effective at preventing pregnancy and can last for up to three years.

What stops the implant from working? 

The implant may not work if you:

  • Are taking some medications or natural remedies (check with your doctor, nurse or pharmacist)
  • Leave it in more than 3 years

How do I use the implant?

The implant is inserted (injected) under the skin of your inner upper arm by a trained doctor. A local anaesthetic  is used so that you will not feel pain when this is happening.

How does the implant work?

The implant works by preventing the ovaries from releasing an egg each month.

It also thickens the fluid around the cervix, (opening to the uterus/womb). This helps to prevent the sperm from entering.

When does it start to be effective?

When the implant is first inserted into the arm it can take up to seven days to start working to prevent pregnancy.

Where can I get the implant?

Your doctor will write you a script and you can get the implant from your pharmacy. You will then need to return to the clinic to have the implant inserted. If you don’t have a Medicare card it will be more expensive. It will be cheaper if you have a healthcare card.

What is good about the implant?

  • It is the most effective method of contraception
  • Once inserted (put in) you can forget about it for 3/three years
  • It can last up to three years
  • Many users have no vaginal bleeding (period) at all or very light bleeding
  • Periods may be less painful
  • Acne can improve
  • It is another choice if you have problems taking the hormone oestrogen. The Pill (combined pill) and vaginal ring contains oestrogen and progestogen. The implant only contains progestogen.
  • You can use it while breast feeding
  • It is easy to remove
  • Once removed your fertility quickly returns to normal

Are there any side effects from using the implant?

Your vaginal bleeding pattern (period) will change. It might be more often and/or irregular (at odd times). Around 20% of women will have no bleeding at all (this is not harmful to the body). Frequent or prolonged bleeding, may get better with time. Some medications can help with this bleeding, speak to your doctor or nurse.

Other possible side effects for a small number of users can include:

  • Headaches
  • Bloating
  • Changes to your skin
  • Sore/ tender breasts; and
  • Mood changes

These side effects often settle with time. The implant has not been shown to cause weight gain.

Can the implant cause any serious health problems?

Rarely the implant is inserted too deep and you may need minor surgery to have it removed.

Reasons why the implant might not be a good option for you:

  • Have been treated for breast cancer
  • Have severe liver disease take certain medications which may prevent the contraceptive implant from working (check with your doctor, nurse or pharmacist).

What if I’m late having my implant changed?

Once the implant has been in for more than 3 years, use condoms until you can have it replaced.

What happens if I get pregnant while I’m using the implant?

The implant is not known to harm a pregnancy. It is safe to continue the pregnancy (and remove the implant) or to have an abortion.

Can I use the implant after I’ve had a baby?

The implant can be inserted straight after you give birth, even if you are breast feeding.

What if I’m using the implant and I want to become pregnant?

The implant must be removed by a trained doctor or nurse.Your fertility will quickly return.

What else should I know about the implant?

  • The implant does not protect you from sexually transmissible infections (STIs).
  • It is good to write down the date when you had the implant put in. You will need to make sure it is taken out before it expires (up to 3 years after being inserted).

 

IUD

Intrauterine Device Contraception (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).

The hormonal IUD contains progestogen, which is a synthetic version of the hormone progesterone that women make naturally.

Both types are among the most effective methods of contraception and can stay in place for at least five years.

How IUDs work

IUDs affect the way sperm move and survive in the uterus, stopping these cells from reaching and fertilising the ovum (egg). IUDs can also change the lining of the uterus to stop a fertilised ovum from sticking. The hormonal IUD can make the fluid at the opening to the uterus thicker, stopping sperm from getting through. It can also affect ovulation by changing the hormones that cause an ovum to be released each month.

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 the copper or hormonal IUD, as well as other methods of contraception. Other methods include the contraceptive implant or injection, the vaginal ring or the combined oral contraceptive pill.

Copper IUD 

The copper IUD is a small plastic device with copper wire wrapped around it and a fine nylon thread attached to the end. When the device is in place, the thread comes out through the cervix (entrance to the uterus) into the top of the vagina. This piece of thread lets you check that the IUD is still in place and makes it easy for a doctor to take it out. You cannot feel the thread unless you put your finger deep inside your vagina.

Hormonal IUD (Mirena)

The hormonal IUD (MirenaTM) is a small plastic T-shaped device that contains progestogen. This is a synthetic version of the hormone progesterone that women make naturally. The device has a coating (membrane) that controls the release of progestogen into the uterus. Like the copper IUD, it has a fine nylon thread attached to the end to make checking and taking it out easier.

Advantages of IUDs

Advantages of using the copper or hormonal IUD include:

  • Both the copper and hormonal IUD are more than 99 per cent effective in preventing pregnancy.
  • Both types last between five and ten years.
  • Once it has been put in, you will only need to check the thread each month.
  • The device can be taken out at any time by a specially 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.

Disadvantages of IUDs 

Disadvantages of using the copper or hormonal IUD include:

  • Both types need to be put in by a specially trained doctor or nurse.
  • You may have extra costs and difficulty accessing the service.
  • There is a small risk of infection at the time the IUD is put in and for the first 3 weeks.
  • There is a small risk of perforation, which is when the IUD makes a hole in the wall of the uterus when it is put in.
  • If the IUD does not work and you get pregnant, there may be complications with the pregnancy if you continue.
  • The IUD can fall out.
  • Neither type gives protection from STIs.

Differences between the copper and hormonal IUD (Mirena)

There are a number of differences between the copper and hormonal IUD.

Differences in menstruation include:

  • After a hormonal IUD has been put in, you may have three to five months of frequent and irregular bleeding between periods. After this time, your periods may be shorter, lighter, and less painful. About 50 per cent of women stop bleeding all together.
  • After a copper IUD has been put in, you may have a few weeks of irregular bleeding between periods. After this time, your periods may be heavier and more painful.

Differences in cost include:

  • The hormonal IUD is covered by a health care card in Australia. It costs around $6 if you are a card holder and around $37 if you do not have a card.
  • The copper IUD is not covered by a health care card and may cost around $120 outside a public hospital setting.

Differences in side effects include:

  • The hormonal IUD may cause headaches, acne, breast tenderness and an increase in appetite in the first few months.
  • The copper IUD has no hormonal side effects.

Differences in medical conditions include:

  • The hormonal IUD should not be used if you have had breast cancer in the last five years.
  • With rare exceptions, the copper IUD will not have any known effect on existing medical conditions.

Making an appointment:

  • Booking an IUD insertion requires an initial assessment and examination with tests if indicated to determine medical suitability.
  • If appropriate the doctor will then schedule an IUD insertion appointment. If any complicating factors are identified then this will be required to be addressed prior to the consideration of an IUD insertion.
  • Please note that the Medicare rebate does not fully cover the cost of the IUD insertion.   Please call and ask for the fee schedule.

Reference: www.fpv.org.au