Copper IUD

Question 1

Types of IUD

Answer 1

1. Copper
2. Levonorgestrel

Question 2

Who is IUD not suitable in?

Answer 2

Under 25 = increased risk of PID
IBD (high risk of infection)

Question 3

Levonorgestrel releasing

Answer 3

Reduced bleeidng/period pain
Lower risk of PID
Prescribe by Brand
- Mirena
- Levosert
- Jaydees

Question 4

Mirena

Answer 4

5 years
Contraception
Menorrhagia
Oestrogen opposition in HRT

Question 5

Levosert

Answer 5

3 years
Contraception
Menorrhagia

Question 6

Jaydees

Answer 6

3 years
Contraception

Question 7

Side effects

Answer 7

• Pain on insertion/bleeding
• PID (abdominal pain)
• Uterine perforation
• Infection

Question 8

Uterine perforation

Answer 8

MHRA: reports of uterine perforation with IUD.
Report:
- Severe pelvic pain after insertion
- Change in periods
- Pain during sex
- Pain/increased bleeding for more than 3 weeks
- Unable to feel threads

Question 9

Risk of infection

Answer 9

Related to carriage of existing STI
Main excess risk in first 20 days.
Pre-insertion chlamydia screen for high risk groups.
EHC = Abx prophylaxis
Treat as emergency if sustained pain over next 20 days

Question 10

Infection - at risk groups

Answer 10

• Under 25
• New partner
• Multiple partners in past year
• Regular partner has other partners
• Local prevalence
• History of STI

Question 11

Removal of IUD

Answer 11

Do not remove mid-cycle unless additional contraceptive used for 7 days
If removal essential and UPSI occurs, give EHC
Pregnant = remove in 1st trimester