The Intrauterine Device (IUD)
What is it?
An intrauterine device (IUD) is perfect if you want a low maintenance contraceptive. It's a fit-and-forget contraceptive, which means you do not have to remember to use it regularly like condoms or the pill.
There are two types of IUDs: the copper IUDs (also known as copper coils) and hormone IUDs (also known as intrauterine system or IUS).
Hormone IUDs include the Mirena, which lasts about 5 years, and Jaydess, which lasts about 3 years. The hormone IUD has a small reservoir containing the hormone levonorgestrel, which prevents you from getting pregnant. They do not contain oestrogen.
Copper coils include the Flexi T and Eurogine, which last about 5 years, and the Monalisa which lasts about 10 years. Copper IUDs have a copper wire wound tightly around the device's stem and do not contain hormones. This makes them popular among women who cannot take hormones due to medical conditions or side effects.
All types of IUD provide 99% protection against pregnancy when fitted correctly. The hormone based coils also used to treat certain gynaecological problems like heavy periods.
How is it fitted?
If you've had a vaginal delivery in the past, the copper coil or Mirena are the usual IUDs of choice. The Jaydess is ideal for women who've never given birth vaginally. IUDs are inserted by most gynaecologists in Malta in their clinics.
The doctor will make sure that you're not pregnant at the time of insertion since an IUD could complicate a pregnancy.
You may be given some local anaesthetic but you'll feel little or no pain during the insertion.
After 3-5 years, the IUD can also be removed, and replaced if necessary, at a doctor's clinic. Again, some local anaesthetic might be used.
How does it feel having an IUD?
You will feel nothing at all. If you insert your fingers in your vagina, you should feel the tips of the strings from the device.
What happens to your period with an IUD?
Periods become lighter and may sometimes stop completely with the hormonal IUDs, making them a good choice for women with heavy or painful periods. Copper IUDs may make periods heavier.
Are IUDs abortive?
No, they're not. They are a contraceptive which means they prevent a pregnancy, not terminate it.
What happens if you get pregnant with an IUD?
IUDs are among the most effective contraceptives, and pregnancy is very rare. If the IUD fails for some reason and you become pregnant, it might cause some complications to the pregnancy. For example, there is a higher risk of ectopic pregnancy than normal if you get pregnant with an IUD. If you get a positive pregnancy test with an IUD in place, you should see your doctor urgently.
How much does it cost?
In Malta, the Mirena currently costs around EUR 180, excluding clinic and consultation fees. Jaydess costs around EUR 145. The copper coils are cheaper and cost around EUR 80.
If you suffer from heavy or painful periods you may be eligible to have a hormone IUD inserted on the national health service. You should speak to your GP for a referral if this is the case. If you need the IUD solely for contraception, this will need to be done privately.
Watch this video about the IUD:
Honorable Mention: The Vaginal Ring
Although not an intrauterine device - because it sits in the vagina not inside the uterus - the Vaginal Ring is a contraceptive that contains two hormones and is inserted into the vagina every month. It is removed after 21 days, and following a 7 day break a new ring is inserted.
The NuvaRing is a vaginal ring that costs around EUR 20-30 a month. If NuvaRing is not available, ask your doctor whether generic vaginal rings with different names are available. All vaginal rings require a doctor's prescription.