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. The Mirena is the usual hormone IUD of choice for women who have given birth. The Jaydess is ideal for women who have never given birth before.
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 the IUD inserted?
IUDs are inserted by most gynaecologists in Malta in their clinics. IUD insertion is a relatively simple procedure and serious complications are rare. The procedure usually takes only a couple of minutes.
The doctor will make sure that you're not pregnant at the time of insertion since an IUD could complicate a pregnancy. You may also be tested for sexually transmitted infections (STIs).
You will probably be given some local anaesthetic and you will feel little or no pain during the insertion. The doctor will put a speculum into the vagina and then insert the IUD using a special inserter through the cervix into the uterus. After the procedure the doctor will teach you how to check that the IUD is still in place.
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 an IUD cost and where can I get an IUD in Malta?
In Malta, most IUDs are done in private gynaecology clinics, such as at St James Hospital, and are paid for out of pocket. The Mirena currently costs around EUR 180. Jaydess costs around EUR 145. The copper coils are cheaper and cost around EUR 80. Remember that these costs are only for the device, and you will also have to pay clinic and doctors' fees. It is normal for the total cost of insertion of a hormone IUD to be in the region of EUR 300.
If you suffer from heavy or painful periods (menorrhagia or dysmenorrhoea) you may be eligible to have a hormone IUD inserted on the national health service. You could speak to your GP for a referral to Mater Dei Hospital if this is the case. Eligibility is determined the national health service and we will not be able to advise you whether you are eligible or not. If you need the IUD solely for contraception, this will usually need to be done privately. If you need financial support with purchasing an IUD, you can contact the Women for Women Foundation.
Watch this video about the IUD: