Here are the steps for the procedure:

1. Consultation: Before insertion, the doctor will review the patient’s medical history and perform a pelvic exam.
2. Preparation: The procedure typically takes place in the clinic. Some patients may be advised to take pain relief medication before the appointment.
3. Insertion: During the procedure, the doctor will insert a speculum to view the cervix. The IUD is then inserted through the cervical canal into the uterus using a special applicator. The insertion process is performed under ultrasound guidance to minimise any potential risks. The process takes only a few minutes. Sedation (light anaesthetic) can be offered at patient’s request.
4. Post-Insertion: After insertion, the strings of the IUD are trimmed so they extend slightly into the vagina. The doctor will  schedule a speculum examination and ultrasound scan to ensure the IUD is positioned correctly.

Side Effects

• Common Side Effects:
  • Cramping and Discomfort: It is common to experience cramping and mild discomfort during and shortly after insertion.
  • Spotting and Irregular Bleeding: Spotting and irregular bleeding can occur, especially in the first few months after insertion.
  • Heavier Periods: Some women may experience heavier and longer menstrual periods.
• Less Common Side Effects:
  • Expulsion: The IUD can sometimes be expelled from the uterus, particularly in the first year of use.
  • Perforation: Rarely, the IUD can perforate the uterine wall during insertion.
  • Infection: There is a small risk of developing an infection shortly after insertion.
• Other Considerations:
  • Copper Allergy: Women with a known allergy to copper should not use a copper IUD.
  • Pelvic Inflammatory Disease (PID): The risk of PID is slightly increased in the first few weeks after insertion, especially in women with existing sexually transmitted infections (STIs).

Advantages

• Long-Lasting: A copper IUD can provide protection against pregnancy for up to 10 years, depending on the specific type.
• Hormone-Free: It is a good option for women who prefer or need to avoid hormonal contraception.
• Immediate Reversal: Fertility typically returns immediately after the IUD is removed.

Disadvantages

• Menstrual Changes: The potential for heavier and more painful periods may be a drawback for some women.
• Discomfort During Insertion: The insertion process can be uncomfortable and sometimes painful.

Uses

• Contraception: The primary use of an IUS is to prevent pregnancy. It is highly effective, with a failure rate of less than 1%.
• Menstrual Management: An IUS can help manage heavy menstrual bleeding and reduce menstrual cramps. The Mirena coil is approved for the treatment of heavy menstrual bleeding (menorrhagia).
• Endometrial Protection: It can be used to protect the endometrium (lining of the uterus) in women who are taking oestrogen as part of hormone replacement therapy (HRT).

Insertion

• Procedure:
  1. Consultation: The doctor will review the patient’s medical history and perform a pelvic exam to ensure the IUS is a suitable option.
  2. Preparation: The procedure is typically done in the clinic. Pain relief medication may be recommended before the appointment. The procedure can be performed under sedation (light anaesthetic) if the patient wishes.
  3. Insertion: During the procedure, a speculum is used to visualize the cervix. The IUS is then inserted through the cervical canal into the uterus using a special applicator. The insertion is carried out under ultrasound guidance The process usually takes only a few minutes.
  4. Post-Insertion: The strings of the IUS are trimmed so they extend slightly into the vagina. A follow-up appointment is scheduled after 6 weeks for a speculum examination and ultrasound scan, to ensure the IUS is properly positioned.

Side Effects

• Common Side Effects:
  1. Irregular Bleeding and Spotting: Irregular bleeding and spotting are common in the first 3-6 months after insertion.
  2. Amenorrhea: Some women may experience the absence of menstrual periods after using an IUS for a while.
  3. Cramping and Discomfort: Some women may experience cramping and discomfort during and shortly after insertion.
• Less Common Side Effects:
  1. Hormonal Side Effects: As the IUS releases progestin, some women may experience hormonal side effects such as breast tenderness, headaches, acne, and mood changes.
  2. Expulsion: The IUS can sometimes be expelled from the uterus, particularly in the first year of use.
  3. Perforation: Rarely, the IUS can perforate the uterine wall during insertion.
  4. Infection: There is a small risk of developing an infection shortly after insertion.
• Other Considerations:
  1. Ovarian Cysts: Some women may develop benign ovarian cysts that usually resolve on their own.
  2. Pelvic Inflammatory Disease (PID): The risk of PID is slightly increased in the first few weeks after insertion, especially in women with existing sexually transmitted infections (STIs).

Advantages

• Highly Effective: Offers long-term protection against pregnancy for 3 to 7 years, depending on the specific type.
• Reduced Menstrual Bleeding: Often reduces menstrual bleeding and cramps.
• Convenience: Once inserted, no daily action is required from the patient.

Disadvantages

• Initial Irregular Bleeding: The potential for irregular bleeding and spotting in the first 3-6 months following insertion can be a drawback for some women.
• Hormonal Side Effects: Some women may experience side effects related to the hormone progestin.
• Discomfort During Insertion: The insertion process can be uncomfortable and sometimes painful.