IUD Insertions

Dr. Aquino trained in residency to insert intrauterine devices for contraception - both hormonal (Kyleena, Mirena), and copper. She offers this services to her registered patients only at this time.

If you are a registered patient of one of our other doctors, and are interested in having an IUD inserted, please chat with your own GP about a referral to an outside practitioner.

If you are still unsure about what form of contraception is right for you, please visit: www.itsaplan.ca
Also consider booking an appointment with your GP.

Intrauterine devices or IUDs are among the most effective form of contraception - comparable to having tubal ligation (having your “tubes tied”).

Fortunately, Pharmacare in BC now covers the cost of IUDs, and the insertion procedure is covered by MSP.

The hormonal IUDs release low-levels of progesterone which work to prevent pregnancy within the uterus. The non-hormonal, copper IUDs act on their own to prevent pregnancy within the uterus. These methods do NOT suppress ovulation. Please see the infographics below, sourced from sexandu.ca, for more information.

To learn more about the procedure, click to expand each subject below.

  • 1 in 1000 risk of uterine perforation (poking a hole in the uterus)

    1 in 100 risk of infection, highest within the first month

    3-6 in 100 risk of expulsion, or IUD falling out

    The risk of pregnancy with an IUD in place is very low (2-8 in 1000 depending on type) but if a person becomes pregnant with an IUD in place, the risk of ectopic pregnancy (a pregnancy not within the uterus) is higher.

  • Make sure you have a good meal, and are hydrated before the appointment. This helps prevent fainting - which is quite common after this procedure, as patients are generally nervous and worked up, and the procedure itself can be a tense time.

    Take a strong dose of an NSAID (anti-inflammatory) 30 minutes prior to your appointment. Suggestion - either ibuprofen 800 mg, OR naproxen 500 mg. You can combine this with acetaminophen 500 to 1000 mg.

    You may drive yourself to the appointment, as sedation is not provided. You may wish to have a support person drive you, or even be present in the room with you.

    The IUD prescription will have been sent to your pharmacy well in advance. Don’t forget to bring the IUD!!

    The office staff will request a urine sample to confirm NO pregnancy, just prior to the IUD insertion so please come prepared.

  • Usually the actual procedure only takes 10-15 minutes. It begins much like a Pap test - you lay on your back with legs in foot rests. Note that we use METAL equipment for this procedure, as we are able to sterilize metal but not plastic. As such the instruments will likely be cool / cold to the touch.

    The doctor will start by checking your uterine position and cervix to help determine an approach. This is done with an internal exam.

    A metal speculum will be placed (just like one used for a Pap test). This may cause slight discomfort. A swab will be taken to rule out infection. If you are due for a Pap, it can be done at this point as well.

    The cervix will be cleansed with a solution to reduce the risk of infection. This part may feel like a slight stinging or burning inside.

    You can expect three big “cramping moments.” The cervix will be stabilized with an instrument. Generally this part causes a strong menstrual-like cramp. Then, the uterus will be measured with a sterile instrument. This also causes strong cramping. The IUD will then be removed from the packaging, inserted into the uterus, and released from the tubing. This is the last strong cramp you will feel.

    The IUD string is trimmed with scissors (you will not feel anything). All instruments will be removed. You may feel ongoing but milder cramping that gets better with time. You will likely also have spotting.

    The doctor will monitor you as you sit up and recover. You can ask follow up questions as well.

  • Before you leave the office - book a follow up appointment 1 month after the IUD insertion to review how things are going, and for your doctor to perform a string check (just a quick peek with a plastic speculum to confirm that the strings are visible).

    You will feel cramping for the first 24-48 hours. You can manage this with ibuprofen 400 mg every 6 hours, or naproxen 500 mg every 12 hours, PLUS acetaminophen 500 mg every 6 hours.

    You will have some spotting for the first few days, and may experience intermittent spotting and light bleeding within the first 3-4 months. This is normal as your body adjusts. If it persists after 4 months, please book a follow up.

    NOTHING IN THE VAGINA FOR 24 HOURS AFTER. This includes, but is not limited to: tampons, fingers and other appendages, objects, or being immersed in water (baths, hot tubs are bad, showers are okay). This reduces the risk of infection.

    WEAR CONDOMS AS BACKUP FOR THE FIRST 7 DAYS.

    We suggest patients with IUDs check for their strings regularly - once a month. Using one finger, insert into the vagina and gently advance until you feel the cervix and/or the strings. The cervix feels like a smooth, rubbery surface. The strings feel like fishing line (Dr. Aquino will show and let you feel strings in the office).

    Please remember the IUD prevents pregnancy, but DOES NOT protect against sexually-transmitted illness. Get tested, and continue to use barrier protection whenever you have a new partner with unknown status.

  • Seek medical attention if these symptoms and signs present.

    Within the first month after IUD insertion: fever (higher than 38 degrees Celsius), chills, strong or sharp pain in lower abdomen, odorous vaginal discharge.

    At any time: if you suspect you may be pregnant, if you get a positive pregnancy test, or cannot feel your IUD strings

  • It is much, much easier and simpler to remove the IUD. You can call the office and book this even if you have not used the IUD to its full “lifetime”.

    Some patients wish to remove it due to side effects. Other times it is removed when the patient feels the time is right to start trying to get pregnant. Once the IUD is removed, the contraceptive effects dissipate fairly quickly and there is no significant delay to fertility.