SHQ is not funded to insert Intrauterine Systems (mirena) for heavy menstrual bleeding. Patients with heavy menstrual bleeding should be investigated according to the following guidelines and referred to a gynaecologist if further treatment is necessary.
Update: Insertion technique for Kyleena
Kyleena insertion technique is the same as that for Mirena. There is no need for existing IUD inserters to do extra training. Kyleena is a little narrower than other IUDs, and most inserters find it easier to insert than other IUDs. Kyleena’s lower hormone content also means there is a smaller reduction in bleeding compared to Mirena.
SHQ offers appointments for intrauterine device (IUD) insertions. We offer insertion services for both copper and hormonal (Mirena®) IUDs.
We recommend all patients have a pre-IUD discussion prior to the appointment in order to screen for appropriate patients. We can do this, but there can sometimes be delays in getting this type of appointment.
To assist patients to access IUD insertions more quickly, GPs are invited to participate in the process by discussing IUDs with patients prior to insertion of the device at SHQ. The following guide is a template for referral to SHQ. SHQ can provide an insertion appointment for the patient if the form is completed and faxed/ emailed to us. Contact details are provided at the end of the document.
GPs referring directly for IUD insertion should be familiar with the procedure/ risks/ benefits and both copper and hormonal devices. If the GP is not confident in discussing these issues with the patient, the patient can be advised to come to our clinic for an IUD discussion.
Most women are suitable for an IUD, including young women and nulliparous women.
IUDs are contra-indicated in the following circumstances:
- Current Pelvic Inflammatory Disease or STI
- Known or suspected significant distortion of the uterine cavity
- Current or past history of breast cancer (for those considering the hormonal-IUD)
- Vaginal delivery < 4 weeks prior, or Caesarean delivery < 12 weeks prior
- Unexplained or uninvestigated abnormal vaginal bleeding. If a patient has abnormal bleeding, please follow the guidelines Abnormal Vaginal Bleeding In Pre- And Peri-Menopausal Women, found here. SHQ will insert IUS (mirena devices) for contraceptive purposes only. Patients with heavy menstrual bleeding need to be investigated and referred to a gynaecologist if further treatment is necessary.
If the patient requires a copper IUD for emergency contraception within 5 days of unprotected sexual intercourse, please contact the Sexual Health Helpline for an urgent appointment on (08) 9227 6178.
- Extended use of Mirena for contraception (FPAA)
- Malposition and perforation of IUDs (FPAA)
- Pregnancy with an IUD in situ (FPAA)
- Menstrual cups and IUDs (FPAA)
- IUD and cervical cleansing (FPAA)
- The levonorgestrel IUD as Emergency Contraception (FPAA)