Summary of consultation/procedure

Box 8: Summary of Intrauterine Contraception Consultation/procedure

Discuss all contraception options
Medical eligibility
For all IUC avoid
  • 48h-4weeks postpartum
  • Postpartum sepsis
  • Unexplained vaginal bleeding
  • Cervical cancer
  • Distorted uterine cavity (inc large fibroids)
  • Current PID/chlamydia/gonorrhoea/pelvic TB
  • CD4 count <200
  • Long QT syndrome
 
For LNG-IUS only avoid
  • Breast cancer
  • Severe liver disease
  • Development of CVD/stroke while using
Discuss possible side effects
  • Altered bleeding (often persistent)
  • Recurrent vaginal infections
  • Headaches
  • Acne
  • Reduced libido
  • Skin atrophy
Rule out pregnancy, consider chlamydia screening
Explain procedure, including risks
Consent
Extra precautions needed

None needed for Cu-IUC

For LNG-IUC

  • If starting within 7 days of cycle none needed
  • After 7 days, extra precautions for 7 days
  • If switching from POP, CHC or Cu-IUC, extra precautions for 7 days*
Insert & document
  • Only trained professional to insert
  • Pelvic examine & apply forceps
  • Probe first, then insert/release coil
  • Check canal and cut threads 2-3cm
  • Document batch number and expiry date
Follow-up advice
  • Monitor threads
  • Advise signs of infection/perforation/loss coil
  • Offer follow-up at 6 weeks if woman wishes (sooner if concern)
  • Date when IUC needs to be changed

*Up to day 7 only applies to true cycles.  These rules do not apply for women on CHC.  For women on CHC, 7 days extra precautions are needed if inserted from day 3 of HFI and during first week of taking CHC.  If LNG-IUS inserted week 2 or 3 then no extra precautions needed

 

 


Previous

Next

This website uses cookies to ensure you get the best experience, please accept these so we can deliver a more reliable service.

Manage preferences