Intrauterine System (IUS)

What is the IUS?
The Intrauterine System (IUS) is a hormonal method of contraception.  It is a small piece of plastic containing the hormone progestin which is inserted by a health care practitioner into the uterus to prevent pregnancy. Attached to the IUS are two threads that hang down through the cervix (the opening to the uterus) and into the top of the vagina. The threads do not hang outside the body. There is only one version of the IUS currently available in Canada, the Mirena.

How does an IUS work?
The IUS slowly releases the hormone progestin, which causes the following changes to take place to help prevent pregnancy:
Thins out the lining of the uterus making implantation of a fertilized ovum difficult
Changes the consistency of your cervical fluid, making it harder for the sperm to enter the uterus

How effective is the IUS?
The IUS is approximately 99% effective in preventing pregnancy.  Because the IUS is inserted by a health care professional there is not a separate effectiveness rate representing typical use.
* The IUS does not protect against sexually transmitted infections *

How do I use an IUS?
An IUS must be inserted by a doctor.
An initial visit and pelvic exam are necessary before insertion of an IUS to make sure there is no pregnancy, vaginal infection or sexually transmitted infection present and to check the position of the uterus.
The IUS is usually inserted when a woman has her period
The insertion can be uncomfortable; however, you can take pain medication prior to your appointment which can help.
During the procedure, they will insert a speculum into your vagina to view the cervix and then they will wash the cervix with an antiseptic solution. 
Next an IUS is inserted into your uterus and the strings are cut just below your cervix.
Check the strings after each period. If you can feel the plastic part or the strings are missing, use another form of birth control such as condoms and spermicide until you can see your doctor
Have a follow-up appointment after 1 month to make sure the strings and the IUS are still in place 
NEVER attempt to remove the IUS yourself

* Period-like cramping and spotting is common within the first 3 months of insertion. Contact a sexual health clinic or doctor if you have any of the following symptoms: late period/no period, intense abdominal pain, fever, chills, increased or unpleasant smelling discharge or clots with your period. *

What are the advantages to using the IUS?
Very effective in preventing pregnancy
Cheaper in the long term because you pay one chunk of money initially and then the IUS does not need replacing for five years. 
Does not interrupt sex
Does not require a partner’s involvement 
Can be used for a long period of time (up to 5 years)
Does not interfere with breast feeding
Decreases cramping and greatly reduces flow of menstrual cycle. Many women who stay on the IUS end up stopping their periods while on it.
Does not require daily monitoring

What are the disadvantages of using the IUS?
Does not protect against sexually transmitted infections (STIs).
If you get a sexually transmitted infection, the IUS could increase the likelihood of developing pelvic inflammatory disease (infection of the reproductive organs), which may lead to infertility. This risk is only associated with getting a sexually transmitted infection. If you do not get an STI your risk does not increase.
Cramping and discomfort during the first 24-48 hours after insertion
High initial cost
A doctor must insert and remove the IUS
Small chance the IUS may be expelled or dislodged, causing it to come out
It can be difficult to find a doctor who inserts IUSs. 
If you are uncomfortable using hormones or are sensitive to hormones this may not be the best method for you

How can I get the IUS?
A prescription is required from a doctor. You can have an IUS inserted at some walk-in clinics. If you have a family doctor, you can ask them if they insert IUS. 

How much does an IUS cost?
Pharmacy: Approximately $350.00, covered by most drug/ health plans
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