7.3.4 Contraceptive devices

Intrauterine contraceptive devices (IUDs)

IUDs are suitable for use in all women, including nulliparae

The most effective IUDs contain at least 380mm2 of copper and have banded copper on the arms e.g. T-Safe® Cu 380A QuickLoad are thought to be more efficacious. Alternatives are Nova-T® 380 and Mini TT 380® Slimline for women whose uterine cavity is of an insufficient size for the T-Safe Cu 380A QuickLoad

All IUDs should only be fitted by those who have been appropriately trained.

MHRA Drug Safety Alert (June 2015): Before inserting an intrauterine system (IUS) or intrauterine device (IUD), inform women that perforation occurs in less than 1 in 1,000 women and that the symptoms include:

  • severe pelvic pain after insertion (worse than period cramps)
  • pain or heavy bleeding after insertion which continues for more than a few weeks
  • sudden changes in periods
  • pain during sex
  • not being able to feel the threads

Explain to women how to check their threads and tell them to return for a check-up if they cannot feel them (especially if they also have significant pain). Partial perforation may have occurred even if the threads can still be seen; consider this if there is severe pain following insertion.

An IUD fitted or re-fitted after a woman's 40th birthday, does not need to be changed. It can be removed one year after the last period

If a surgery is unable to provide an IUD insertion, patients can arrange a fitting by contacting The Centre:

Nurse Helpline : 01392 284931

Main Reception: 01392 284982 or 01392 284983

Walk-in Clinic: Monday to Friday 09:30 – 15:30

Patient or GP must mention the appointment is for an emergency fitting.

T-Safe® CU 380A QL
  • Intra-uterine device (£10.55 each)

Notes

  1. 10-year life and more effective than other Cu IUDs
Nova-T® 380
  • Intra-uterine device (£15.20 each)

Notes

  1. A slimmer device but 5 year life
Mini TT 380® Slimline
  • Intra-uterine device (£12.46 each)

Notes

  1. Requires minimum uterine length 5cm. Replace every 5 years

Vaginal contraceptive caps and diaphragms

Caps and diaphragms are the least effective form of contraception. These methods are used infrequently and patients are best referred to the Contraception Service (01392 284982 or 284931 for appointments) for advice on choice, prescription and fitting of caps and diaphragms. For this reason these products are 'second line'.

Diaphragms are usually used. They are normally replaced approximately annually, have expiry dates and are used with spermicides.

Type B Coil spring diaphragm
  • Silicone sizes 60-100mm (rising in 5mm) (£10.21 each)
Type C Arcing spring diaphragm
  • Silicone sizes 60-95mm (rising in 5mm) (£10.21 each)

Caps are used less often, e.g. prolapse, poor muscle tone, urinary symptoms. They last longer than diaphragms, have expiry dates and are used with spermicides.

Cervical cap (type B)
  • Silicone sizes 22, 26, and 30mm (£15.29 each)

 

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