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IUD After Care Patient Education
[ ] Copper-T IUD (Paragard®)
- It begins working now to prevent pregnancy.
- It is approved for birth control for 10 years.
- Removal date _______________ (10 years from today)
[ ] Progestin IUD (Liletta®, Skyla®, Mirena®)
- It begins working in 7 days to prevent pregnancy.
- You MUST use condoms for the first 7 days after your IUD was inserted. If you have sex without using a condom, you will need to take emergency contraception as soon as possible to prevent pregnancy.
- Mirena® & Liletta® are approved as effective birth control for 6 years, Skyla® is approved for 3 years.
- Removal date _______________ 6 years (Liletta/Mirena) or 3 years (Skyla) from today
Today you may go back to school or work after your visit but may need to take Tylenol 650 mg or Motrin 600- 800 mg every 6 hours for cramps.
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You must wait 24 hours after your IUD is put in before you can use tampons, take a bath, or have vaginal sex.
The chance that your IUD was accidentally placed outside your uterus (perforation) occurs in about 1 in every 1000 insertions. We obtain ultrasound images before and after the IUD insertion and at your one month follow up to ensure this rarely if ever happens.
You may have more cramps or heavier bleeding with your periods, spotting between your periods. This is normal. The irregular cramping and bleeding can last for 3-6 months with hormonal IUDs. After 6 months, the cramping and bleeding should get better. Many women will stop having periods after 1 or 2 years with hormonal IUDs. If you have the non-hormonal Paragard® (copper) IUD, you will get your period but may have more cramping and more bleeding with your periods.
Ibuprofen (also called Advil® or Motrin®) helps decrease both painful cramps and the amount of bleeding. You can buy Ibuprofen at any drug store without a prescription. You can take as many as 4 pills (800 mg) of Ibuprofen every 6-8 hours with food (each pill contains 200 mg). To prevent cramping, start taking Ibuprofen as soon as your period starts and keep taking it every 6-8 hours for the first 2-3 days of your period. You can also put a hot water bottle on your belly if you have bad cramps.
Expulsion of your IUD happens between 2-10% in the first year. Recent study with women who use menstrual cups demonstrated a 20% expulsion rate. This is why it is important to check the strings after your menses especially if you have a non-hormonal Paragard IUD. If you can feel the strings, the IUD is in the right place. If your IUD comes out, you can become pregnant immediately. If you are not sure how to check the strings, we can help you (Call the office.) Meanwhile, use condoms. The hormonal IUD’s typically make your period lighter or stop it all together. If your bleeding pattern changes after your IUD has been in for 6 months, this may suggest your IUD is not in the right place and you should be seen.
The IUD does NOT protect you against sexually transmitted infections (STI/STD). ALWAYS use protection against sexually transmitted infections (male condoms, female condoms) if you are at risk. If you think you have been exposed to an STI, discuss testing with your healthcare provider. Most infections can be treated WITHOUT removing your IUD.
WARNING SIGNS:
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After insertion of the IUD:
– Fever (>100.4F)
– Chills
– Strong or sharp pain not relieved with OTC pain meds
Call when the office is open (these are very rare):
– Feeling pregnant (breast tenderness, nausea, vomiting)
– Positive home pregnancy test needs immediate attention
If you develop any of the above warning signs, please call the office at 925-935-6952.
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