Intrauterine Contraceptive Device - Fitting, monitoring and changing

Where do I go to get an intrauterine contraceptive device?

The intrauterine contraceptive device (IUCD) may be offered at your local GP surgery or sexual health clinic. You will need to make an appointment.

How is the intrauterine contraceptive device fitted?

This is usually done towards the end of a period or shortly afterwards, as this tends to be more comfortable for you. Also, the doctor can be sure that you are not pregnant. However, it can be fitted at any time provided that you are certain you are not pregnant.

You will need to have a vaginal examination. The doctor or nurse will pass a small instrument into your womb (uterus) to check its size and position. The IUCD is then fitted using a small plastic insertion device. You will be taught how to feel the threads of the IUCD so you can check it is in place. It is best to check the threads regularly - for example, once a month just after a period.

Female reproductive organs
IUCD in place

The process of fitting an IUCD can sometimes be very uncomfortable. Once the IUCD has been inserted, some women have crampy pains like period pains for a few hours (and up to 48 hours) afterwards. These can be eased by painkillers such as paracetamol or ibuprofen, and it can be sensible to take these an hour before your fitting. Light vaginal bleeding may also occur for a short while.

Does the intrauterine contraceptive device work immediately?

The IUCD is immediately effective as a contraceptive.

Do I need follow-up?

The doctor or nurse will usually want to check that there are no problems a few weeks after fitting an IUCD. It is best done after your next period. After this, there is no need for any routine check until it is time to remove the IUCD. However, return to see your doctor or nurse at any time if you have any problems or queries. Most women have no problems, and the IUCD can remain in place for several years.

How do you remove or change an intrauterine contraceptive device?

An IUCD can be removed at any time by a trained doctor or nurse. If you plan to have it removed but do not want to get pregnant, you should abstain from having sex (intercourse). Or, you should use other methods of contraception (such as condoms) for seven days before the IUCD is removed. This is because sperm can last up to seven days in the womb (uterus) and can fertilise an egg after the IUCD is removed.

If you have had your IUCD for its maximum effective time (usually five or ten years, depending on the device) and you need, therefore, to have it changed for another one, you should again abstain from having sex. Or, you should use other forms of contraception for seven days before removal. This is because occasionally when the device is removed, the neck of your womb (cervix) clamps tightly shut for a while. The doctor cannot therefore immediately insert the new device. As sperm can last up to seven days in the womb, they could, therefore, fertilise an egg whilst you are waiting for your replacement IUCD fitting.

Can I use tampons with an intrauterine contraceptive device?

You can use sanitary towels or tampons with an IUCD in place. A cervical smear can also be taken with an IUCD in place. Sometimes, the smear result may show that there is an organism in the cervix; these are called actinomyces-like organisms. These are normally found in the vagina and do not mean the IUCD should be removed. If you have had pelvic pain together with signs of infection, such as a temperature, your doctor may consider removing the IUCD.

Can I use a menstrual cup with an intrauterine contraceptive device?

Mooncup® is a silicone cup designed to sit over the cervix to catch menstrual blood, as an alternative to tampons and sanitary pads.

The Mooncup® manufacturer recommends waiting six weeks after the insertion of your IUCD before using the cup. They also recommend checking for IUCD threads after each menses. They say that there have been instances where an IUCD/intrauterine system (IUS) has become dislodged when using the devices together, possibly due to wearing the cup too high, or the cervix being very low. One in twenty IUCDs/IUS will be expelled, most commonly in the first three months after the device has been inserted. These expulsions happen most frequently during menstruation. This is generally thought not to be the fault of the Mooncup®.

There should always be a space between the Mooncup® and the cervix. If you have a low-sitting cervix there may not be enough room for the cup to sit safely and work effectively. You should always place the Mooncup® low in the vagina and ensure you have an adequate seal. Always release the seal before removing.

When should I see a doctor about my intrauterine contraceptive device?

You should consult a doctor if any of the following occur:

  • Prolonged tummy (abdominal) pain (severe or beyond 48 hours) after an IUCD is inserted.
  • A delayed period, or bleeding between periods.
  • A delayed period and lower or one-sided tummy (abdominal) pain (which may be due to an ectopic pregnancy).
  • Vaginal discharge with or without pain (which may indicate infection).
  • If you suspect that the IUCD has come out or is coming out. It is usually possible to feel the threads of the IUCD inside the vagina to check it is in place. If you cannot feel the threads then use other contraceptive methods (such as condoms) until you have been checked by a doctor or nurse.

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Author:
Dr Mary Lowth
Peer Reviewer:
Dr Jacqueline Payne
Document ID:
4285 (v42)
Last Checked:
08 July 2017
Next Review:
07 July 2020

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Patient Platform Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.