Irregular bleeding and spotting is common in the first 6 months after insertion of the LNG-IUS. By 1 year after LNG-IUS insertion amenorrhoea or oligomenorrhoea is usual. Hormonal side effects can be due to due to systemic absorption of progestogen but few women discontinue use of the LNG-IUS for this reason and discontinuation rates are not significantly different from Cu-IUD users. Insertion procedure and likely discomfort during and after intrauterine contraceptive insertion should be discussed with women and oral analgesia can be advised before insertion. TIMING OF INSERTION A Cu-IUD can be inserted at any time in the menstrual cycle if it is reasonably certain the woman is not pregnant. A Cu-IUD will provide immediate contraceptive protection. The LNG-IUS can be inserted at any time in the menstrual if it is reasonably certain the woman is not pregnant and the clinician is reasonably certain there has been no risk of conception. Unless the LNG-IUS is inserted within the first 7 days of the menstrual cycle, condoms or abstinence is advised for 7 days after insertion. PROCEDURES FOR INSERTION Clinicians who insert intrauterine contraceptive methods should be appropriately trained, maintain competence and attend regular updates in dealing with emergencies. should be given information (oral and written) about the device inserted and duration of use. Women should be instructed on how to check for the intrauterine contraceptive and its threads and advised that if they are unable to feel them it may be that the device has been expelled. Alternative contraception should then be used until medical advice is sought. Women should be advised to seek medical help at any time if they develop symptoms of pelvic infection, pain, persistent menstrual abnormalities, missed period, non-palpable threads or if they can feel the stem of the device. A follow-up visit after the next menses or 3–4 weeks after insertion is recommended. Annual is not routinely recommended and women should attend if problems arise at any time.
Irregular bleeding and spotting is common in the first 6 months after insertion of the LNG-IUS. By 1 year after LNG-IUS insertion amenorrhoea or oligomenorrhoea is usual. Hormonal side effects can be due to due to systemic absorption of progestogen but few women discontinue use of the LNG-IUS for this reason and discontinuation rates are not significantly different from Cu-IUD users. Insertion procedure and likely discomfort during and after intrauterine contraceptive insertion should be discussed with women and oral analgesia can be advised before insertion. TIMING OF INSERTION A Cu-IUD can be inserted at any time in the menstrual cycle if it is reasonably certain the woman is not pregnant. A Cu-IUD will provide immediate contraceptive protection. The LNG-IUS can be inserted at any time in the menstrual if it is reasonably certain the woman is not pregnant and the clinician is reasonably certain there has been no risk of conception. Unless the LNG-IUS is inserted within the first 7 days of the menstrual cycle, condoms or abstinence is advised for 7 days after insertion. PROCEDURES FOR INSERTION Clinicians who insert intrauterine contraceptive methods should be appropriately trained, maintain competence and attend regular updates in dealing with emergencies. should be given information (oral and written) about the device inserted and duration of use. Women should be instructed on how to check for the intrauterine contraceptive and its threads and advised that if they are unable to feel them it may be that the device has been expelled. Alternative contraception should then be used until medical advice is sought. Women should be advised to seek medical help at any time if they develop symptoms of pelvic infection, pain, persistent menstrual abnormalities, missed period, non-palpable threads or if they can feel the stem of the device. A follow-up visit after the next menses or 3–4 weeks after insertion is recommended. Annual is not routinely recommended and women should attend if problems arise at any time.