11 responses to “Part 1: Who should be offered an IUD, and selection of the appropriate IUD”

  1. I find that IUDs are rapidly increasing in popularity among young nulliparous females, and usually the hormonal ones. They are well tolerated except for some cramping and bleeding intermittently in the first few months.

  2. The patient handout is apprecisted.
    The clear pathway for physician and patient for decision making is excellent.

  3. Excellent summary, thank you. I especially appreciated the listing of existing copper IUCD options with commentary on differentiators, I too find insertion of the Flexi T troublesome at times! One comment I would add, it is important to screen for a history abnormal uterine bleeding prior to IUCD insertion, especially in women at increased risk for endometrial hyperplasia.

  4. For patients handouts Sylvia, go to http://www.rleon.ca and you’ll find them there.

  5. Good and succint summary

  6. What methods are you using to decrease the pain of insertion?

    And I find that the increased effectiveness of the hormonal IUS vs. the copper is important to mention.

  7. very practical information.

  8. Questions

    Do you use any product intravaginal prior to help open the cervix before IUD insertion

    What do you use as spray as anesthetic to cervix …What type of infiltrating block to use for the cervix

    I seem hesitant to try IUD insertion because of the pain….It seem less painful in women who are 6 weeks post partum

    Let me know. Thanks

  9. Dr. Kim Grieve


    We often have samples of Arthrotec 50 or 75 in the clinic. We give them 2 tabs – one to be taken the night before the insertion and morning of. The misoprostil softens the cervix and the diclofenac reduced pain of insertion.

    With respect to insertion post ppartum , I generally wait 12 weeks to reduce risk of perforation, however would appreciate others thoughts on this.

  10. Dr.Leon

    Thank you for the very useful patient handout.

  11. very detailed education about the IUD, I feel I have certainly gained more insight which will help me in making decisions and supporting patients

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