Mirena Poster

Dr Diana Mansour answers your questions

  • When can an Intrauterine System, an Intrauterine Device and a Contraceptive Implant be removed?
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  • What should women know about the removal procedure?
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Removal of the method

If you decide that you no longer want contraceptive protection provided by a long-acting reversible contraceptive (LARC) such as the intrauterine system, the intrauterine device and the contraceptive implant, you should visit a healthcare professional trained in their removal. If you stop having the 3-monthly contraceptive injection, the contraceptive effects wear off from 12 weeks after your final injection1.

Intrauterine system

The intrauterine system can be removed very easily by a healthcare professional by pulling on the removal threads. Removal is usually a painless procedure. Fertility returns to normal immediately after removal1.

If pregnancy is not desired, the removal should be carried out during a period in women of fertile age, provided that there appears to be a menstrual cycle2. If the system is removed in the mid-cycle and you have had intercourse within a week, you are at risk of pregnancy unless a new system is placed immediately following removal2

Note: The intrauterine system (IUS) is also known as the ‘hormonal coil’.

Intrauterine device

Your intrauterine device can be removed very easily and usually painlessly by a healthcare professional by pulling on the removal threads3. Fertility returns to normal immediately after removal1. To avoid pregnancy, removal should be carried out during your period4. Sex during the week before removal during the middle of your cycle can lead to pregnancy4. So, you should use an alternative form of contraceptive a few days before and after removal of the device4.

Note: The intrauterine device (IUD) is also known as ‘the coil’ or copper IUD.

Contraceptive implant

Your contraceptive implant should be removed by a trained healthcare professional. He/she will feel for the ends of the implant using the fingertips, but if it cannot be felt, an imaging method, such as ultrasound or X-ray, will provide the exact location5. After applying a local anesthetic, a small incision is made in the skin and the tip of the implant can then be gently pushed out of your arm and removed using forceps5. Sometimes a tissue capsule has formed around the implant, which needs to be opened first before the implant can be removed5. The incision is then covered with a sterile dressing along with a pressure bandage5. The bandage can be removed after 24 hours, and the dressing after 3 to 5 days5.

3-monthly contraceptive injection

To stop using the 3-monthly contraceptive injection you simply stop having the injections. The contraceptive effects wear off 12 weeks from your final injection and while you can get pregnant within the next month it may take up to a year before your fertility is restored, unlike with the intrauterine system, the intrauterine device and the contraceptive implant, where removal allows you to get pregnant straight away1. However, in most women the effect will have worn off 5 to 6 months after the last injection6. Over 80 % of women will conceive within a year of their last injection6.