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IUD / LNG-IUS insertion

Contraception, heavy bleeding (LNG-IUS), HRT endometrial protection, emergency contraception (Cu-IUD).

Source: FSRH

Steps

  1. Exclude pregnancy; STI risk assessment; consent; chaperone.
  2. Bimanual exam for size and position.
  3. Speculum; clean; offer local anaesthetic.
  4. Apply tenaculum slowly; gentle traction straightens the canal.
  5. Sound uterus (no-touch); typical 6.5–9 cm.
  6. Load device; set flange to sounded depth.
  7. Insert to fundus; release arms per device instructions.
  8. Remove inserter; cut threads ~3 cm.
  9. Watch for vasovagal; record device and batch; teach thread checks.

Risks

Perforation<2 per 1000 (higher if breastfeeding / <6 wk postpartum)
Expulsion~1 in 20
InfectionMainly first 20 days
Postpartum: insert within 48 h of birth or from 4 weeks.
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.