• All patients requesting an IUD or LNG-IUS fitting should be counselled about the types of Intrauterine Devices available, both copper and hormonal, as well as the risks and benefits of each method in order that they may make an informed decision.
• They should be offered routine swabs prior to fitting: Chlamydia and high vaginal swabs

Post-insertion

• Analgesic given (suggest which)
• Instructions including thread check/tampons etc
• Leaflet
• Letter to GP (if being fitted by FPC or not own GP)
• Follow-up appointment in 6 weeks

This is a non-exhaustive list, several other conditions must also be considered along with patient history

Mirena IUS and copper UID - What to tell the Patient

• Efficacy and duration
• Effects on menstrual cycles (initial bleeding/spotting with Mirena followed by possible amenorrhoea) and differences between devices as periods may well get worse with IUCD long term.
• Insertion procedure
• Risk of infection/expulsion/perforation/ectopic and differences between devices
• Infections testing/chlamydia counselling - may be done in own surgery or fitting surgery, or FPC
• How and when to and check threads and in place
• What to do if they want to have a baby (reversibility)
• Time of fitting - take ibuprofen prior to fitting. Eat breakfast/lunch before appointment.
• - require D1 - D7 of cycle for IUS and up to 5 days after ovulation for IUD. Post-partum - at least six weeks (due to increased risk of perforation)

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