Simple steps from INTRA to successfully counsel women about intrauterine contraception (IUC) in under 7 minutes.
Aims of this section:
*Formation of the INTRA group and its ongoing work is supported by Bayer
The global INTRA group is a panel of independent physicians with an expert interest in intrauterine contraception.*
The Global INTRA group identified six key steps, which they believe form the basis of an effective counselling session about IUC.
Every step includes a short explanation, example questions and an estimated time recommendation.
If you would like to learn more, click here to access the downloads at the bottom of the page.
Establish her contraceptive needs
Introduce long-acting reversible contraception (LARC)
Communicate the potential benefits of IUC
Provide reassurance and address her concerns
Help her decide
Confirm her choice and schedule placement(if choice was IUC)
To establish a women’s contraceptive needs:
‘Do you have any plans to get pregnant?
If yes, how soon?’
‘How important is it for you not to be pregnant right now?’
‘What contraception do you use now (if any)?
What have you used before (if any)?’
‘How happy are/were you with those methods?
What did you like most about your previous/current method?
What did you like least?’
‘There are many myths associated with intrauterine
contraception, let me tell you some of the real facts which
‘You seem quite knowledgeable about intrauterine
contraception, is there something that has stopped you
considering it as an option in the past?’
‘You mentioned you have heavy periods, one benefit of
some types of intrauterine contraception can be reduced
bleeding or for your periods to stop altogether.’
Addresses HCP misconceptions regarding:
The risk of PID, infertility and ectopic pregnancy
The difficulty and risks of insertion of IUCs
The mechanism of action
Health system barriers include
Lack of understanding of the value/
cost effectiveness of IUCs
The number of trained providers
User barriers include:
Lack of awareness and
understanding of IUC
Fear of IUC, particularly pain on insertion
Cost of IUC
Pain on insertion has been shown to be lower than often feared:
‘The most common side effects can be headaches and abdominal
pains but not all women experience these. Just be aware that
having an IUC won’t protect you against STIs so as you would with
the pill, you’ll need to use a condom if you think you might be at risk.’
‘Based on what you’ve told me these are the most
effective options to suit your needs – which of these do
you think would suit you best?’
‘For most women, placement can cause a little pain, a bit
like period pain, which quickly passes.’
‘In our practice we have a large number of women using
‘Amongst the patients I see, there are many who opt for an IUC.’
‘Many of the women who work here use IUC.’
(If you and your colleagues are comfortable)
IUC placement is done within 7 days of menstruation, and the IUC can be replaced at any time in the cycle.1
STI screening can be performed on the same day as placement
and, if the screen comes back positive, the infection can be treated
with the device/system in situ. Mirena must be removed if the
woman experiences recurrent endometritis or pelvic infection, or if
an acute infection is severe2
If she has any concerns following placement, she can return to
discuss these with you at any time or call the clinic
You meet your local requirements for informed consent at the time
when the woman returns for the device to be inserted. When gaining
this consent, remind her of the potential risks and side effects1
If the woman does experience side effects she should contact her
healthcare professional immediately including pain, fever, unusual
discharge, or severe bleeding2
It is important to note that cervical screening is independent of IUC
placement and not a pre-requisite2
These videos demonstrate that it is possible to have a simple, short, & very effective counselling session about IUC in under 7 minutes.
To support contraceptive counselling in the UK, the Bayer Women's Health team have developed technology to help deliver LARC counselling to patients. The Digital Contraceptive Counselling tool offers interactive content to help women understand the different options available when considering contraceptive methods, including Long Acting Reversible Contraceptives. The following video is a brief introduction to the Digital Contraceptive Counselling tool.
If you would like to learn more, or are interested in using Digital Contraceptive Counselling tool in your practice, please submit a request via the contact a rep. page.
16 page, A5 booklet entitled ‘Straight to the Point: Talking IUC’
Aim: to assist HCPs when counselling women about IUC in under 7 minutes
A one page A4 summary of the key topics, including the most important questions
Follows the same six key themes for discussion, as advised by the Global INTRA group
Aim: to act as a quick reference during a consultation, and to ensure the relevant topics have been covered without needing to refer to the full booklet
Reporting adverse events and quality complaints
Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard. Adverse events should also be reported to Bayer plc.
If you want to report an adverse event or quality complaint, reports can be directed to: Tel: 01182063500 or email: email@example.com
Further information is available on the “contact” tab at www.bayer.co.uk.