Mirena should be replaced after Year 5 if continued treatment of heavy menstrual bleeding is needed 1. The Mirena is immediately effective only if inserted within 7 days from the start of the last menses. Vaginal bleeding In the 2 largest clinical trials with ParaGard (see ADVERSE REACTIONS, Table 2), menstrual changes were the most common medical reason for discontinuation of ParaGard The white inserter rod is placed into the insertion tube. Cramping is also a common side effect. Start by washing your hands with soap and water. Check strings after each menstrual period and call immediately if you are unable to locate the strings. Skyla may go into or go through the uterus and cause other problems. Using sterile gloves, bend the T-Arms of Paragard by folding the two horizontal arms down against the stem. Copper wire coiled around the device produces an inflammatory reaction that is . Some complications, such as uterine perforation . Cervix and Vaginal Canal (with Augmented Feedback) Simulator. Mirena is indicated for the treatment of heavy menstrual bleeding for up to 5 years in women who choose to use intrauterine contraception. Ready for practice? For one week following the insertion procedure, you must refrain from having sex or inserting anything (such as a tampon, douche, or any other object) into your vagina. An intrauterine device or IUD is a small T-shaped device that a doctor or nurse can implant into the uterus to prevent pregnancy. Only the tips of the T-Arms should be in the insertion tube. Levonorgestrel-releasing (LNG) IUD Insertion. Information regarding insertion instructions, patient counseling and record keeping, patient follow-up, removal of Mirena and continuation of contraception after removal is provided below. The total exposed copper surface area is 380 23 mm. 2.1. ParaGard is packaged together with an insertion tube and solid white rod in a Tyvek polyethylene pouch that is then sterilized. 1.start paragard in females not currently using contraception at any time during the menstrual cycle. Its T-shaped plastic frame wrapped in copper wire continuously releases trace amounts of copper into the uterine lining, which causes an inflammatory reaction that is toxic to sperm. Slightly withdraw insertion tube, push arms down along the stem, slide insertion tube over the tips of the T-Arms (see Figure 2). You may have other side effects with Paragard. The Only IUD FDA Approved for Over 30 Years IUDs are long-acting, are reversible, and can be used by women of . (See INSTRUCTIONS FOR USE.) Paragard, Mirena, Follow Us Here: This video is only for the healthcare professionals. CLINICAL PHARMACOLOGY Common removal side effects are mild and include cramping and light bleeding. Return to the clinic in 6 weeks for a follow-up visit to check string length and side effects. I instructed them to take pain medication as needed and that their first few menstrual cycles may be heavier than usual. 3. If you do not have sterile gloves, you can do steps 1 and 2 while PARAGARD is in the sterile package. If you are getting an IUD placed, take an over-the-counter medication for cramping like ibuprofen or naproxen. This video provides an animation for the insertion procedure for the 52mg LNG IUD Mirena. With gentle traction on the tenaculum, the IUD was inserted to the appropriate depth and deposited by withdrawing on the insertion tube holding the rod steady. As with other methods of birth control, it may take your body time to get used to your IUD. Look for any problems with your uterus. Contraception. Once released, Mirena cannot be re-loaded. Within the first 3 weeks of the IUD insertion: - Fever (>101F) - Chills - Strong or sharp pain in your stomach or belly At Any Time (these are very rare): - Late period (for Paragard users) - Feeling pregnant (breast tenderness, nausea, vomiting) - Positive home pregnancy test Take one or the other and be sure to take it with food. 2.1. 6. Paragard works by preventing sperm from reaching an egg. NDA 18-680/S-060 Page 8 2. The physician should insert the . 2.switch to paragard from an oral, hormonal contraception or an injectable progestin contraceptive at any time during the menstrual cycle; discontinue the previous method. Visit Instructions: IUD Insertion (Mirena/ParaGard) Important Considerations Before Your Appointment: In order to have the IUD inserted, you cannot have unprotected sex for two weeks prior to your appointment. The insertion instructions and tools mentioned in this video do not apply to immediate insertion after childbirth or second-trimester abortion or miscarriage. Discover step by step how the IUS mirena is inserted, removed, and replaced.Find out more on the blog http://www.procuromaissaude.com Special instructions for insertion are in the package. A moveable flange on the insertion tube aids in . Straight after Mirena is inserted, you might feel pain, dizziness, and bleeding. Medical examination. Women also may feel dizzy or nauseous. Step-by-step with Paragard IUS Choose your training option below You have options when it comes to learning how to place and remove Paragard, and additional resources. Care must, therefore, be given to adequate training in the correct insertion technique and the availability of appropriate instruments for the insertion of Mirena. Note: Do not open the IUD package until uterus depth is sounded successfully. Bayer Women's HealthCare (WHC) Support Center. Check expiration date of Mirena prior to initiating insertion. Paragard is a copper-containing intrauterine system (IUS) indicated for prevention of pregnancy in females of reproductive potential for up to 10 years. Do not pull on the threads. (2.1) See the Full Prescribing Information for recommended timing of insertion preparation instructions, insertion procedures, postplacement management, The threads should be fixed tightly in the cleft at the end of the handle ( Figure 9), and the flange should be set to the depth measured by the sound ( Figure 10). You should use a backup method of contraception for the next two weeks. 1001 Potrero Ave San Francisco, CA 94110 info@innovating-education.org. Paragard is a small, T-shaped, intrauterine, non-hormonal contraceptive device that works by continuously releasing a small number of copper ions into the uterine cavity which prevents pregnancy. Risk ratios (RRs) were calculated as measures of relative risk, together with their 95% confidence intervals (95% CI). For . But, in some instances, complications can occur during Mirena insertion or shortly after. A First, place the package face up on a clean surface. Training Logbook - Copper T380A IUD Insertion. Within the first 3 weeks of the IUD insertion: - Fever (>101F) - Chills - Strong or sharp pain in your stomach or belly At Any Time (these are very rare): - Late period (for Paragard users) - Feeling pregnant (breast tenderness, nausea, vomiting) - Positive home pregnancy test Insertion precautions, continuing care, and removal. Line up your cervix with your uterus. . Method of administration. Visit Instructions: IUD Insertion (Mirena/ParaGard) Important Considerations Before Your Appointment: In order to have the IUD inserted, you cannot have unprotected sex for two weeks prior to your appointment. If you had the IUD placed for birth control, the Paragard IUD is effective immediately. LILETTA Insertion Inside you will find key points and images from the Healthcare Provider's Reference for Preparing and Inserting LILETTA. One ParaGard weighs less than one (1) gram. Mirena is inserted with the provided inserter (Figure 1a) into the uterine cavity within seven days of the Innovating Education in Reproductive Health. 21 Wednesday Oct 2015. and the insertion wasn't any different then insertion with. ParaGard is a very effective contraceptive. Tell your healthcare provider about any side effect . Insertion may be associated with some pain and/or bleeding or vasovagal reactions (for example, syncope, bradycardia), or with seizure, especially in patients with a predisposition to these conditions. Bayer WHC Support Center. 3.switch to paragard from a contraceptive implant or other intrauterine Ovarian cysts may occur but usually disappear. Examine you to find the exact position of your uterus Cleanse your vagina and cervix Measure your uterus Slide a plastic tube containing Paragard into your uterus Remove the tube, leaving Paragard inside your uterus Trim the threads so they are just long enough for you to feel with your fingers when doing a self-check IMPORTANT SAFETY INFORMATION CONTRAINDICATIONS The use of Paragard is contraindicated when one or more of the following conditions exist: Healthcare providers should become thoroughly familiar with the insertion instructions before attempting insertion of Mirena. Others report a sensation similar to mild menstrual cramping. The number needed to treat (NNT) and the number needed to harm . IUDs are shaped like a T, with one arm on either side. An IUD is a small T-shaped flexible device that is inserted into the uterus. Load PARAGARD(intrauterine copper contraceptive) into the insertion tube by folding the 2 horizontal arms of PARAGARD against the stem and pushing the tips of the arms securely into the insertion tube. Please read the complete insertion instructions from the Mirena package before performin. The Paragard insertion kit was opened, the arms of the IUD are put into the insertion tube and the blue phalange was set to the uterine depth, & aligned with the IUD arms. This makes it almost impossible for sperm to survive the swim through the uterus to reach the egg. IUD=intrauterine device. For example, you may experience anemia (low blood count), expulsion, pain during sex, spotting, prolonged or painful periods, vaginal irritation, vaginal discharge, backache, cramping or pain. (2.1) Insert and remove Paragard only if you are a healthcare provider trained on these procedures. Healthcare providers are advised to become thoroughly familiar with the insertion instruc-tions before attempting insertion of Mirena. To view more videos in our LARC Series visit the course page. Ordering and Reimbursement Order Now Placement and Removal Training See Options Resources for You and Your Patients Download Now Paragard is Here to Support Your Practice Request a Placement Go to WHC Support Center. Once in place inside a woman's uterus, Paragard is effective immediately. IUD -Post Insertion Instructions. This video provides an animation for the insertion procedure for the copper IUD Paragard. Access 24-hour online support. There are 2 ways to order Mirena. For some women, the Mirena insertion is painful. Summary. 3D Printed Uterus Simulators. ParaGard is the only non-medicated IUD available in the United States. Remember to check the expiration date of Mirena prior to initiating insertion. Copper T380A IUD Insertion. If you do not have health insurance, or if Mirena is not covered by your insurance, the cost of Mirena is $1,049.24. Once ParaGard is removed, the fluids return to normal and fertility is restored. Paragard removal is an outpatient procedure and typically takes a few minutes in a health care provider's office. 95% of women were covered for a Bayer IUD, like Mirena, with little or no out-of-pocket costs (based on past benefit investigation submissions to Bayer in 2017). At the end of the insertion procedure, your doctor will schedule you for a follow-up examination in 4 to 6 weeks. Phase 2: Simulator Build. Over 99% Effective One of the most effective methods of birth control available-and lasts up to 10 years! The doctor will fold down the arms and place the device into an . The ParaGard device is a T-shaped plastic frame that's inserted into the uterus. doc IUD Aftercare Instructions Also available in: Spanish, Simplified Chinese, Traditional Chinese; Filed under. The string was cut to an estimated 4 cm length. The Paragard IUD has been around since the 1980s, but the copper birth control device has been back in the news this year because of lawsuits that claim the device can break and imbed in other organs. If the Mirena is inserted outside of this time, it will take 7 days to become effective. IUD Insertion: Paragard. If you have Mirena inserted at any other time during your menstrual cycle, use another method of birth control, like condoms for at least 7 days. IUD Insertion: Paragard. The insertion instructions and tools do not apply to immediate insertion after childbirth or second-trimester abortion or miscarriage. Paragard no later than 10 years from the date of insertion. Mirena (progesterone only, good up to 5 years) Skyla (progesterone only, good up to 3 years) Paragard (copper device, no hormones, good up to 10 years) Instructions for Day of Insertion: Take Ibuprofen/Motrin 600mg 1-2 hours prior to appointment to help with pain and cramping. Paragard is a copper-containing intrauterine system (IUS) indicated for prevention of pregnancy in females of reproductive potential for up to 10 years. If you are using a hormonal birth control method like the pill, patch, ring or Depo-Provera ("The Shot"), please make sure to continue to use it until your IUD Paragard is a popular choice for women who want long-term, non-hormonal birth control. Phase 3: Skills Practice. A moveable flange on the insertion tube aids in gauging the depth of insertion through the cervical canal and into the uterine cavity. Placement & Removal Training Videos Watch our step-by-step video on how to prepare, load, place, and remove Paragard. Open the package 1 Open the package. Download Instructions After IUD insertion please take the following precautions: Nothing inside the vagina for 2-3 days, including tampons or intercourse Make a follow-up appointment for 4 weeks after IUD insertion. Contraceptive Pearl: Locating Intrauterine Devices with Missing Strings; Contraceptive Pearl: Fertility following IUD use . The patient tolerated the procedure well. A total of 179 women were randomly allocated to two groups: 86 to receive 400 g of misoprostol vaginally 4 h prior to IUD insertion and 93 to receive placebo. Mirena, Liletta, Kyleena, and Skyla are types that release a small amount of the progestin levonorgestrel and are effective for up to seven, six, five, and three years, respectively. The FDA notes that you could feel dizzy or even faint during insertion. Meet the Paragard IUD, birth control that's: 100% Hormone Free Pregnancy prevention without artificial hormones. No component of ParaGard or its packaging contains latex. Here's what your healthcare practitioner will do during your Paragard insertion: Examine your pelvis to find the position of your uterus Insert a speculum and use an antiseptic solution around your vagina and cervix Measure the depth of your uterine cavity Insert the Paragard IUD into your uterus Properly position the IUD and remove the inserter Preparation for insertion Examine the patient to establish the size and position of the uterus, in order to detect any signs of acute genital infections or other contraindications for the insertion of . If you are using a hormonal birth control method like the pill, the patch, the ring or Depo-Provera You should check your IUD strings every month, preferably just after a period. Copper IUD (ParaGard) ParaGard is an intrauterine device (IUD) that can provide long-term birth control (contraception). Once ParaGard has been inserted, the uterus and fallopian tube fluids change. 1 Simple Active Ingredient Works using just 1 simple active ingredient-copper. If unable to locate the IUD strings or they have lengthened you should make an appointment to see your provider immediately and to use a backup method of birth . Reach up to the top of your vagina with clean fingers to feel the 2 threads. Once the uterine depth is determined, follow the package instructions for the specific IUD being inserted (Mirena/Kyleena/Skyla vs Liletta vs Paragard). Four IUDs are available in the United States, the copper-bearing IUD and three levonorgestrel-releasing IUDs (containing a total of either 13.5 mg or 52 mg levonorgestrel). Mirena is packaged sterile within an inserter. Rarely, the IUD may break upon removal, requiring surgery. The contents of the package are sterile Using sterile gloves, lift the handle of the sterile inserter and remove from the sterile package 2. This video provides an animation for the insertion procedure for the copper IUD Paragard. understanding of these instructions. Please read the complete insertion . They were given a detailed instruction sheet about their IUD. Overview. Insertion Instructions NOTE: Mirena should be inserted by a trained health-care provider. Pregnancy while using Skyla is uncommon but can be life threatening and may result in loss of pregnancy or fertility. IUD Insertion: Mirena. Insertion tube then placed into the uterus until the flange is against the cervical os. Related Resources. However, when the time of ovulation can be estimated, the Cu- IUD can be inserted beyond 5 days after intercourse, if necessary, as long as the insertion does not occur >5 days after ovulation. If you do not have sterile gloves, you can do STEPS 1 and 2 while Paragard is in the sterile package. Mirena is inserted with the provided inserter (figure 1) into the uterine cavity by carefully following the insertion instructions. Visit Instructions: IUD Insertion (ParaGard) Important Considerations Before Your Appointment: In order to have the IUD inserted, you cannot have unprotected sex for two weeks prior to your appointment. Followup: The patient tolerated the procedure well without complications. Place orders online, by phone, or by fax. These copper ions change the fluid within the fallopian . Insertion Instructions NOTE: Mirena should be inserted by a trained healthcare provider. The insertion technique differs to that for other intrauterine devices. Bleeding was minimal. This is not a complete list of possible side effects. Skyla and Kyleena users are counseled to use condoms for the first 7 days post insertion. Ibuprofen (Advil) Take 3-4 of 200 mg tablets 30 minutes prior to the appointment. Bayer Women's HealthCare (WHC) Specialty Pharmacy Program. For complete insertion instructions, please refer to the step-by-step insertion instructions below or the full Prescribing Information for Kyleena. Official answer. . Fewer than 1 woman out of 100 becomes pregnant in the first year of using IUDs (with typical use) ( 14 ). If you are using a hormonal birth control method like the pill, the patch, the After IUD insertion, women can continue daily activities. The Mirena IUD is effective immediately if it was inserted within seven days after the start of your period. IUD Guide: Removal of Jaydess / Insertion and Day 1-3 of Mirena. ParaGard is packaged together with an insertion tube and solid white rod in a Tyvek polyethylene pouch that is then sterilized. The ParaGard is immediately effective upon insertion. No component of ParaGard or its packaging contains latex. Training Logbook - Hormonal IUD Insertion. It's sometimes referred to as a nonhormonal IUD option. Phase 4: Self-Assessment. Load Paragard into the insertion tube by folding the two horizontal arms of Paragard against the stem and push the tips of the arms securely into the insertion tube. Naproxen (Aleve) Take 2 of the 220 mg tablets 30 minutes prior to the appointment. Use this online virtual training simulation. To view more videos in our LARC Series visit the course page. [1-877-727-2427 or hcp.paragard.com for more info] contraception [postmenarchal females] Dose: 1 IUD q10y; Start: any time during menstrual cycle, or immed. Nebraska woman Stephanie Ideus was one of the people who filed a suit against Teva Pharmaceuticals, one of the manufacturers of the device, in 2016. Contraception, IUD. When inserting, make sure not to insert any further than the depth of the uterine cavity (from the step above). It is among the most effective forms of reversible birth . Client InstructionsLevonorgestrel-Releasing IUD (Mirena) Give client the card to have Mirena IUD removed after 5 years. once the above steps are completed and paragard is in the insertion tube, grasp the insertion tube at the open end of the package; adjust the blue flange so that the distance from the top of the paragard insertion tube is the same as the uterine depth measured with the uterine sound or use the sterile card to adjust the blue flange according to Copper ions, enzymes, prostaglandins, and white blood cells contained in the fluids impair sperm function and prevent fertility. 1. 5. This comes to $12.49 per month over a 7-year period when using . Check account status and track orders. During post-counseling, the client will receive instruction on checking for the string, what to . Mirena should be inserted by a trained healthcare provider. 1. Bleeding and spotting may increase in the first 3 to 6 months and remain irregular. Eat A Light Meal And Drink Water For complete insertion instructions please refer to either of the following: The full Prescribing Information on the inside lid of the LILETTA intrauterine system (IUS) demonstration kit . Do not advance beyond the copper collars. Follow the insertion instructions exactly as described to ensure proper placement and avoid premature release of Mirena from the inserter. after delivery otherwise >4wk postpartum; see pkg insert for timing post-abortion; Info: see pkg insert for insertion instructions *emergency contraception [postmenarchal females]

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