Name of the Procedure:

Levonorgestrel-releasing intrauterine contraceptive system (IUD), 19.5 mg (Kyleena)

Summary

Kyleena is a small, T-shaped intrauterine device (IUD) that releases a hormone called levonorgestrel over time to help prevent pregnancy. It is placed inside the uterus by a healthcare provider and provides long-term contraceptive benefits for up to 5 years.

Purpose

Kyleena is used to prevent pregnancy. It offers an effective long-term contraceptive option for women who prefer not to use daily, weekly, or monthly birth control methods. It also helps minimize menstrual bleeding and cramping for some women.

Indications

• Desire for long-term, reversible contraception
• Contraindication or intolerance to estrogen-containing birth control methods
• Heavy menstrual bleeding (menorrhagia) and menstrual cramps

Preparation

• Consult with a healthcare provider to ensure Kyleena is suitable based on medical history and physical examination.
• A pregnancy test may be performed to confirm you're not pregnant.
• It is often recommended to schedule the insertion during the menstrual period when the cervix is slightly dilated.
• You may be advised to take over-the-counter pain relief, like ibuprofen, prior to the procedure to minimize discomfort.

Procedure Description

1. Insertion:
   • A pelvic exam is performed to assess the position and size of the uterus.
   • A speculum is inserted into the vagina to visualize the cervix.
   • The cervix is cleaned with an antiseptic solution.
   • A narrow, flexible tube containing the Kyleena IUD is inserted through the cervix into the uterus.
   • The IUD is then released into the uterus, and the tube is removed.
   • The strings of the IUD are trimmed to an appropriate length.

Tools: Speculum, antiseptic solution, insertion tube containing the IUD.

Anesthesia: Typically, no anesthesia or sedation is required, although local anesthesia may be used in some cases.

Duration

The insertion process usually takes about 5-10 minutes.

Setting

Kyleena insertion is performed in an outpatient setting, such as a gynecologist's office or a clinic.

Personnel

• Gynecologist or trained healthcare provider
• Nurse or medical assistant for support

Risks and Complications

• Cramping and discomfort during and after insertion
• Spotting or irregular bleeding in the first few months
• Risk of expulsion (IUD coming out)
• Perforation of the uterine wall (rare)
• Pelvic inflammatory disease (rare but serious)

Benefits

• Highly effective at preventing pregnancy (over 99% effective)
• Long-term contraception (effective for up to 5 years)
• Reduced menstrual bleeding and cramping for some users

Recovery

• Some cramping and spotting may occur post-insertion and can last a few days to weeks.
• Avoid inserting anything into the vagina (tampons, sexual intercourse) for 24 hours post-insertion.
• Normal activities can usually be resumed immediately, but take it easy if you feel discomfort.
• Follow-up appointment in 4-6 weeks to ensure proper placement of the IUD.
• Strings should be checked monthly to ensure the IUD is in place.

Alternatives

• Oral contraceptive pills
• Hormonal patches and rings
• Other types of IUDs (copper or different hormonal IUDs)
• Barrier methods (condoms, diaphragms)
• Contraceptive implants
• Sterilization (permanent)

Pros and Cons of Alternatives:

• Oral contraceptives require daily administration but are easy to discontinue.
• Copper IUDs are hormone-free but can cause heavier periods.
• Barrier methods require use at the time of intercourse and are less effective.

Patient Experience

During the procedure, you may feel cramping and pressure similar to menstrual cramps. Some women report dizziness or feeling faint. Post-insertion cramping and spotting are common but manageable with over-the-counter pain relief. Long-term, many users experience lightened menstrual periods and appreciate the convenience of not needing to think about daily contraception.