Birth control


You can have sexual intercourse again about 6 weeks after the birth, the uterus has then recovered and the blood loss has often stopped. The moment when you are ready for sexual contact again for the first time differs per person. Because you do not know exactly when your period will start again, it is advisable to use contraceptives if you do not want to get pregnant again soon.
It is usually unclear when the first ovulation occurs after childbirth, which also means that you can get pregnant without realizing it. You can get pregnant again from 4 weeks after the birth. It takes about 9 months before your hormone balance is stabilized again. If you do not want to become pregnant (for the time being), think about which contraception is right for you.
Which method of contraception is best for you depends on several factors. For example, are you breastfeeding, do you want to get pregnant again quickly or do you no longer want to have children; your situation will influence the choice you make for contraceptives. During pregnancy or childbirth, we provide you with information about various contraceptive methods. This topic is discussed again during the follow-up check six weeks after the birth.

Forms of Contraception (Birth Control)

Hormonal Contraception 
These forms of birth control contain hormones (progestins and oestrogens) that prevent you from getting pregnant:
  • the combination pill
  • the contraceptive patch
  • the contraceptive ring
These forms of contraception contain only progestogens
  • hormone IUD (intra- uterine device)
  • mini pill
  • implant rod
  • contraceptive injection (if you stop taking the contraceptive injection it can take a long time before you are pregnant again. Not recommended if you want to get pregnant again soon after stopping)
Hormone-Free Contraception
  • copper IUD (intra- uterine device)
  • condom
  • pessary
Final Methods
  • Female sterilization
  • Male sterilization
For more information and an explanation about the different forms of contraception, see:

IUD (intra- uterine device)

If you want or are considering an IUD, you can also come to our practice. Even if you are not yet a patient of ours (if you have never been pregnant) you can have an IUD placed by us.
It's a very reliable form of birth control and is also a good option during breastfeeding. If you use medication or if you have problems with your menstrual cycle (for example PCOS, endometriosis), always consult your doctor.

We list the different types of IUD's below. Feel free to contact us if you have any questions!
Copper IUD (hormone-free)
A copper IUD is a hormone-free form of birth control and gradually releases some copper. Copper makes sperm cells entering the uterus inactive so that fertilization cannot take place. In the unlikely event that fertilization takes place, the buyer ensures that implantation is not possible. With a copper IUD you maintain your own menstrual cycle.

There copper IUD is called the T-Safe. Below we describe some aspects of the T-safe. 

The form
The T-safe is a T-shaped IUD (just like the hormone IUDs, only a few millimeters larger). The legs expand after the IUD is in your uterus. That way it stays in place.

Pros and cons
The legs of the T-safe can possibly irritate your endometrium a little, causing abdominal pain and interim blood loss. You cannot regulate the timing of your period with an IUD yourself.

Operating time
T-safe: 10 years (you can always remove it earlier).

Costs
The T-safe costs €69,-  (excluding consultation costs).

Reliability
T-Safe is registrated for 99.8% reliability.

Side effects
During the first 3 to 6 months after insertion of the IUD, the bleeding may be heavier and accompanied by more abdominal pain than usual. After that, your natural cycle recovers, it becomes more regular/predictable. Some women keep a small increase in blood loss with their periods.
Some women experience lower abdominal/back pain. In rare cases, the IUD is expelled from the uterus or is incorrectly placed.


Do you notice after 3-6 months that you suffer from side effects of the IUD. Please contact us.

Advice on use
Tampons: You can safely use tampons if you have had an IUD placed. Do not use a tampon until a few days after insertion of your IUD and preferably not at night during the first menstrual period. You don't have to worry about pulling out the IUD when you remove a tampon, it is safely in the uterus.
Menstrual cup: Little research has been done on the use of a menstrual cup by women with an IUD. The literature shows that the use of a menstrual cup may lead to an increased risk of expulsion of the IUD. If you do want to use a menstrual cup, do not use it until 3 months after insertion of your IUD, because the risk of expulsion is greatest during the first few months. Then very carefully break the vacuum before removing the cup. Be careful not to accidentally pull the wires of the IUD when removing the cup and check that the IUD is not in your cup.

Feel monthly if you can feel the threads of the spiral. That way you know it's in place.

Hormone IUD
The IUD gradually releases a small amount of hormones and causes the mucus in the cervix to become 'tougher', making it more difficult for sperm cells to pass through. The release of the hormone Levonorgestrel in the uterus slows down the sperm cells.
The hormonal IUD can suppress ovulation. If no egg is released, fertilization cannot take place. If it does come to fertilization, it cannot implant because the endometrium is not built up. Because the endometrium is hardly built up, some women with a hormonal IUD have little or no periods.

There are two types of hormonal IUDs, namely the Mirena and Kyleena. Below we describe some similarities and differences of these two spirals.

The form
The Mirena and Kyleena are both a T-shaped IUD. The legs expand after the IUD is in your uterus. That way it stays in place.
The Kyleena is slightly smaller than the Mirena (this is a 4 millimeter difference). Therefore, a Kyleena might be a better option if you've never been pregnant.
The Kyleena releases slightly less hormone than the Mirena (Kyleena 0.009 mg per day, Mirena 0.012 mg per day). This is both a very low dose that is therefore continuously released gradually.

Pros and cons
A hormonal IUD may be a suitable method if you normally have heavy periods. Many women have less blood loss during menstruation with a hormonal IUD (Mirena 57%, Kyleena 26%) or even no blood loss at all (Mirena 16%, Kyleena 12%).
NB! Some women notice no difference in their menstrual pattern or have more breakthrough bleeding.
You cannot regulate the timing of your period yourself.

Operating time
The Mirena coil can remain in place for 6 years, the Kyleena for 5 years (you can always remove it earlier).

Costs
Both spirals cost approximately €140 (excluding costs for installation).

Reliability
Is equal in both and very high, namely 99%.

Side effects
The first months (up to 1 year) after placement there may be an unpredictable bleeding pattern: from much to little blood loss, possibly with abdominal and back pain.
The most common side effects in >10% of women are: headache, abdominal pain, (youth) pimples/oily skin, altered menstrual pattern and breakthrough bleeding.
Less often we see in 1-10% of women: gloomy mood/depression, decreased sex drive, migraine, nausea, hair loss, sore/tender breasts, more vaginal discharge, inflammation of the labia and vagina or weight gain.


Do you notice after 6 months that you suffer from side effects of the IUD. Please contact us.

Advice on use
Tampons: You can safely use tampons if you have had an IUD placed. Do not use a tampon until a few days after insertion of your IUD and preferably not at night during the first menstrual period. You do not have to worry that you will pull out the IUD when you remove a tampon, it is safely in the uterus.
Menstrual cup: Little research has been done on the use of a menstrual cup by women with an IUD. The literature shows that the use of a menstrual cup may lead to an increased risk of expulsion of the IUD. If you do want to use a menstrual cup, do not use it until 3 months after insertion of your IUD, because the risk of expulsion is greatest during the first few months. Then very carefully break the vacuum before removing the cup. Be careful not to accidentally pull the wires of the IUD when removing the cup and check that the IUD is not in your cup.

Feel monthly if you can feel the threads of the IUD. That way you know it's in place.

Placement of a IUD
Make an appointment
You can discuss with us which IUD you want by telephone or during an appointment. Once you have made a choice, we will schedule an appointment for the placement of the coil and send a prescription to your pharmacy. You can then collect your IUD from the pharmacy prior to the placement and bring it with you to the appointment with us.

When to post
We can place an IUD from 10 weeks after delivery. The cervix and uterus are then fully restored. It does not matter whether you have your period during the placement.
It is important to make sure that you are not pregnant and do not have an STD (Sexually Transmitted Disease). So test this beforehand if you are not sure.

How does it work?
Insertion of an IUD is generally simple and quite fast. The actual installation takes about 5 to 10 minutes. We plan plenty of time so that we can explain everything to you calmly and take the time to make the placement as pleasant as possible.
We assess the position of your uterus by means of an internal ultrasound. This makes installation easier. A speculum is then inserted into the vagina to get a good view of the cervix. To check whether the uterus is suitable for the IUD, the length of the uterus is measured with a probe (a thin rod). After this, the IUD can be inserted into the uterus via the introducer sheath and the wires are cut to the correct length. Finally, an internal ultrasound is used to assess whether the IUD is in the right place in the uterus.

The placement can give a nagging feeling in the lower abdomen. In some cases, placing an IUD is experienced as painful. When one hour before placement two 500mg paracetamol or one 400mg ibuprofen is taken it will reduce the pain. It is normal for abdominal cramps or a nagging feeling in the lower abdomen after the placement the IUD.

Follow-up
6 weeks after insertion of an IUD or after the next menstrual period, we offer the possibility to check with an internal ultrasound whether the IUD is still in the right place.
The costs for this consultation cannot be submitted directly to the health insurer.

Removing the IUD
You can also contact us for the removal and, if necessary, immediate installation of a new IUD.
You are fertile again immediately after removing an IUD.

Cost
Placement/removal of the IUD: €64.66 (this includes ultrasound before placement and immediately after for check-up). We can declare the costs of placing or removing an IUD directly from your health insurer, depending on your policy, these costs will be reimbursed.

Whether the IUD itself is also reimbursed depends on your health insurance. Sometimes this is reimbursed or deducted from your deductible.
So check this beforehand.
  • Mirena coil: about €140.00
  • Kyleena coil: about €140.00
  • T-Safe: €69.00
Extra check-up ultrasound after placement in connection with your own wishes (not related to the placement): €30.00 (this ultrasound cannot be submitted directly to the health insurer).
Ultrasound check after placement elsewhere (e.g. at the GP): €35.00
If for some reason it is not possible to place the IUD, we will charge €20.00 for the scheduled time.



More information?

IUD's general information: www.spiraalplaatsen.nl
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