Resources

Counselling patients

Straight to the point: Talking IUC

Simple steps from INTRA to successfully counsel women about intrauterine contraception (IUC) in under 7 minutes.

Aims of this section:

Guide six-step discussion with women to help them reach an informed decision where IUC is actively considered as a contraceptive option
Increase the number of HCPs proactively integrating IUC as part of routine contraceptive care in a way that women can easily understand
Demonstrate (video) it is possible to have a simple, short, & very effective counselling session about IUC in under 7 minutes

The global INTRA group is a panel of independent physicians with an expert interest in intrauterine contraception.*

^{* Formation of the INTRA group and its ongoing work is supported by Bayer Healthcare}

An introduction to INTRA

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.

Step by Step Guide:

45 seconds

Step 1: Establish her contraceptive needs

In this step, HCPs should:

Understand what a woman wants from her contraception
Discover what previous methods of contraception she has used including the pros and cons
Establish her goals in the coming years

Step 1 - Starting the conversation

To establish a women’s contraceptive needs:

Form questions that match a woman’s goals and needs, for example:

Understand her experience of different methods:

30 seconds

Step 2: Introduce long-acting reversible contraception (LARC)

In this step, HCPs should:

Use a women’s contraceptive needs to link to LARC (if appropriate)
Introduce IUC as a method of LARC
Increase a woman’s awareness and knowledge of LARC
Bear in mind that a woman’s contraceptive needs change through her life – LARC may be an option in the future if it isn’t right now

Step 2 - Linking to LARC

Encourage HCPs to continue to ask a woman about her contraception as her needs change throughout her reproductive life
Use simple linking phrases to increase awareness and knowledge about LARC using her established contraceptive needs:

Step 2 - Introducing IUC

Once interest in a long-acting method of contraception is confirmed, introduce IUC as a potential method:

90 seconds

Step 3: Communicate the potential benefits of IUC

In this step, HCPs should:

Discuss the potential benefits of IUC, linking back to her contraceptive needs
Use extra time to compare benefits to other methods
Discuss non-contraceptive benefits of some IUC methods

Step 3 - Discussing the benefits of IUC

Discuss the key potential benefits of IUC with the woman:
- Highly effective
- Cost-effective
- No need for daily, weekly or monthly administration
- Potential non contraceptive benefits
- Rapidly reversible
- Inserted quickly
Supporting information is provided for HCPs
This step includes discussion points for extra time

Step 3 - Extra time?

In certain cases, you may find that you have a little more time available with your patient. If so, consider discussing:

90 seconds

Step 4: Provide reassurance and address her concerns

In this step, HCPs should:

Build clinical knowledge to dispel common misperceptions around IUC
Feel confident in addressing these with a woman to reassure her
Put risks and side effects into perspective in relation to other methods and pregnancy itself

Step 4 - Background Reading - Common barriers and myths

Many HCPs have misconceptions about IUC which results in them not proactively discussing or offering it as part of their contraceptive discussion
To dispel many of the common barriers and myths, the Global INTRA Group have developed a review paper published in EJC.

Further barriers the use of IUC covered in this review paper include:

Step 4 - Addressing ‘user’ barriers

Women also have a number of misconceptions about IUC which may need to be addressed within a consultation:

Step 4 - Putting risks and side-effects into perspective

Any method of contraception has risks and side effects. Helping a woman make an informed choice about IUC involves an appropriate discussion of these, using your clinical knowledge and experience.

For example:

Risk of ectopic pregnancy
Perforation
Expulsion
Infection
Changes to her monthly bleeding pattern

Step 4 - Extra time?

If possible, this theme can be expanded upon by discussing the CHOICE study:

60 seconds

Step 5: Help her decide

In this step, HCPs should:

Use clinical experience to support a woman in deciding whether to use IUC – referring back to her initial contraceptive needs
Address any further concerns a woman may have openly and honestly
Offer personal experience

Step 5 - Use clinical experience and be honest when addressing concerns

Share your knowledge and clinical experience to support her decision to use IUC
Bear in mind that IUC won’t be the right choice for every woman

Include risks and potential side effects into your counselling

Step 4 - Addressing ‘user’ barriers

If pertinent, personal disclosure has been found to be useful at this time:

60 seconds

Step 6: Confirm her choice and schedule placement (if choice was IUC)

In this step, HCPs should:

Offer guidance to confirm a woman’s choice of IUC
Explain that insertion can take place within 7 days of the onset of menstruation. This is to ensure she is not pregnant.
Answer any final questions
Run through final formalities ahead of insertion

Step 6 - Provide reassurance

Offer guidance to confirm a woman’s choice of IUC including:

Step 6 - Ahead of insertion

Before proceeding with IUC insertion, ensure that:

Effective IUC counselling – video demonstration

These videos demonstrate that it is possible to have a simple, short, & very effective counselling session about IUC in under 7 minutes.

Downloads

Counselling Booklet

16 page, A5 booklet entitled ‘Straight to the Point: Talking IUC’

Aim:

to assist HCPs when counselling women about IUC in under 7 minutes

Guides HCPs through a simple, brief, six step discussion
Developed by the Global INTRA Group, the contents reflect the evidence-based opinion of its members

Download

Counselling Checklist

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

Download

Which-IUS-to-Prescribe-DigitalVersion-image

IUS Counselling

To support contraceptive counselling on the IUS, the Bayer women’s health team have developed the Which IUS to Prescribe guide.

Which IUS to Prescribe:

This guide includes a flowchart which will gives guidance on which IUS - Kyleena®, Mirena® or Jaydess®▼ - best meets your patients needs.

Download

Patient Materials

Useful, downloadable resources.

PP-PF-WHC-IE-0944-1, February 2026

Contraception research among consumers

Explore the voice of the patient through comprehensive insights on contraception research among consumers.

PP-PF-WHC-IE-0937-1, February 2026

Inserter Resources

Step-by-step instructions to guide you through the preparation and insertion of IUS.

PP-PF-WHC-IE-0935-1, February 2026

PP-PF-WHC-IE-0936-1 | February 2026

References

1
Merki-Feld GS et al. Eur J Contracept Reprod Health Care. 2018:183-193.
2
Trussell J. Contraceptive failure in the United States. Contraception 2011;83:397−404.
3
NHS. Intrauterine system (IUS) - Your contraception guide [online]. Updated 22 February 2018. Available from: https://www.nhs.uk/conditions/contraception/ius-intrauterine-system/ [Last accessed: November 2019].
4
NICE clinical guideline [CG30]. Long-acting reversible contraception [online]. Updated July 2019. Available from: https://www.nice.org.uk/guidance/cg30 [Last accessed: September 2019].
5
Brant AR. Curr Obstet Gynecol Rep (2017) 6:109–117
6
Carr BR, et al. Return of fertility in nulliparous and parous women after levonorgestrel 52 mg intrauterine system discontinuation [ASRM abstract O-104]. Fertil Steril. 2018;110(45 suppl):e46.
7
Buhling KJ. The European Journal of Contraception and Reproductive Health Care, 2014; 19: 448–456
8
Brockmeyer A, et al. Experience of IUD/IUS insertions and clinical performance in nulliparous women–a pilot study. Eur J Contracept Reprod Health Care. 2008 Sep;13(3):248-54. doi: 10.1080/02699200802253706.
9
Birgisson NE. J Womens Health (Larchmt). 2015 May 1; 24(5): 349–353.
10
PCWHF. 10 Top Tips for Intrauterine Contraception (IUC) [online]. Updated November 2019. Available from: https://pcwhf.co.uk/wp-content/uploads/2019/01/PCWHF-10-Tips-IUC.pdf.
11
Peipert J, et al. Obstet Gynecol, 2011;117:1105–13
12
Mirena® Product Monograph
13
Johnson BA. Insertion and removal of intrauterine devices, American Family Physician. January (2005).

Footnotes

a
Formation of the INTRA group and its ongoing work is supported by Bayer Healthcare