Cost and Procedures of an IUD in Singapore

Cost and Procedures of an IUD in Singapore

Reviewed by Dr Bosty Chan, MBChB, MRCS

An intrauterine device (IUD) is a popular method of long-acting contraception used by an average of 23% of female contraceptive users worldwide. It is a small, T-shaped device made of plastic that is inserted into the uterus to prevent pregnancy.

Although an IUD is merely the size of a paper clip, they can last up to 5 years and only require a one-time procedure starting from $150. 

That is why IUDs are probably the most effective contraception method other than surgical sterilization or avoiding sex.

Benefits of an IUD

There are multiple benefits of IUD use in women including:

  • Most effective non-surgical option for pregnancy prevention

(>99% – as effective as surgical sterilisation)

  • No need for regular maintenance to keep its high effectiveness

(no need for daily/weekly/monthly reminders)

  • Long-acting

(depending on IUD type, they can last up to 5 years)

  • Cost-effective with long-term use

(an upfront cost is required, but there are no costs beyond that for a few years)

  •  Rapidly reversible

      (quick return of fertility upon removal of IUD)

  • Private, does not interfere with the spontaneity of sex

(no need for pre-sex prep)

  • Possible to avoid exposure to hormones, minimising side effects

(there is no interference of hormones with the use of copper IUD)

  • Reduce risk of cervical, endometrial and ovarian cancers

How does an IUD work to prevent pregnancy?

When an IUD is inserted into the uterus, the body recognizes it as a foreign object. This triggers a reaction in a body that is toxic to the sperm, creating an environment that makes it difficult for the sperm to reach the egg. This prevents fertilisation and implantation from happening. 

Types of IUDs in Singapore and the costs involved

There are two types of IUDs available in Singapore, copper containing and levonorgestrel releasing:

Copper-containing IUDs

The copper-containing IUDs are commonly referred to as the non-hormonal IUDs. The IUD is wrapped in copper coil; this introduces copper ions in the uterus, providing further contraceptive benefits. Copper ions are found to be fearsome sperm killers.   

The copper IUDs registered in Singapore since 2005 and 2010, respectively, are Nova T® by Bayer (South East Asia) and Multilan AG Multiload cu250 and cu375 by MSD Pharma Singapore. 

In the United States, ParaGard is the only brand of copper IUD approved by the FDA.

Copper IUDs can be inserted for emergency contraception for at least five days (120 hours) from un-protected or under-protected sex. It is also the most effective option with the lowest pregnancy rate (<0.1%). It can then be left in place to provide ongoing contraception.

Costs of Copper-containing IUDs

Good news is copper IUDs are available through polyclinics in Singapore that offer women’s health services. 

It can cost around $150-$300. 

For cases that are more complex requiring specialised women’s services, it can also be done at public hospitals like KKH and NUH but it will cost more. You can also check with your private clinic if they offer this service and the cost involved as it varies per clinic.

Levonorgestrel-releasing IUDs

The levonorgestrel-releasing IUDs are commonly referred to as the hormonal IUDs. Levonorgestrel is a type of progestin. You may find it familiar as it is the progestin hormone found in the birth control pill Microgynon and the morning after pill Postinor 2.

Levonorgestrel provides additional contraceptive benefits. It keeps the mucus in the cervix thick, making it harder for sperm to move to meet the egg. It also keeps the lining of the uterus thin, making it difficult for a fertilised egg to continue to develop in the body. Hormonal IUDs release much smaller doses of hormones compared to oral contraceptive pills, minimising hormonal side effects.

The levonorgestrel-releasing IUD registered in Singapore since 1994 is Mirena® by Bayer (South East Asia). 

Mirena® is registered for use as a contraception device. It is also registered for use in the treatment of heavy menstrual bleeding and for protection from endometrial hyperplasia during estrogen replacement therapy.

Costs involved Levonorgestrel-releasing IUDs

Generally hormonal IUDs cost more as they are not offered in the polyclinics in Singapore. It cost around $600 for the whole procedure and consultation at the public hospitals like KKH and NUH. You can also check with your private clinic if they offer this service and the cost involved as it varies per clinic.

How is an IUD inserted?

Your doctor will perform a vaginal examination to determine the size of your uterus and the correct size of IUD to use. You may also be tested for sexually transmitted diseases (STDs).  The IUD will then be inserted using an introducer and the procedure usually takes about 5 minutes.

The IUD is best inserted towards the end of menstrual flow because it is at this time that you are unlikely to be pregnant. The neck of the womb (the cervix), is also softer and opens slightly, allowing for an easier insertion.

People usually feel some cramping or pain when they are getting their IUD inserted. The pain can be worse for some, but (thankfully!) it only lasts for a minute or two. How much discomfort you feel depends on factors like your individual pain tolerance, the length of your cervical canal or whether you have previously delivered a baby vaginally.

Many find the insertion process more uncomfortable than painful and they describe feeling a quick pinching sensation during insertion. Always speak to your doctor if you are concerned about pain or feeling anxious. They can usually prescribe medication such as painkillers in advance.

What can I expect after an IUD insertion procedure?

Temporary pains

Many people feel perfectly fine right after the procedure, while others need to take it easy for a while.  There may be some cramping and backaches, so it is a good idea to chill at home after your appointment – it’s a great excuse to curl up on the couch with your favourite book or Netflix. Heating pads and painkillers can help with the cramps as well.

You may have cramping and spotting after the procedure, but this almost always goes away within 3-6 months. Hormonal IUDs eventually make menstrual flow lighter and improves menstrual cramps. You might even stop getting a period at all.

Unlike the hormonal IUDs, copper IUDs may make menstrual flow heavier and cramps worse. For some, this may go away over time. If your IUD is causing you pain, discomfort or side effects you do not like, always speak to your doctor.

A mysterious string?

Once an IUD is inserted, a string about 1 or 2 inches long will come out of your cervix and into the top of your vagina. 

Over time, the string becomes softer and less noticeable. The string is there so a nurse or doctor can remove the IUD later. 

You can feel the string by putting your fingers in your vagina and reaching up towards your cervix. 

But don’t tug on the string, because you could move your IUD out of place or pull it out.

What if my IUD slips out of place?

There is a very small chance that your IUD could slip out of place. 

It can happen any time, but it is more common during the first 3 months after insertion. IUDs are most likely to come out during your period.

Check your menstrual pads, tampons or cups to see if it fell out. 

You can also check your string to make sure it is still there. 

If your IUD falls out, you are not protected from pregnancy, so make sure to go see your doctor and use condoms or another kind of birth control in the meantime.

Remember when you got your IUD (write it down somewhere), so you’ll know when it needs to be replaced.

It is important that you see your doctor for regular check-ups after the IUD has been inserted. Depending on the type of IUD inserted, your doctor will advise you on the frequency of check-ups and when it needs to be replaced.

Summary

In summary, there are two types of IUDs with these key differences that you will experience when you want an IUD in Singapore.

CopperHormonal
CostsCheaper, $150-$300More expensive, ~$600
AvailabilityNova T®, Multilan AG Multiload cu250 and cu375Mirena®
ProvidersPolyclinic, hospitals, private clinicNot in polyclinics. Only hospital and private clinics
Emergency contraceptive?Yes, within 120 hoursNo
Side effectsHeavier flow, worse cramps (normally up to the first 6 months of use)Lighter flow, improves cramps

Not ready for IUDs? What are my alternatives?

If you are not ready for an invasive and semi-permanent IUD, there are options that will give you more flexibility such as birth control pills or birth control patches.

They can be taken on a daily basis, and should you want to stop them, you are always in control. Whereas with an IUD, you need to see a doctor to remove it.

Although the running cost of regular birth control medications are higher, it provides more freedom, especially if you might be planning to start a family in the near future, or if you are still exploring the various options such as oral contraceptives.

At Dame, we believe in choice. We carry the largest selection of birth control methods that can be readily accessed through our online platform. 

With just a few clicks, you can get a professional consult with our experts, and the medications can be shipped discreetly to you.

There is even an option for subscription, if you are looking to commit to something regular and fuss free.


At Dame, we believe in choice. We carry the largest selection of birth control methods that can be readily access through our online platform. With just a few clicks, you can get a professional consult with our experts, and the medications can be shipped discreetly to you.

There is even an option for subscription, if you are looking to commit to something regular and fuss free.


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