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''Copper coil - IUD''
primary prevents fertilisation, also prevents implantation - esp as EC
380 mm2 - lasts 10yrs
failure <2% at 5yrs, - for EC 99.9% effective
1 in 20 get expelled usually in first 3/12
<1% risk of infection in first 21 days - then same as background
bleeding heavily main issue
perforation - 2/1000 - esp if inserted within 6/12 postpartum, breast feeding, amenorrhoea, uss/xray to check location and then wait 6/52 before retrying

''Mirena - IUS''
25% prevents ovulation, primary - prevents endometrial proliferation and thickens cervical mucus
failure <1% in 5yrs
many women are amenorrhoiec by 3-6/12, 90% reduction in menstrual loss by 1yr
irreg bleeding in 1st 6/12
hormonal effects (breast tenderness, acne, wt gain) and ovarian cysts - are same as for IUD
infection, expulsion and perforation - same as IUD

''Removal''
7 days no sex
1 if >50 2 if <50 yrs after lst period if IUD after 2 high FSH 6/52 apart if IUS