5 Questions to Ask Your Doctor Before Choosing an IUD

When it comes to birth control, there’s no one-size-fits-all, especially with intrauterine devices (IUDs). Many women face conflicting advice, and cultural hesitations when considering their options.

An IUD can be convenient, reliable, and long-lasting, and asking the right questions before deciding can prevent discomfort or complications.

Here we will discusse the five (5) key areas to discuss with your doctor, blending medical insight with practical considerations around health, lifestyle, and cost in Singapore’s unique healthcare landscape.

1. Why Asking the Right Questions Matters

Too often, women walk into gynaecology appointments feeling rushed, uncertain, or worse — dismissed. But contraceptive care isn’t just clinical. It’s deeply personal, and asking the right questions isn’t just encouraged — it’s essential.

From Passive Patient to Active Participant

In Singapore, while access to contraception is generally good, many women still feel hesitant to speak up. A 2023 study by the Association of Women for Action and Research (AWARE) found that over 40% of women felt under-informed about their contraceptive options after seeing a healthcare provider.

This isn’t always a reflection of poor care. Sometimes, it’s a mismatch between what the doctor assumes you know and what you actually need clarified. By coming prepared with thoughtful, relevant questions, you’re shifting from being a passive recipient to an active participant in your own healthcare — and that shift can significantly change outcomes.

Avoiding the ‘Regret Gap’

A common theme in women’s health is the “regret gap” — the difference between what women wish they had known and what they were told. In the case of IUDs, this often revolves around side effects, pain during insertion, or misconceptions about fertility.

Here’s where the right questions serve as your filter. They help you:

Without Questions	With the Right Questions
Assume the IUD is painless and reversible	Understand the pain spectrum and how removal works
Choose based on a friend’s experience	Choose based on your medical history and lifestyle
Accept a default recommendation	Weigh up options tailored to your body and priorities

This clarity is especially important when considering something that may stay in your body for 3 to 10 years.

A Quick Litmus Test

Before we move on: If your doctor seems uncomfortable when you ask questions — especially about risks, alternatives, or personal suitability — that’s a red flag. The right provider welcomes dialogue, not just compliance.

2. Understanding the Types of IUDs

Before choosing an IUD, it’s important to know that not all IUDs are created equal. In Singapore, there are two main categories available: hormonal and non-hormonal. Each functions differently, suits different needs, and comes with its own set of pros and cons.

Let’s break it down:

Hormonal IUDs (e.g. Mirena, Kyleena, Jaydess)

These IUDs release a low dose of levonorgestrel, a synthetic hormone similar to progesterone. They work by thickening cervical mucus, thinning the uterine lining, and sometimes suppressing ovulation.

Brand	Effective Duration	Typical Use Case
Mirena	Up to 5 years	Heavier periods, endometriosis, birth control
Kyleena	Up to 5 years	Long-term contraception with lower hormone dose
Jaydess	Up to 3 years	First-timers, those wanting a smaller size, fewer years

Pros:

• Lighter or no periods over time
• Can reduce menstrual cramps
• Very high effectiveness (over 99%)
• Reversible at any time

Cons:

• Hormonal side effects (e.g. mood changes, acne, breast tenderness)
• Irregular bleeding in the first 3–6 months
• Slight risk of ovarian cysts

Non-Hormonal IUDs (e.g. Copper T)

These IUDs use copper, a natural spermicide, to prevent fertilisation. They don’t release hormones and are favoured by those who prefer natural, hormone-free contraception.

Brand	Effective Duration	Typical Use Case
Copper T 380A	Up to 10 years	Long-term birth control without hormones

Pros:

• No hormonal side effects
• Extremely long-lasting (up to 10 years)
• Fertility returns immediately after removal

Cons:

• Heavier periods and stronger cramps (especially in first few months)
• Risk of copper allergy (rare)
• Insertion discomfort may be more pronounced

Which One Is Right for You?

This depends on several factors — your menstrual patterns, sensitivity to hormones, plans for children, and comfort with side effects. This is why asking detailed questions is essential. For example:

• “Will the hormonal IUD affect my acne or mood?”
• “Is the copper IUD safe if I already have heavy periods?”
• “How quickly can I get pregnant after removal?”

Local Availability in Singapore

Most IUD brands like Mirena and Jaydess are available through gynaecology clinics and public hospitals. The Copper T may be less discussed but still accessible — typically requiring a specific request.

⚠️ Note: IUDs are not stocked at most general practitioners (GPs) in Singapore and require a referral or direct appointment with a women’s health specialist.

3. Health Considerations

An IUD might seem like a convenient “set-it-and-forget-it” contraceptive, but your individual health profile can significantly influence whether it’s the right choice — or even a safe one.

This is where the real nuance lies: the same IUD that works brilliantly for one woman can be entirely unsuitable for another, based on factors that often go undiscussed in quick consultations.

Key Medical Factors to Discuss with Your Doctor

Before choosing an IUD, raise these essential health questions:

1. Do I have any underlying conditions that affect suitability?
   • Conditions like endometriosis, fibroids, or pelvic inflammatory disease (PID) may limit or guide the choice of IUD.
   • Women with autoimmune conditions or prone to infections should be cautious, especially with non-hormonal IUDs.
2. What are the risks of infection or expulsion for my body?
   • The IUD insertion process comes with a small risk of infection (usually within the first 20 days).
   • Uterine shape, size, or previous surgeries may increase the chance of expulsion — when the IUD shifts or is pushed out.
3. Will the IUD interact with any medication I’m taking?
   • While uncommon, some immunosuppressive or anti-inflammatory drugs may affect how your body tolerates the device.
   • Always disclose any ongoing medications, even for unrelated conditions.
4. Is it safe for women who have never been pregnant?
   • Yes, but certain types (like Jaydess or Kyleena) may be more suitable due to their smaller size and lower hormone dose.
   • However, insertion may be more painful, and you’ll want to discuss pain management strategies.

Risk Snapshot: Hormonal vs. Non-Hormonal IUDs

Risk Category	Hormonal IUD	Copper IUD
Risk of infection (early)	Low	Low
Risk of perforation	<1 in 1,000 insertions	<1 in 1,000 insertions
Affects on periods	Lighter periods	Heavier periods
Hormone-related side effects	Possible	None

“One of the biggest mistakes I see is women assuming IUDs are universally safe,” shares Dr Nur Ashikin, a private gynaecologist in Singapore. “They’re generally low-risk, but only if matched properly to the patient’s body and history.”

Don’t Skip STI Screening

It’s recommended that sexually active women, especially those with new or multiple partners, screen for STIs before IUD insertion. An untreated infection like chlamydia can lead to complications if an IUD is inserted while it’s active.

What About Fertility Later?

Contrary to outdated myths, IUDs do not cause infertility. Fertility typically returns within one menstrual cycle after removal. The real risk lies in pre-existing or undiagnosed infections, not the IUD itself.

4. Suitability and Lifestyle Fit

Even with a clean bill of health and medical clearance, the best IUD for you hinges on one thing: your lifestyle. An IUD is a long-term commitment — and like any relationship, compatibility matters.

This is often the most overlooked part of the decision-making process. But the questions you ask here will determine whether your IUD experience feels like liberation… or regret.

Key Lifestyle Considerations to Discuss

1. How comfortable am I with the idea of a long-term device?
   • IUDs can last 3 to 10 years. If you’re planning pregnancy soon or feel anxious about having something inside your body, another method may be more suitable.
2. Can I tolerate irregular spotting or changes to my cycle?
   • Hormonal IUDs may cause light or missed periods. Some women love this. Others find it emotionally unsettling.
   • Copper IUDs may increase bleeding — difficult for women with physically demanding jobs or active routines.
3. How do I feel about potential discomfort during sex?
   • While rare, some partners report feeling the IUD strings during intercourse. Adjusting or trimming the strings can usually fix this.
4. What is my tolerance for pain and downtime?
   • Insertion can be uncomfortable — especially for women who haven’t given birth. If your pain threshold is low, discuss pain relief options: local anaesthetic, sedation, or pre-medication.
5. Will I remember to check my IUD strings?
   • You’re typically advised to check the strings monthly to ensure the IUD hasn’t shifted. If this feels like a chore you’ll forget, speak to your doctor about other monitoring strategies.

Lifestyle Fit Quiz: Are You IUD-Ready?

Question	Yes	No
I want low-maintenance, long-term contraception	✅
I’m okay with potential changes in my periods	✅
I have access to a gynaecologist if needed	✅
I’m not planning pregnancy in the near future	✅
I can tolerate mild discomfort or cramping	✅

If you ticked Yes to most: An IUD could be a great fit.
If you ticked No more than twice: You may want to explore other options.

Consider Your Stage of Life

• Young professionals may appreciate a low-maintenance IUD but need reassurance about reversibility.
• Mothers may prefer hormonal IUDs to manage heavy periods post-birth.
• Perimenopausal women may find IUDs helpful in regulating erratic bleeding as they approach menopause.

5. Cost and Accessibility in Singapore

While IUDs are one of the most cost-effective forms of birth control over time, the upfront costs and accessibility pathways in Singapore can vary widely depending on where and how you get it done.

This is one of the most practical — and often overlooked — conversations to have with your doctor.

How Much Does an IUD Cost in Singapore?

Here’s a breakdown of typical costs across different healthcare settings:

Healthcare Setting	Estimated Total Cost (IUD + Insertion)	Notes
Public hospitals (e.g. KKH, NUH)	S$150 – S$300	With referral; prices subsidised for Singaporeans/PRs
Private gynaecology clinics	S$500 – S$1,000+	Higher cost, faster access, more brand options
GP clinics (with referral)	Varies	GPs generally do not insert IUDs, but may refer you

Note: Prices can vary depending on whether you’re opting for a hormonal or non-hormonal device, and whether anaesthesia or medication is required.

Is It Medisave-Claimable?

In some cases — particularly when an IUD is inserted for medical reasons (e.g. to manage heavy menstrual bleeding or endometriosis) — you may be able to use Medisave under the Day Surgery scheme. However, IUDs for contraception alone are usually not covered.

Ask your doctor:

• “Can this be considered a medically indicated procedure?”
• “What paperwork do I need for Medisave claims?”

Public vs. Private: Which Route Makes Sense?

Criteria	Public Sector	Private Clinics
Cost	Lower with subsidy	Higher out-of-pocket
Waiting time	2–6 weeks for appointment	Often within a few days
Brand options	Fewer (mostly Mirena or Copper T)	Wider (Mirena, Kyleena, Jaydess, others)
Continuity of care	Varies depending on referral system	Higher consistency with one specialist

If speed, privacy, and brand choice matter most — private clinics offer greater convenience. If affordability and public support are priorities, public hospitals are reliable and safe.

Accessing IUDs in Singapore: Step-by-Step

1. Book a consultation – This is mandatory. No doctor will insert an IUD without discussing suitability first.
2. Undergo relevant tests – STI screening or pelvic exam may be required.
3. Schedule the procedure – Insertion may be same-day or scheduled later, depending on your cycle.
4. Post-insertion follow-up – You may need a check-up within 6 weeks to ensure placement.

Conclusion: Choosing with Confidence

An IUD is more than a medical choice — it’s a personal decision shaped by your body, lifestyle, and future plans. The five areas we’ve explored — the right questions, types, health, lifestyle fit, and cost — form the foundation of an informed choice.

In Singapore’s healthcare setting, owning your reproductive health starts with knowledge and open dialogue with your doctor.

Questions Worth Asking

• Can we discuss both hormonal and non-hormonal options?
• What side effects are most likely for me?
• How will this affect my periods, mood, or skin?
• What does follow-up care involve?
• What are the full costs?

These questions protect not just your health, but your peace of mind. The “right” IUD is the one that works for you — and your doctor should help you find it, not decide it for you.