Dr Emma Boulton, CEO of Clinic 66, answers many of the frequently asked questions about the vaginal symptoms of menopause and how the MonaLisa Touch treatment may be able to help alleviate those symptoms

The choice is yours. If you have intravenous sedation, you will have a brief, light anaesthetic and have no recollection of the procedure. You will need someone to drive you home, as you can’t drive on the day of a sedation anaesthetic. Commonly, those who have an IUD insertion (or removal) with sedation are women who: Are nervous or tense about being examined or having cervical screening tests Are only recently or never sexually active Have had surgery to their cervix, such as a LLETZ procedure Have ONLY had elective Caesarean section deliveries (without labouring) Are approaching menopause Want an IUD removed, but the threads cannot be seen in the cervix If you DO opt for sedation, then you should: NOT eat any food during the 6 hours prior to your appointment Drink only water between 6 and 2 hours before your appointment Have nothing pass your lips in the 2 hours immediately before your appointment (this means no food or dring and includes smoking, lollies and chewing gum) An awake IUD insertion procedure takes about 5-10 minutes and there may be some discomfort. We advise that you take some simple pain relief (the same as what you would normally take for period pain) about 30 mins before the procedure. Awake IUD insertion can also be performed using local anaesthetic and/ or a Penthrox inhaler (green whistle). Please note that for women who have NEVER been sexually active, we do not offer IUD insertion as an awake procedure ( must be booked under IV sedation) The doctor who performs your insertion procedure will discuss what kind of anaesthesia might be necessary.

2 or 3 sanitary pads (light flow only) Some photo identification- a driver’s licence or passport Your Medicare card Warm, comfortable clothes and nothing that is too restrictive around the tummy A snack, or some food or drink for AFTER the procedure If you are travelling from more than 100km away, you should schedule yourself a telehealth consultation with one of our doctors prior to travelling, to ensure that you are suitable for an IUD procedure with us. We do not want to disappoint !

If you have a history of breast cancer, we will need a letter from your oncologist and/or breast surgeon to say that you are clear to have a hormonal IUD. If you have a history of uterine fistula or complex surgery to your uterus, an IUD may not be suitable (a previous Caesarean Section is fine). Large fibroids, unusual layout such as bicornuate uterus or any other problem which can distort the inside of your uterus (womb) might make the use of an IUD difficult. We will discuss your options with the report from a formal pelvic ultrasound. If you know you have an unusual uterus, please make an appointment to discuss your options PRIOR to booking in for your procedure. (We dont want you to waste your time by accepting your booking and then us not being able to help you) A pregnancy must be excluded before using an IUD, and that is why we like you to come in for an IUD insertion within 7 days of the start of your menstrual period. In that way, we know that you are not likely to be pregnant. However, if you do not get regular periods, you can still have an IUD inserted but the timing needs to be discussed with one of our doctors or nurses.

If you have heavy periods are any abnormal bleeding (such as bleeding in between your periods), we need you to have a good quality Day 5-9 formal transvaginal pelvic ultrasound scan to make sure that there are no underlying problems. If needed, we can refer you for a pelvic ultrasound scan. Women in their forties who have heavy periods are likely to need to have a Pipelle endometrial biopsy, and there is an additional charge for this procedure. If you have had a termination of pregnancy (medical or surgical), and you haven’t yet had a period after the procedure and you wish to have an IUD inserted, you should have a pelvic ultrasound performed. Please send us the report prior to booking in for your IUD insertion.

Removal of an IUD is usually quite straightforward, and can be done in the consulting rooms by a doctor who has experience at removing an IUD. If the IUD strings are not able to be found in the cervix, and you want to have your IUD removed, we need an ultrasound scan before we attempt to remove the IUD to ensure that the device is still in the uterus (womb). Please dont have unprotected sex for one week prior to the IUD removal or replacement, as sperm can hang around and its possible you could get pregnant once the IUD is removed, even from sperm which have been in the body for a few days.

Please do not have condomless sex one week prior to the replacement OR removal of an IUD (as sperm can hang around, and this can result in an unintended pregnancy).

You do need to have a consultation prior to having your IUD inserted, which can be done with your own doctor, or one of our doctors or clinical nurse specialists. This pre-insertion consultation is important, as the timing of insertion, the type of device and anaesthetic options all need to be discussed. If you dont want to come into the clinic, you can have a consultation with one of our Telehealth doctors. Please make a booking at clinic66online.com.au