Consultations are generally offered in French: please confirm with the clinic (579 305-0344). The French version of this site prevails. Translation under professional review.
Sexual and reproductive health · Saint‑HyacintheNP consultation
Effective, reversible contraceptive methods that require little maintenance.
Long-acting contraception includes methods designed to prevent pregnancy for several years without needing to be taken daily.
These methods are reversible: they can be removed when a pregnancy is desired or when a person wants to change contraceptive methods.
At the Clinique IPS du Palais, we offer assessment, insertion, removal and follow-up for various long-acting contraceptive methods.
The benefits
Once in place, these methods mean you don’t have to think about your contraception every day.
According to the Protocole de contraception du Québec (Quebec contraception protocol), the most effective contraceptive methods include the IUD and the implant.1
Who is it for?
The choice, however, depends on each person’s preferences, health status and goals.
These methods may be suitable, for example, for people who:
The IUD
An IUD, short for intrauterine device, is a small device placed inside the uterus. There are two main categories:
The hormonal IUD gradually releases a progestin directly into the uterus. Depending on the device used, it can provide contraception for several years.
It can also change menstrual periods. For some people, periods become:
The effect varies depending on the person and the device used.
The copper IUD is a hormone-free option. Copper creates an environment that is unfavourable to sperm and thus helps prevent fertilization. It also provides long-lasting contraception.
Unlike the hormonal IUD, in some people it can cause:
Emergency contraception: the copper IUD can also be used in certain circumstances after unprotected or inadequately protected sex. The Protocole de contraception du Québec describes it as a very effective option up to 7 days after intercourse.3
Compare
No single IUD is automatically better.
A person who already has very heavy or painful periods might, for example, have different needs from a person who absolutely wants to avoid hormonal contraception.
The decision is therefore personalized.
The choice depends, among other things, on:
Your appointment
The NP checks, among other things, your medical history, your medications, your current contraceptive method, the possibility of pregnancy, certain gynecological symptoms, possible contraindications and the type of IUD being considered.
The procedure is explained and questions can be discussed before proceeding.
A speculum is used to view the cervix. The device is then inserted into the uterus using the system designed for this purpose.
The IUD strings are trimmed so that they remain accessible at the cervix. Recommendations are given on expected symptoms and what to watch for.
After insertion
The sensation varies greatly from one person to another. Some mainly feel pressure or cramps, while others may feel more significant pain for a short time.
Cramps may also persist after insertion. The professional can discuss with you measures that may improve your comfort.
Some people may temporarily experience:
The pattern often changes over the first few months and depends on the type of IUD used.
A consultation can be done to have your IUD checked or to assess symptoms after insertion. The NP can assess, among other things:
If an ultrasound becomes necessary, it is a separate test and is not included in the consultation.
An assessment is indicated, for example, if you have:
Depending on the situation, a clinical assessment may be necessary.
Removal is generally a short procedure when the strings are visible and easily accessible. The professional grasps the strings and gradually removes the device. A brief cramp may be felt.
If the strings are not visible or if removal turns out to be more complex than expected, further investigation or a referral may be necessary.
Depending on the clinical situation, a new device can sometimes be inserted at the time the old one is removed. This depends, among other things, on the device used, the reason for removal, the absence of contraindications and the risk of pregnancy.
The implant
Nexplanon is a hormonal contraceptive implant placed under the skin of the arm.
It is a small, flexible rod containing 68 mg of etonogestrel, a progestin. Once inserted, the implant gradually releases the hormone to prevent pregnancy. In Canada, Nexplanon is a prescription medication.4
Nexplanon
Nexplanon is inserted under the skin of the upper arm. It is not a procedure inside the uterus.
A local anesthetic is used. After insertion, it should be possible to feel the implant under the skin.4
According to the Canadian product monograph, Nexplanon can be left in place for up to three years.4
It can be removed earlier if you want to become pregnant, change methods or stop using it for another reason. Fertility can return quickly after removal.
Etonogestrel works mainly by preventing ovulation. It also changes the cervical mucus, which helps prevent sperm from reaching the egg.4
As with any hormonal method, its use must be preceded by an eligibility assessment.
Menstrual periods
Changes in bleeding patterns are among the most frequently observed effects with Nexplanon.4
It is difficult to predict exactly how periods will change before insertion.
A change in menstrual pattern does not necessarily mean that the contraception is working less well.
Periods may become:
Your appointment
The NP checks that the implant is an appropriate method for your situation.
The area of the arm where the implant will be inserted is numbed.
The implant is inserted under the skin using the applicator designed for this purpose.
The professional checks that the implant can be felt under the skin.
A dressing is applied and instructions are given on local care and symptoms to watch for.
Removal is also done under local anesthesia. A small incision is made so the professional can grasp and remove the implant.
When the implant is easily palpable and correctly positioned, the procedure is usually simple. However, an implant that is:
may require localization by imaging or a referral to an appropriate resource.
Yes, when the clinical situation allows.
The old implant can be removed and a new one inserted during the same appointment.
A prior assessment is still necessary to confirm that the method remains appropriate.
Both are among the most effective reversible contraceptive methods.1 For the IUD, the INSPQ reports fewer than one pregnancy per 100 women in one year.2
The choice between the two therefore depends less on a major difference in effectiveness than on your preferences, your periods, your tolerance to hormones, the desired duration, ease of insertion, your history and your reproductive goals.
Choose
The choice is both personal and medical.
The best option is the one that matches your health, your preferences and your goals.
Good to know
Not necessarily for everyone. The assessment takes into account risk factors and any symptoms present.
When the situation warrants it, STBBI screening or other tests may be recommended.
Never having given birth does not automatically rule out the use of an intrauterine device.
Eligibility depends on the overall clinical situation.
Yes. The IUD and Nexplanon are reversible methods: fertility can return quickly after they are removed.
If no pregnancy is desired, a new method should be planned to avoid a period without protection.
No.
Neither the IUD nor Nexplanon protects against sexually transmitted and blood-borne infections.4 Condoms are still appropriate when protection against STBBIs is desired.
Pill, ring, injection: our health education page on contraception presents all the options, the safety of hormonal methods and follow-up.
Frequently asked questions
The choice can be discussed during the assessment. The NP can explain the differences between the available options and check which one is suited to your situation.
The requirements depend on the method chosen and the clinical situation. Our team can explain the necessary steps when you book your appointment.
Displacement or expulsion can occur, although this does not happen in most users. Unusual pain, significant changes or difficulty locating the strings may warrant a check.
No. Removal must be performed by a qualified professional.
The implant is placed under the skin of the arm. It should generally be possible to feel it, but it is usually not very visible.
It depends on the method and your individual response. With certain hormonal methods, periods may decrease or stop. With Nexplanon, bleeding may also become irregular and how it will change is difficult to predict before insertion.
Fees
Clinique IPS du Palais offers insertion, removal and follow-up of long-acting contraceptive methods in Saint-Hyacinthe.
240 $
Prior assessment and insertion of a hormonal or copper intrauterine device by a qualified professional.
The choice of device and the possibility of proceeding with insertion are confirmed based on the clinical situation.
95 $
Removal of an intrauterine device in place.
If removal proves more complex than expected, further investigation or a referral may be necessary.
185 $
Consultation to check an IUD or assess symptoms that have occurred after insertion, including pain, unusual bleeding or difficulty locating the strings.
An ultrasound, if needed, is not included.
220 $
Prior assessment and insertion of the Nexplanon contraceptive implant under the skin of the arm by a qualified professional.
The procedure is performed only when its use is deemed appropriate.
275 $
Removal of the contraceptive implant placed under the skin of the arm.
An implant that is difficult to locate or placed too deeply may require further investigation or a referral.
375 $
Removal of the implant in place and insertion of a new implant during the same appointment when the clinical situation allows.
The choice between a hormonal IUD, a copper IUD and a Nexplanon implant depends on several factors.
An assessment allows you to discuss your needs, your preferences and the characteristics of each method in order to determine the one that best suits your situation.
The information on this page is provided for informational purposes and does not replace an assessment by a health professional.
