Print Print
CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.

Contraception - Management
When can a levonorgestrel-releasing intrauterine system (IUS) be removed?

  • If the woman wishes to conceive, the levonorgestrel-releasing intrauterine system (IUS) can be removed at any time.
  • If the woman does not want to become pregnant:
    • Remove the device at menstruation or, if there has been no unprotected intercourse in the preceding 7 days, at any other time.
  • If the levonorgestrel-releasing IUS is to be exchanged for a new IUS:
    • The woman should avoid intercourse or use barrier contraception for the 7 days before the procedure, in case reinsertion fails.
  • If the device is to be changed for a hormonal contraceptive method and the woman is amenorrhoeic, the new method should be used for sufficient time for contraceptive protection to be established before removal of the device.
    • The minimum time is 7 days for:
      • Combined oral contraceptives.
      • Combined contraceptive patch.
      • Progestogen-only implants and injectables.
    • The minimum time is 2 days for:
      • Progestogen-only pill.
    • Alternatively, if the hormonal contraceptive is started after the removal of IUS, she will need to abstain from sex or use additional contraceptive protection (e.g. condoms) until contraceptive protection is established.
  • If the device is to be changed for a copper intrauterine device (IUD):
    • This can be done at any time.
    • No additional contraceptive protection is required if the IUD is inserted immediately after removing the levonorgestrel-releasing IUS.
Basis for recommendation
  • These recommendations are based on guidelines published by the Faculty of Sexual and Reproductive Healthcare (FSRH), formerly the Faculty of Family Planning and Reproductive Healthcare (FFPRHC) [FFPRHC, 2004d].

© NHS Institute for Innovation and Improvement