Last week we began our discussion of contraception options in Israel. We introduced the main options for hormonal methods. Now, let’s review our longer-term methods, that can include hormones.
The most popular LARCs, or long acting reversible contraceptives as they are referred to in the field, are IUDs (intrauterine devices); small copper devices (of various sizes and shapes) that are fit inside the uterus, and prevent pregnancy. These devices can also hold hormones inside, and release them over time. Technically, the IUD is not covered in the basket of services, and one must pay full price. However, most of the health services offer a subsidized option.
According to the Ministry of Health, as of April 2017, the kupah is able to charge an additional 291 shekels for insertion of the IUD. As of October 23, 2017, these are the following prices for IUD insertion by a doctor working in a kupah clinic (brand to be determined by the kupot):
- Clalit: 291 shekels
- Clalit zahav/platinum: free
- Maccabi basic: 289 shekels
- Maccabi zahav/sheli: no further discounts
- Meuhedet: 290 shekels
- Meuhdet adif/C: no further discounts
- Leumit: 291 shekels
- Leumit Zahav/kesef: must pay something but not clear how much
As IUD (and other contraceptives) are not technically in the basket of services, the cost can be subsidized by the kupot:
- Meuhedet: No subsidy
- Maccabi: No subsidy
- Clalit Zahav/Platinum: 65% subsidy
- Leumit zahav/kesef: up to 80% of the cost (limit of 62 NIS subsidy)
Options in Israel for IUD with hormone:
- Mirena (Bayer company) [in the basket of services for women over 45 who suffer from overly heavy periods and have previously tried medication].
- Janess (Bayer)
Options in Israel for IUD copper (non-hormonal):
- T- Shaped options: Mona Lisa (CU380)/Multiload
- Gynefix: copper pieces on a string (not T-shaped)
- Ballerine: round with copper balls
You should know that all of these devices are also inserted by private gynecologists, who will charge on average ~1,200 for a private appointment. This is often a good option for women who have fear or serious concerns about IUD usage, but haven’t had success with other methods.
Remember, if you have any negative side effects from a IUD, you should report it to the Ministry of Health by completing this online form. (It works in Explorer only)
Next week: how to find non-hormonal contraception in Israel and stay tuned for everything you wanted to know about the patch and Nuvaring.
Where (what hospital) will insert an iud right after delivery?
Hi Dana, you’d have to make an appointment with a gynecologist for your 6 week visit.
Would they do it right then and there at your 6 week checkup? Or will I have to make another seperate appointment to insert an IUD?
Depends on the gynecologist, but most will give you a prescription, have you fill it and come back at a different time. There’s a ~350 shekel co-pay for IUD insertion.
At my 6 week check up, my gynaecologist gave me what looks like a prescription with ”nova T” written on it. Am I meant to take this to the pharmacy and ”buy” the IUD before the follow up appointment I booked to have it inserted? Am I able to go any time to the pharmacy or will they only give it to me the day of the insertion?
you got it. you go purchase the IUD, whenever and bring it with you to the doctor on the day of insertion. FYI that now gynecologists are allowed to charge extra, I believe its around 350ILS to insert the IUD.
What are the side effects of Janess? I had a copper iud and after many infections decided to change to a hormonal iud, but there is no information on this Janess.
Hi. Janess is similar to other hormonal IUDs in its side effects. Anecdotally from drs it seems that fewer women get their period when using the Mirena, then when using Janess.
Which of these options Copper IUD/Gynefix/Intra Uterine Ballerine has the least risk of moving out of place to another place in the body, such as the abdomen?
Thanks for the question. So, to clarify, the IUD can’t go anywhere else in the body, because the uterus is a closed system. The only options are, to be pushed out of the body (which is rare, but can happen), or moving around inside the uterus (making it less effective to prevent pregnancy) or sticking to the uterine wall. That’s why its so important to have routine ultrasounds when you have an IUD inserted to make sure it is in place. Because the gynefix and the ballerine are balls or just string, they have almost no risk of perforating the uterine wall (a rare but possible side effect when inserting the IUD).
Do I need an appointment with a family doctor first to be prescribed the device? And then go to a gynecologist to get it installed?
How do I know when booking an appointment if the specific Gynecology will be able to do an installation of an IUD?
Nope. No family dr. necessary. The ob/gyn needs to give your the prescription, then you go purchase it at the pharmacy and return of the installation. :). In Israel almost all ob/gyns insert the regular T shaped IUDs. If you’re looking for something different, then you’ll need to ask them at the appt. If you’ve seen the dr already, though, you can write to him/her for the prescrption through the app so you only need to go in once. IF they don’t work with that IUD, they’ll tell you then. Remember, this is only for Israel.
What is the common side effects of Janess?
It doesn’t differ greatly than other IUDs with hormone. Anecdotally, it seems that more women get a regular period on it then other IUDs .