Patients struggle to access non-hormonal copper IUDs amid confusion over supply of contraceptive

Australian patients are struggling to get long-acting, non-hormonal contraceptives, with suppliers and authorities at odds over whether there is a shortage.

Copper intra-uterine devices (IUDs) are the only non-hormonal, long-acting contraceptive available in Australia, but suppliers have told the ABC recently imposed European rules have put a strain on the local supply.

The medical devices regulator said it was not aware of any shortages. However, that is at odds with what patients have told the ABC.

IUDs are one of the most common long-acting reversible contraceptives on the market.

There are two different types — non-hormonal copper IUDs, which are toxic to sperm and eggs, and hormonal ones that prevent sperm from getting into the uterus and can sometimes prevent ovulation.

'Really not good enough'

Sydneysider Allana McAffee, 32, said she had to go to multiple pharmacies to try to get a copper IUD.

"I had a prescription from my doctor, and I just went into a pharmacist and was told, 'No,'" she said.

"I wasn't really given an explanation or a reason. They just said, 'No, we can't get this,' and, 'No, we can't order any in. Bye.'

"I went to a different pharmacy and I sort of had the same reaction except the pharmacist was a little bit nicer and explained that they had trouble previously with other doctors trying to source copper IUDs for their patients, but they couldn't tell me why."

After getting a superficial blood clot from the pill and having mood swings and acne while using the hormonal IUD, Ms McAffee found the copper IUD to be the perfect fit.

But getting it replaced has been difficult. When she finally found a clinic with some in stock, it didn't have the longest-lasting option.

"When I went to replace it and I wanted to go for the 10-year one, as opposed to the smaller five-year one, I couldn't find the 10-year one at all," she said.

She said it had been a frustrating process.

"At the clinic, the advice from one of the nurses was, 'It's going to be hard, but you should just call up every pharmacist in Sydney,' and, 'Surely someone's got an old stock lying on a shelf.'

"That's really not good enough."

Chemists struggling to get stock as suppliers cite European Union changes

Pharmacist Martin Ly had difficulty getting stock of copper IUDs in his pharmacy

"From my knowledge, they have actually been discontinued from the suppliers," he said.

"It's not readily available as a commercially available product in Australia at the moment."

He has had very few requests for the device in the past year, with most patients asking for the hormonal version, which is widely and readily available.

But Mr Ly hasn't heard anything from authorities or pharmaceutical companies about why non-hormonal versions are so hard to get in stock when patients come in with a prescription.

"I don't think it's the fault of the doctors either, because I think they're probably left out in the dark," he said.

Suppliers of non-hormonal IUDs source the product from overseas as it isn't manufactured in Australia.

Many source their product from countries in the European Union, where a new medical device regulation code is coming into force.

It was meant to start in May 2021 but due to the pandemic the transition period was pushed back, meaning some devices are only just being affected by the changes, which require more exhaustive checks.

Angus Taylor, the managing director of Australian importer Contiform, said his company had been affected.

"The shortage of copper IUDs is temporary and due to a few IUD manufacturers withdrawing from the manufacture of TT380 type as a consequence of new EU regulatory compliance requirements," he said.

The group also imports short-sized silver copper IUDs, which have not been affected by the changes.

"We have just recently ordered a batch of Choice NA380 Silver/Copper IUDs for the Australian market — and anticipate supply in early May," he said.

Authorities say there isn't a shortage

Long-acting reversible contraceptives such as IUDs are among the most cost-effective and reliable contraception options available, but they have low uptake compared to other options in Australia.

In response to questions from the ABC, the Department of Health said the Therapeutic Goods Administration (TGA), which regulates medical devices, had not received signals of any supply disruption to non-hormonal IUDs in Australia.

"The TGA has strategies in place to help Australian medical device suppliers and users of devices that have European certification transition to the new European Union Medical Devices Regulation (EU MDR) and to understand and meet their obligations under the Australian regulatory framework," a spokesperson said in a statement.

"The European Commission recently extended the transition arrangements and timelines for higher risk devices to comply with the EUMDR, such as non-hormonal IUDs, until 31 December 2027 and the Australian Government has recognised and aligned this extension for devices supplied in Australia."

Increasing the use of long-acting contraceptives such as IUDs and the contraceptive implant is a key measure in the federal government's national women's health strategy.

Health Minister Mark Butler and Assistant Minister for Health Ged Kearney said a recent Senate inquiry into access to reproductive and sexual health care would help inform how that commitment would be reached.

The government's response to the inquiry is currently seven months overdue.