Coil fittings

Guidance for coil fittings (both IUD and IUS)

This information is to help inform you about having a coil fitted in Hingham Surgery.

There are two sorts of coils. The first type is the IUD (Intra-Uterine Device) which is also called the copper coil. The second is the IUS (Intra-Uterine System) also known as Mirena.

Both types are small T shaped plastic objects which sit inside the womb. The IUD is hormone-free and the IUS contains a small reservoir of progesterone which is slowly released into the womb over five years. Both coils have monofilament threads which go down from the coil through the cervix. Once the coil is fitted you will not feel it, though it is possible to feel the threads.

The usual IUS is the Mirena. There is now a new “light” version of the IUS called Kyleena which is a little smaller than Mirena and contains less hormone.

The person who fits coils in Hingham is Dr Shaun Conway. Dr Conway is male.

More information from the NHS about the IUD and the IUS

Key information

  • Both types of coil are extremely reliable. The failure rate is 0.6% for the IUD and 0.2% for the IUS. (This compares with a failure rate of up to 9% for the pill.)
  • Both coils work for 5 years. Coils are hassle free. The coil needs to be checked at 4 – 6 weeks after fitting. Most women do this themselves. The manufacturers advise self-checking after a period for the duration of the next 5 years.
  • Coils do not affect blood pressure and do not increase your risk of thrombosis.
  • The coil is effective immediately if it is fitted within 7 days of the start of a period (otherwise it takes 7 days to work). It is also less painful if the coil is fitted at the end of a period. It is best to abstain from sex from day one of your period until after the coil has been fitted (the coil cannot work if you are already pregnant!). So, if possible, have your coil fitted just after the end of your period.
  • The effect of the coil stops as soon as you have it removed. So, if a patient had a problem with the coil it can be taken out to immediately resolve any problems. There is also an immediate return of fertility when it is removed.
  • The IUS can give you lighter periods. Some women will enjoy almost no periods at all with the IUS, particularly those who have light periods to begin with.

Alternatives

Please discuss alternative contraception with your doctor or practice nurse.

What can go wrong?

  • Discomfort at the time when the coil is fitted – Over 50% of women will have brief, period like pain at the time of insertion. The discomfort can be minimised by taking pain killers (paracetamol and/or ibuprofen) about an hour before the appointment for coil fitting.
  • Severe pain at the time the coil is fitted – Less than 10% of women experience quite severe period-like pain at the time of coil fitting.
  • It may be impossible to insert the coil – This is particularly a problem in women who have previously had cervical surgery.
  • Fainting – About 5% of women feel faint after the coil is fitted.
  • Increased vaginal bleeding/periods – About 30% of women get light bleeding or spotting in the first few months after a coil fit. A smaller number (about 10%) get severe period bleeding during that time.
  • The IUS releases a small amount of a hormone (a progestogen) and this could be a problem if you have a history of complex heart problems, breast cancer, severe acne or depression associated with hormones.
  • Expulsion – It is possible for the coil to fall out or be squeezed out by the womb. The risk of this is said to be 6%. This is most likely to happen in the first month after fitting which is why we suggest getting the coil checked at 6 weeks.
  • Infection – The IUD is associated with a risk of infection. The risk is often quoted as 1%. The risk is higher in women who have multiple partners. A pre-existing infection could be activated by a new coil. To minimise the risk we suggest that women should be screened for chlamydial infection before the coil is fitted.
  • The coil can perforate the womb during fitting – This is extremely rare with a risk of less 1 in 1000. Almost all cases occur in women who have just had a baby and are breastfeeding; this is because the womb is softer then. So we usually advise waiting at least 6 weeks after delivery before having a coil fitted.
  • Ectopic pregnancy – Coils are excellent at preventing pregnancy in the womb but they do not prevent ectopic pregnancy. It is not that the coil causes an ectopic. But if you were to fall pregnant with a coil in place, then you must see a doctor soon so that we can arrange a scan to check for an ectopic.

Practicalities

  • See your practice nurse for a chlamydia test.
  • Book a double appointment with Dr Conway.
  • If you would like a chaperone, please tell the receptionist when you book the appointment so that we can arrange for a nurse to be present.
  • Take pain killers (e.g., ibuprofen 400mg) an hour before the coil is fitted.