The contraceptive coil

Small T-shape contraceptive device

The contraceptive coil is an effective form of long term hormonal contraception. It's a small t-shaped device that is inserted into the base of the uterus and lasts for 5-10 years depending on the type. Once it's in, you don't need to worry about it, and they can be removed at any time should you wish to try for a baby. There are two different types: the copper coil and the hormonal coil.

 

How does the IUD work?

The IUD stands for Intrauterine Device and is commonly known as the copper coil. It works by releasing copper to kill sperm and prevent fertilisation. It can also stop a fertilised egg from being able to implant in the uterus.

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What are the advantages of the copper coil?

Once inserted, the IUD lasts for up to ten years and is more than 99% effective. The major advantage is that you don't need to think about it, so it won't interrupt sex once it's in. You can also have it fitted at any time, and it works right away. The copper coil also doesn't produce the side effects that come with using hormonal contraceptives, so this could be a good option if you wish to avoid additional hormones.

 

What are the disadvantages of the copper coil?

The procedure to have it fitted can be uncomfortable, and you'll usually get cramps afterwards similar to period pain. Your doctor may give you a local anaesthetic and painkillers to ease your discomfort. There is a small risk of infection after having the coil fitted. If your cramps continue and you notice a smelly discharge then see your doctor for a check-up. If untreated, it could lead to a pelvic inflammatory infection. The coil can also cause your periods to become heavier, longer and more painful. This often eases off after a couple of months.

 

What are the side effects of the copper coil?

The copper coil does not cause side effects other than possible changes to your period as it doesn't contain hormones. However, there are associated risks with using it. A pelvic infection could occur in the first month after having the coil inserted. Your body may reject the coil or cause it to move. Checking the strings regularly to make sure it's still in place will alert you to this. If you cannot feel them or are unsure, then see your GP or nurse who can check for you.

There is a small risk of the coil, causing damage to the womb. This is rare but if you are in pain then report this to your GP immediately so they can assess the situation. If you do fall pregnant, having the coil means you're at an increased risk of an ectopic pregnancy.

 

How does the hormonal coil work?

The hormonal coil, or IUS (intrauterine system), is a small plastic t-shaped device. It's similar to the copper coil but releases the progesterone hormone into the womb rather than copper. It works by thickening the cervical mucus to prevent sperm moving through the cervix and lining the womb thinner to stop a fertilised egg from attaching.

 

What are the advantages of the hormonal coil?

After it's been inserted, the hormonal coil provides you with protection against pregnancy for 3-5 years depending on the type. There are two different varieties: the Mirena (5 years) and Jaydess (3 years). It's more than 99% effective, making it convenient and reliable as you don't need to think about it until it needs replacing or you wish to have it removed. It usually makes your periods lighter and sometimes they stop altogether, and it can be fitted any time.

If you are sensitive to estrogen, then the hormonal coil might be a good option for you. The effectiveness of it isn't impacted by other medications, unlike the pill.

 

What are the disadvantages of the hormonal coil?

As with the copper coil having it inserted can be uncomfortable, and you may experience painful cramps afterwards. Painkillers are available to relieve discomfort, and the procedure itself only takes about 5 minutes. You'll need to have a check-up with your GP 4-6 weeks afterwards to make sure everything is okay and that your coil is in the right place. There is a slight risk of developing an infection in the first 30 days. Prolonged cramps or pain can be a warning sign of an infection, always tell your GP if you are unsure.

 

What are the side effects of the hormonal coil?

The possible side effects include acne, breast tenderness, headaches, mood swings and altered libido. While your periods are usually shorter and less painful, they can also become irregular which can cause inconvenience. Small cysts can occur in the ovaries with the IUS. These are not harmful and often disappear on their own, and this side effect is quite rare.

There is also a possibility of rejection, displacement, damage to the womb and ectopic pregnancy as with the copper coil.

 

How is the coil fitted?

You'll usually have an appointment with your GP or family planning clinic to discuss whether or not the coil is suitable for you. They'll go through the different options and help you to decide whether the copper or hormonal coil will suit you. You may also be tested for STIs or infections beforehand.

The fitting itself may feel similar to having a smear test done. The vagina is held open, and then the coil is inserted into the womb through your cervix. It's a quick procedure that only takes around 5 minutes, but the process can feel very uncomfortable and painful cramps afterwards are normal. It's advisable to take it easy after your appointment so that you can rest. Some women feel woozy several hours afterwards, so it's a good idea to be somewhere comfortable where you can lie down if you need to.

You'll need to see your GP 4-6 weeks after having the coil fitted so they can check the threads and make sure your device is in the right place and there are no problems. They will show you how to do this yourself to check the threads at regular intervals. If it any time you can't feel them, make an appointment to see a nurse or GP to make sure your coil is still in the right place.

The coil does not protect you from sexually transmitted infections so you may want to use condoms too.

 

Sources

https://www.nhs.uk/conditions/contraception/iud-coil/#advantages-and-disadvantages-of-the-iud

https://www.nhs.uk/conditions/contraception/ius-intrauterine-system/#advantages-and-disadvantages-of-the-ius

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