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Coils

Coil Insertion IUS or IUD

To arrange an appointment, please read and confirm you have understood the following statements

What is an IUS & IUD?

Intrauterine System (IUS) and Intrauterine Device (IUD) are long-acting reversible contraceptives (LARC). The word ‘intrauterine’ means inside the womb, and both the IUS & IUD are small ‘T’ shaped devices inserted inside the womb. They are effective methods of contraception that can be used for extended periods of time.

The IUS & IUD is commonly referred to as a ‘coil’ due to their original shape – which is different nowadays! In both instances, this is a small plastic (or plastic and copper) device, (about the size of a match), which is placed inside the uterus (womb) to prevent pregnancy. When inserted the thread(s) hang down through the cervix. These threads are cut about 3cms from the top of the vagina and will be left there until the device is removed at a later date.

 

What is the difference between an IUS & IUD?

IUS (intrauterine system) contains a progestogen hormone put into the womb (uterus). The progestogen is released at a slow but constant rate.

 

How does the IUS work?

It makes the lining of your uterus thinner, so it is less likely to accept a fertilised egg. It also thickens the mucus in your cervix. This makes it difficult for sperm to move through it and reach an egg. In some women, it stops the ovaries releasing an egg (ovulation), but most women who use an IUS continue to ovulate.

The advantages of IUS:

  • You can forget about contraception for years at a time.
  • The Mirena, Levosert and Kyleena work for 5 years and Jaydess works for 3 (more information on the different IUS later). 
  • You usually experience lighter periods and may even stop completely especially with the mirena and levosert.
  • The IUS is not affected by other medicines.
  • The IUS can be used if you are breastfeeding.
  • Once the IUS is removed, your fertility will return to normal.
  • It is useful if you cannot use estrogens, like those found in the combined pill, the contraceptive patch and the contraceptive vaginal ring.
  • It’s reversible, and you can have it removed at any time.

The disadvantages of an IUS:

  • Changes to your menstrual cycle include irregular bleeding or spotting. In some instances, periods can stop altogether. This is nothing to worry about.
  • Hormonal side effects such as acne, headaches, nausea, fluid retention and breast tenderness.
  • Follicular cysts on ovaries may develop. These are not harmful and do not usually need to be treated. These cysts typically disappear without treatment.
  • Initially, there may be a slightly higher risk of infection. The use of an IUS does not increase your risk of an STI, nor does it protect against sexually transmitted infections (STIs). If you get one when the IUS is in place, this could lead to a pelvic infection if it is not treated.

 

How does the IUD work?

IUD (intrauterine device) do not use hormones, so there are no side-effects due to hormonal changes in your body.

The copper in the IUD acts as a contraceptive immediately and will last for up to 10 years.

How does it work?

The copper in the IUD prevents sperm from surviving and alters your cervical mucus to prevent sperm from reaching an egg. An IUD may also help to stop a fertilised egg from implanting in the uterus.

The advantages of an IUD:

  • It is effective immediately. 
  • Depending on the type, it works for 5 or 10 years.
  • You can breastfeed.
  • It’s not affected by other medicines.
  • Once the IUD is removed, your fertility returns to normal.
  • It doesn’t require you to remember to take it daily/weekly.

The disadvantages of an IUD:

  • Your periods may be heavier, longer or more painful but this may improve after a few months. 
  • You’ll need an internal examination when the IUD is fitted.
  • The IUD will not protect you from sexually transmitted infections, so you may need to use condoms as well.
  • While an IUD does not increase your risk of infection, if you get an infection while an IUD is in place, this may lead to a pelvic infection if not treated.

 

Potential risks involved in IUS & IUD:

  • Although small, there’s a possibility of you getting an infection in the first three weeks after an IUS/IUD is inserted.
  • If you get an infection, this could lead to a pelvic infection if it is not treated.
  • You may be advised either before or at the time an IUD if fitted, to have a check for sexually transmitted infections.
  • The IUS/IUD can be pushed out (expulsion) by your uterus (womb), or it can move. While uncommon, it’s more likely to happen soon after the IUS/IUD’s been inserted. Your doctor or nurse will teach you how to check the threads in place.
  • A very small risk the IUS/IUD might perforate your uterus or cervix when inserted. There is an increased risk if you’ve recently given birth or are breastfeeding. This may cause pain but often there are no symptoms, and the uterus or cervix will heal by itself. The risk of perforation is low when an experienced doctor or nurse fit an IUS/IUD. If it does happen, the IUS/IUD may have to be removed by surgery.
  • You're unlikely to get pregnant while using an IUS/IUD but if you do, there’s a risk of having an ectopic pregnancy. You’re less likely to have an ectopic pregnancy while you’re using an IUS/IUD than when you’re not using any contraception.

 

There are some conditions which may mean you shouldn’t use an IUD, these include:

  • Think you might already be pregnant, have had a baby <4 weeks ago or still being monitored after a molar pregnancy.
  • Have an untreated sexually transmitted infection or pelvic infection
  • Have problems with your uterus or cervix
  • Have or being treated for breast cancer or malignant liver cancer (IUS).
  • Have or being treated for cervical or endometrial cancer (IUS and IUD).
  • Have a serious heart condition.
  • Have unexplained bleeding from your vagina (for example, between periods or after sex)?

 

Is an IUD or IUS the right form of contraception for you?

The right form of contraception for you will depend on several factors, e.g., age, medical history, whether you smoke, etc. Not all woman have an IUS or IUD fitted for contraceptive purposes. If this applies to you, please ensure you have discussed this with your medical practitioner or GP.

Help to decide which form of contraception is right for you, can be found by visiting the Family Planning Association (FPA)
https://sexwise.fpa.org.uk/contraception?utm_campaign=fpa-homepage

More information on long-acting reversible contraceptives can be found here:

https://sexwise.fpa.org.uk/contraception/long-acting-reversible-contraception-larc

 

The Procedure

Before the IUS/IUD is inserted, your GP or medical practitioner will review your medical history to ensure this procedure is right for you.

It is really important you do not have unprotected sex at least 7 days before the IUS/IUD is inserted, to reduce any risk of pregnancy.

If you need an interpreter, please contact your practice.

Please download and read the FPA leaflet, available here which will explain the risks and benefits of this procedure.
https://www.sexwise.fpa.org.uk/contraception/ius-intrauterine-system

Please watch the following video as it will help you to understand the procedure and what to expect. https://www.youtube.com/watch?v=bn9BTOrABa4

 

On The Day

We recommended you eat a light meal and take 400mg of ibuprofen before your appointment; unless contraindications or you are allergic to ibuprofen, please take 1g of paracetamol.

Your appointment will last around 20–30 minutes and a doctor or nurse will perform the procedure. Inserting the IUS/IUD usually takes approximately 5 minutes, and some woman may experience some discomfort or pain. In some instances, a woman may be offered a local anaesthetic.

After the procedure you may experience some discomfort or bleeding; therefore it’s a good idea to rest afterwards.

More information on post-insertion can be found here (link to post insertion leaflet) and your doctor or nurse will discuss this with you on the day of your appointment.

 

Listen to this contraception podcast for more information:
https://anchor.fm/dr.amy/episodes/So-youre-thinking-of-having-a-coil-fitted-e3t1te/a-ae6gca