Coils
Two Types
- Copper Coils – other names – IUD or The intrauterine device
- Hormonal Coil – other names IUS or The intrauterine system
COPPER COIL
A copper coil is a small plastic and copper device that is fitted into the uterus. It is fitted through the neck of your uterus (cervix). It can only be fitted by a fully trained doctor or nurse. Its contraceptive effect can last for 5 to 10 years depending on which type is fitted.
How does the coil work?
- Coils stop sperm reaching an egg.
- Slows egg movement along the fallopian tube
- Prevents the egg from embedding into the uterus
Prior to fitting a full medical history is taken. Information will need to be given about the 1st day of your last period, whether this was a normal period for you, how often they occurs. The coil is usually fitted during a period or towards the end of a period. If you experience painful heavy periods, as it may not be suitable method for you as a copper coil can make your periods heavier and more painful.
If you or your partner is at risk of getting a sexually transmitted infection, this method of contraception may not be suitable for you. Screening for sexually transmitted infection is usually routine.
Information also needs to given on your own and familyÂ’s medical history. If you have a history surgery or treatment on your uterus or cervix
History of tubal pregnancy (ectopic pregnancy)
Unexplained vaginal bleeding in-between your periods or after sex will have to be investigated prior to insertion
Also if you have artificial heart valve you will be required to have antibiotic cover needed before coil insertion.
What are the advantages of having a coil fitted?
- It is effective as soon as it is inserted
- You do not have to think about contraception for as long as the device lasts
- Infrequent check ups.
What are the disadvantages of having a coil fitting?
You periods could become heavier and more painful especially at first. This should improve within the first few months of having the device fitted.
At insertion there is a very small chance of getting infection during the first 20 days after insertion. Routinely you should have had screening for infection prior to insertion. As previously outlined you must let the clinic know if you are at risk of getting sexually transmitted infection as you could be at risk of getting a pelvic inflammatory disease at any time.
The coil can be expelled from your uterus, this is more likely soon after the fitting and you may not know this has happened. You will be taught how to check your threads after fitting so that you will be aware that your coil is still in place.
Very rarely the coil might go through your uterus or cervix when it is fitted. It may cause pain, but often there are no symptoms if this happens the coil may have to remove by surgery.
If you do become pregnant while you are using the coil as your contraceptive method, there is a chance the risk of you having a pregnancy developed inside your fallopian tube. This is rare, but it does require urgent medical help.
How effective is the coil?
For all current coils the overall failure rate is low, 99% including pregnancies that are due unrecognized expulsions.
Where can I get a coil fitted?
Click here for where you get a coil fitted in Bolton.
How is a coil fitted?
As previously mentioned the coil is usually fitted during a period or just after you have finished.
You will need to be examined internally as they will need to assess the size and shape of your uterus.
They will need to make sure you are not pregnant prior to fitting, and check for pre-existing infection.
It can be uncomfortable having a coil fitted and you need to discuss the possibility of having pain relief.
You will be taught after fitting how to check your threads.
After Coil Fitting
You may get period pains and bleeding after a coil fitting. Pain relief may be needed for the first few days.
If this persists after a few days and/or you develop a high temperature or smelly vaginal discharge, you need to return to the place where you had the coil fitting for advice, as it may mean you have an infection.
After fitting the nurse will instruct you how to check your coil threads, which will hang down a little way into your vagina.
You should check your threads regularly, if you cannot feel your threads, use extra protection, as your coil may have been expelled, and seek advice from staff where it was fitted.
Rarely your partner may tell you he can feel the threads during sexual intercourse, staff will give you instructions on how to move them out of the way, or if too long they may need shortening
You can use tampons with the coil, it usually not advisable during the first few weeks after fitting, as there is an increased rate of infection in the first 20 days. Also it is inadvisable to use tampons at the end of your period, as the coil threads may become entangled with your tampon, and could result in unintentional expulsion of your coil.
After 6 weeks it is advisable to have your coil checked. Follow up routine check are annually.
HORMONAL COIL
Intra uterine system (IUS) as there is only one on the UK market it is often called by its trade name "Mirena".
IUS is a small T-shaped plastic device, which has reservoir of the hormone progestogen; it works up to 5 years.
How effective is this method?
0.2 per 100 woman years
How does it work?
- The hormones thicken the mucus in the neck of the uterus. This will make it very difficult for the sperm to enter the uterus.
- It makes the lining of the uterus thinner so a fertilised egg will less likely to be accepted.
- It can stop an egg being released from an ovary.
What are the advantages of an IUS (Mirena)?
- Highly reliable method that lasts for 5 years.
- Periods after 3 months become lighter and shorter, eventually in some women their period stops.
- This method can be used as a treatment for heavy painful periods.
- Fertility returns to normal very quickly after removal.
What are the disadvantages of IUS (Mirena)?
It may take at least 3 months to settle the bleeding; it can be heavy in some women initially. This bleeding should be painless after the first few days of fitting.
Other side effects, which are usually during the first few months, headaches, bloatedness around the abdomen, breast tenderness.
Some women may develop cysts on their ovaries in the first few months, these are not dangerous and do not need to be treated, they usually disappear.
It can be expelled or displaced, this is more likely to happen in the first few weeks after fitting
Checking Mirena (IUS) threads every months is very important as that reassures you that it is still in place.
After having Mirena fitted do not use tampons in the first few weeks. Tampons can be used after these weeks, but never at your driest, which is usually at the end of your period, as your tampon could be entangled into the threads of your Mirena.
During the fitting of your Mirena, very rarely it could perforate your uterus (womb) or the cervix. If pain persists after fitting it could be a sign that this has happened. If perforation does occur Mirena may needed to be removed surgically. Perforation is very rare when an experience doctor fits it.
Can anyone have one fitted?
Your own and family's medical history will need to be taken.
It will need to be fitted in the first 5 days of your period, to make sure you are not already pregnant.
Not suitable for cancer or the uterus or ovary.
Active Liver disease
Unexplained bleeding in-between your periods or after sex,
Untreated sexually transmitted infection
Previous treatment on the uterus or cervix.
Can I have Mirena (IUS) fitted if I have never had any children?
You can have one fitted, but it may be more uncomfortable during the fitting procedure.
Where can I get a Mirena (IUS) fitted?
Click here
How is it fitted?
Click here; see previous coil instructions for fitting.
How often do I need have it checked?
It needs to be checked 4 to 6 weeks after fitting and then once a year. The IUS lasts for 5 years.
Removal
IUS can removed at any time, You will need to take extra precautions for 7 days, as your fertility returns very quickly after removal, and the male sperm can stay alive up to 7 days after sex. Alternatively you can commence another method of contraception 7 days prior to removal.
Even if you wish another IUS to be inserted, extra precautions for 7 days is advisable, as there is always the possibility after removal we are unable to insert another IUS, due to the cervix going into spasm, and it will have to be fitted at a later date.
What if I get pregnant whilst using an IUS?
This rarely happens; if you are worried see your doctor or nurse, who will if necessary carry out a pregnancy test. If this happens your IUS will be taken out.
How soon after having a baby can I have it fitted?
Usually 6 weeks after having a baby.
How soon after a termination or miscarriage can I have it fitted?
It could be fitted immediately if you were less than 12 weeks pregnant.
How soon will I be able to get pregnant after removal?
Fertility returns as soon as the IUS is removed.
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