BEFORE the fitting of Intrauterine Contraception (Copper or hormone coil)
Who is it for?
This leaflet is written for women who are planning to have a coil fitted. It tells you about tests we may recommend before the insertion and about the timing of appointments to make the fitting as safe and comfortable as possible.
Before your coil is fitted
The doctor or nurse in the clinic should have discussed your choice with you and will have provided written leaflets about your chosen method. Read them carefully and keep them in a safe place for future reference.
Timing of appointment for coil insertion
We can fit a coil on any day of your menstrual cycle as long as we can be certain that you are not already at risk of pregnancy.
- 1. If you have been using a reliable method of contraception (‘pill’ taken correctly, injection or implant) for the previous month, coil fitting can take place at any time.
- If you are not using one of the methods above or you are relying on condoms/cap, you should avoid intercourse from the first day of your period until your coil fitting appointment.
- If you have recently had a baby you should start using reliable contraception 21 days after giving birth. You can have a coil inserted from four weeks after the birth.
- If you have recently had a miscarriage or abortion you can have a coil inserted at any time afterwards provided we can be certain you are not pregnant – so you should either not have had sex since then or have used another reliable contraceptive method (see 1).
- If you are not having regular periods and not using a reliable method of contraception, as above, YOU MUST AVOID HAVING SEX FOR AT LEAST THREE WEEKS before your appointment. We will do a pregnancy test for you before fitting your coil.
- If you are having a coil replaced (old one removed, new one fitted), this can be done on any day. YOU MUST AVOID HAVING SEX FOR SEVEN DAYS BEFORE YOUR APPOINTMENT. This is to ensure that there is no sperm in your body that could result in a pregnancy if it is not possible to fit a new coil after the original one is removed.
How soon does it work?
Hormone coil (Mirena, Jaydess, Kyleena, Levosert)
Fitted up to day 7 of menstrual cycle – works immediately
Fitted after day 7 of menstrual cycle – works after another 7 days
On the appointment day:
Please try not to bring small children with you. If you have to bring children please bring an adult with you to look after them in the waiting area.
Have something to eat and take a mild painkiller such as Paracetamol /ibuprofen1 hour before your appointment to help reduce discomfort.
Do not miss a meal; it is best to have eaten before you attend.
Please allow one hour for your appointment. Although the procedure does not take long, a few women do feel faint afterwards and need time to rest and recover.
You will need a sanitary towel. Tampons are not recommended immediately after the fitting.
What to expect: The coil is inserted by a trained Specialist
The procedure is similar to a smear test and involves he insertion of the IUD into the uterus through the cervix.
It is usual to experience some period-like pain or cramping during and after the insertion. This may continue for a few hours during the day of the procedure and may be accompanied by some period-like bleeding.
Please consider taking some paracetamol or ibuprofen about half an hour before your appointment to ease any discomfort. Please also write down and bring the start date of your last period with you to the appointment.
Whilst the procedure is very safe there are some infrequent but important risks about which you should be aware.
Infection
Usually in the first 21 days of insertion. This would cause heavier pain/ bleeding or a temperature after the coil insertion and would require antibiotics.
Expulsion
About 1 in 20 coils fall out – this is not dangerous. We teach women to be able to check for their coil threads to ensure the coil is still in place. A new coil can be inserted if the coil is expelled. Expulsion is most common in the first year and particularly during the first 3 months.
Perforation
A rare occurrence (2 in 1000) is when a small hole is made in the lining of the womb during the coil insertion. This can cause heavier pain after the coil insertion and may necessitate surgical removal.
Ectopic pregnancy
In the very unlikely event of a woman falling pregnant with a coil in place, there is a greater risk of this being an ectopic pregnancy. But this method of contraception is so reliable that falling pregnant in the first place is unlikely.
Cervical Shock: A rare occurrence when intervention to the cervix causes a woman’s blood pressure to drop, resulting in light headedness. This is usually reversed by stopping the procedure.
How is an IUD Coil Removed?
Removal of a coil is a quick and safe procedure, some mild period-like pain may occur but would be transient. The coil is removed by gentle traction on the threads.
After your coil is fitted:
We like you to rest for 10-15 minutes after the fitting before going home.
We advise you do not plan to do anything energetic for the rest of the day if you feel unwell
You are likely to experience some period type cramps and light bleeding for a few days. It is a good idea to take a mild painkiller (e.g. Paracetamol or Ibuprofen) to help with this.
