Having a copper coil (IUD) or Mirena/Kyleena (IUS) fitted

It is a small T-shaped device that is put into your uterus (womb). It has one or two threads on the end. These threads hang through the opening of your womb (cervix) into the top of your vagina.

Mirena/Kyleena

A Mirena/Kyleena intrauterine system (IUS) slowly releases a hormone called progestogen. Mirena (IUS) lasts 8 years for contraception or 5 years for HRT. Kyleena (IUS) for 5 years for contraception.

Click the link below for more information on IUS:
What is an IUS (intrauterine system) or hormonal coil? – NHS (www.nhs.uk)

Copper Coil (IUD)

An intrauterine device (IUD) is made of copper and plastic and does not contain any hormone. Copper coil (IUD) lasts 10 years. 

Click the link below for more information on IUD:
IUD (intrauterine device) or copper coil – NHS (www.nhs.uk)

We need to be certain that you are not already at risk of pregnancy.

This is the case when:

• You are using a reliable form of contraception e.g. the contraceptive pill, implant, injection, ring or patch.  Condoms are only considered reliable if used consistently and correctly.
• OR you have not had sex since the start of your last period.
• OR you have not had sex for 3 weeks and have a negative pregnancy test on the day.

Change of coils: If you are attending for a change of coil and your coil is within date, please do not have sex for 7 days before your appointment to avoid the risk of pregnancy in case we are unable to replace your coil. If your coil has expired, please use alternative contraception (or abstain from sex) for at least 21 days before your appointment.

Removal: If you are having your coil removed, and not having another coil put in and don’t want to become pregnant soon after the coil removal, avoid sex for 7 days before you have your coil removed. It is possible to get pregnant as soon as the coil is taken out.

The procedure will take 10-15 minutes. Your appointment will take approximately 30 minutes overall.  It may take longer if there are complications.  There will be 2 clinicians present for your appointment – a coil fitter and an assistant.

• Please ensure you have something to eat and drink before you attend as this can help prevent you feeling unwell during this procedure.
• Ibuprofen or Paracetamol will help with any discomfort during the fitting and we suggest that you take this 30-60 minutes before you attend for the coil fit.  Local anaesthetic gel (instillagel) or spray is usually used to make the procedure more comfortable.
• You may experience mild period like pain for a day or two afterwards.  Paracetamol or ibuprofen can help with this symptom.
• You are likely to bleed afterwards so please bring a sanitary pad with you. We advise against using tampons until at least 4 weeks after your fitting.
• Try not to give yourself tight deadlines immediately afterwards and do not plan any vigorous exercise that evening.
• If you have a baby or young children, we suggest you ask someone to mind them for you if possible, rather than bring them with you for your appointment. 
• The ideal time to fit a coil is towards the end of a period, although it can be done at any time provided you are sure you are not pregnant. 

Having a coil fitted is generally very safe and is a simple procedure. With any medical procedure there are some risks which we would like to make sure you are aware of in the table below.

Risk of infection	The risk of developing pelvic infection is 1 in 100 in the first 3 weeks after the coil is fitted.
Risk of expulsion (coil falling out)	The risk of expulsion is 1 in 20
Risk of contraceptive failure	The IUS and IUD are more than 99% effective. Fewer than 1 in 100 women will become pregnant in a year. If you do become pregnant, there is a small increased risk of having an ectopic pregnancy (a pregnancy in the fallopian tube). The risk of ectopic pregnancy is 1 in 1000 at 5 years. The symptoms of ectopic pregnancy are lower abdominal pain and missed periods, or unexpected bleeding if your periods have stopped. If you do become pregnant you need to see a healthcare professional as soon as possible in order for an ectopic pregnancy to be excluded.
Risk of womb perforation (Perforation means a small hole is made in the womb wall)	The risk of perforation is 2 in 1000 and is slightly higher in breastfeeding women (which continues for up to 6 months post-delivery). If this happens a hospital visit, and further procedure may be needed.
Changes to periods	You may have irregular bleeding in the first 3-6 months after you have had the coil fitted. With the hormonal coil (IUS) your periods may become lighter and many people find that their periods stop altogether. With the copper coil (IUD) you may have heavier, longer and more painful periods.
Hormonal side effects of the IUS	Side effects with the IUS (not copper coil) can include acne, headaches, mood changes and breast tenderness.

• It is important to learn to check your threads and this will be discussed at your appointment.  If you cannot feel the threads or can feel the stem of the coil, this may be because your coil has come out or is coming out. Therefore, you may not be protected against pregnancy. Use additional protection e.g. condoms and make an appointment with a healthcare professional as soon as possible. If you had sex recently you may need emergency contraception.
• The contraceptive coil will not protect against sexually transmitted infections. Extra precautions such as condoms are required for this.
• If you feel unwell and have any persistent lower abdominal pain, heavy bleeding, fever or smelly discharge from your vagina you should see a healthcare professional as soon as possible to assess for complications.
• The date for removal of your coil will be provided by the doctor at the time of fitting. We will not contact you to remind you when it needs replacing – it is your responsibility to arrange removal or replacement.