Contraceptive IUD Coil Fit

Patient information leaflet for Contraceptive intra-uterine devices

Hormonal coils e.g. MIRENA and Non-hormonal coils e.g. COPPER offer long-acting reversible contraception (LARC) and can be fitted, removed and replaced at Headcorn Surgery. The LARC Clinic is led by Nurse Practitioner Amanda Davis and assisted by Health Care Assistant Angie Martin.

Counselling and Consent

Once your appointment has been arranged, the nurse will contact you by phone to talk you through the procedure, confirm there are no contraindications to you having a coil fitted, and answer any questions you may have. It is routine procedure to arrange a swab test a few weeks before fitting your coil in order to exclude infection such as Chlamydia.

Fitting procedure

Normally fitting a coil takes approximately 20-30 minutes in total, but occasionally can take a little longer. Please allow at least an hour, to allow for any late running etc.

A coil can be fitted at any time during your menstrual cycle as long as there is no risk of pregnancy.
If you are due a cervical smear, it can be taken at this stage.
Having a coil fitted can be uncomfortable but usually only for a very short time, and a local anaesthetic is available if you prefer.
You may get period-type cramps afterwards, but regular painkillers can ease this
You may also have erratic bleeding after having a coil fitting. This usually gradually settles within the first 3 months.
You will be offered a follow-up appointment with the nurse after 6-8 weeks.

The procedure is very safe, but there are some rare but important risks you should be aware of;

Failed fitting

Sometimes we are unable to fit the coil. This also occasionally happens when a coil is being changed- in these cases we would usually be able to easily fit the second one at a separate appointment in a week or two, but you would need to use alternative contraception in the meantime.

If we have been completely unable to fit a coil but you still wish this form of contraception, we would refer you to the local Sexual Health clinic.

Infection (usually in the first 20 days after insertion)

This would cause heavier pain / bleeding or a temperature / smelly discharge after the coil insertion and would require treatment with antibiotics

Expulsion

About 1 in 20 coils fall out – this is not dangerous, but you would no longer be protected against pregnancy. We advise women to check for their coil threads regularly to ensure the coil is still in place. Expulsion is most common during the first year of having a coil, and particularly during the first 3 months.

Vaso-vagal

Rarely some women feel faint, and their heart rate drops a bit during coil fitting. This usually settles as soon as the coil is fitted, but sometimes we might have to stop the fitting, or very occasionally take the coil back out again. Very, very rarely, if doesn’t settle, we might need to give an injection to raise your blood pressure again.

Perforation

A rare occurrence when a small hole is made in the lining of the womb during the coil insertion. This would cause heavier pain / bleeding after the coil insertion and may require surgical removal of the coil. This occurs in less than 1 in 1000 coil fittings but may be more likely if you have recently given birth or are breastfeeding. The doctors are trained in insertion techniques to minimise this risk.

Failure

No contraceptive option is 100%, however failure rate of both kinds of coils is very low- less than 1%. This is equivalent to (or even better) than sterilisation.

Ectopic

In the very unlikely event of a woman falling pregnant with a coil in place, there is greater risk of this being an ectopic pregnancy (a pregnancy developing outside the womb). But this method of contraception is so reliable that falling pregnant with a coil in place is extremely unlikely.

Non-urgent advice: It is extremely important that there is no chance of early or potential pregnancy at the time we fit the coil

If we have any doubt about this, then we will have to postpone the fitting appointment to another date.

Please read the information below carefully. If you have any questions or concerns, please discuss with the nurse during your counselling and consent telephone.

Please bring a urine sample (for pregnancy test) even if you do not think there is any risk of pregnancy – it is our policy to do a pregnancy test before any coil fit.
Please continue using your current method of contraception until you are advised to stop. This is usually at least 7 days AFTER the coil is fitted.
Do not have unprotected sex for at least 3 weeks before your appointment.
If attending for a coil replacement, please do not have sex for 7 days before your appointment.
This is to protect you in case we are unable to re-fit the coil on the same day.
If your original coil is out of date, please do not have unprotected sex for 3 weeks before your appointment.
Please note there is no need to cancel your appointment if you are having your period at the time of the coil fit-we can still do coil fits during this time
We have a waiting list for appointments. If you are unable to attend your coil fitting appointment, please inform reception so that we can offer the appointment to another patient.
Please have something light to eat before your appointment- there is no need to fast.
Please take some painkillers 30-60 minutes before your appointment to help the discomfort that can be associated with coil fitting. Paracetamol or Ibuprofen are good options if you can take these.
If you have any concerns after your coil fit, please contact the practice for advice.

After coil fitting

You are likely to have some light bleeding or spotting for a few days, and erratic bleeding is common in the first few months.
Seek medical advice if you have severe or increasing pain, heavy bleeding, smelly discharge or you are concerned the coil may have come out.
If you cannot feel the threads or are concerned about the coil coming out, use alternative contraception until told otherwise.