“Contraception and Me” speaks to real people about the contraception experiences and gives you their honest answers. Each month, we’ll look at a different kind of contraception. This month, we’re looking at ‘the coil’, also known as the Intrauterine Device (IUD) or Intrauterine System (IUS). To protect people’s privacy, we have only used initials instead of names.
—
The IUS, sometimes known as the hormonal coil, is made of plastic, while the IUD is of similar size and shape, and is made of plastic and copper. The IUS works in a similar way to other hormonal contraception, by releasing synthetic progesterone which thickens cervical mucus to stop sperm entering the uterus, thins the womb lining so egg implantation is less likely, and can also stop ovulation in some users. The IUD doesn’t work by releasing hormones – instead it creates an environment inside the uterus where sperm and eggs cannot survive, and also prevents egg implantation in the womb lining.
Both are long-acting (3-10 years, depending on the type), reversible contraception that don’t rely on you remembering to do something daily or every time you have sex. It’s worth remembering, however, that neither the IUS nor the IUD protect against sexually transmitted infections.
Why Choose the Coil?
Like most hormonal contraception, the IUS can be used to alter a person’s menstrual cycle. It can change or lessen PMS symptoms, reduce pain, and in some cases will even stop periods. As such, it is often used to help people who suffer from extremely painful or extremely irregular periods.
“I chose the hormonal coil because my periods were excessively heavy and irregular,” said LM. “I was having 23-38 day cycles, bleeding for a minimum of 11 days, and had to change my tampon and pads every 90 minutes or else I would leak.”
It can even help further than that. SD tells of her experience getting a coil after having a scan to confirm fibroids: “I was told something hormonal could really help, and I didn’t want the faff of a pill!”
Unlike some other methods of contraception, however, both the hormonal coil and the copper coil can be suitable for people who can’t use traditional hormonal contraception — the hormonal coil because it releases a lower dose of hormones, and the copper coil because it releases no additional hormones into the body.
“I can’t have the pill or implant due to side effects from that high a dose of hormones, but my periods were so heavy that they were making anaemic,” explained SLB. “The Mirena (hormonal) was suggested as the hormones are at a lower dose and can help ease PMS symptoms.”
Hormones aside, some people prefer the IUS or IUD because it doesn’t rely on remembering to do something, and because it can last for up to 10 years. As RC put it: “I have a baby, so I’m always in a rush. I thought the coil would be the best option as I didn’t need to think about it.”
Fitting an IUS or IUD
Most GP surgeries, community contraception or ‘family planning’ clinics, and sexual health clinics can fit either the hormonal or copper coil. Similar to a cervical screening (or smear test), the vagina is held open and the coil is inserted into the uterus via the cervix. The cervix can be numbed using a local anaesthetic – but this injection can be just as painful so it is not always used. Following fitting, cramps can also be experienced – pain killers, rest and a hot water bottle can be helpful here. The coil should be checked by a doctor or nurse after six weeks or so to ensure it is in the right place.
The coil is notorious for being painful to fit, as SLB found out: “I took my boyfriend to the fitting, and I think I hurt his hand squeezing because it hurt like hell! I spent the rest of the day after the fitting in bed, tired and in paid, and had awful cramps for two days afterwards.”
FH also found the experience painful, and described it to The Nopebook as “close to a nightmare.”
“I vividly recall lying on the table, smear-test style, and feeling absolutely trapped because I wanted to get away from the pain but there was no escape,” they explained. “I nearly fainted twice, threw up, and had to rush to the loo and throw up again in there.”
These responses are fairly common, due to the body’s autonomic response when anything of a visible size is pushed past the cervix.
However, everybody is different, and while some experience severe pain, others find the experience mildly uncomfortable at worst.
“It wasn’t too bad from what I can remember,” said SLD. “Kind of like a smear — except sticking something up there and leaving it!”
Removal
Removing the coil is similar to fitting it — the vagina is held open so the coil can be removed via the cervix. You can have another coil put in when you have one removed – but if you’re not then you should avoid sex or use alternative methods of contraception such as condoms for seven days before the removal.
Removing the coil is typically less painful than having it fitted, and LM described removal as “easy peasy.” Similarly, FH found it “mildly uncomfortable”, but nothing more than that.
Of course, everybody’s experiences are different, are for some people removal can be painful — particularly if the coil comes out on its own.
“My coil came out on its own, and it was pretty painful,” said SLD. “I had a scan and they discovered I had a polyp that may have caused it, since the it prevented the coil from sitting properly.”
Side Effects
Side effects of the IUS include period changes – irregularities and sometimes stopping altogether – irregular bleeding and spotting, headaches, acne, and breast tenderness. Common reasons for IUS removal — other than it is time and wanting to become pregnant — are vaginal bleeding and pain, but this is uncommon. With the IUD, periods may become heavier or more painful, although not always, and this may improve over time.
GKD experienced a few severe symptoms when they had the coil, including “extremely painful periods, diarrhoea, and ovulation pain,” and RC experienced “every side effect possible. Mood changes, pain, constant sore breasts, paranoia, and dryness.” SD says “The first six months were hell, I didn’t know if I would be bleeding from day to day, but once it settled down it was a dream for four and a half years.”
As with all contraception or medication, however not everyone will experience side effects. LM said they “didn’t notice any side effects,” and SLB doesn’t remember any either.
Rare complications of the coil can occur, usually within the first year. In fewer than 1 in 1000 insertions, a coil can make a hole in the uterus or cervix – this will cause pain that doesn’t go away and you should contact your GP or the clinic where your coil was inserted if you get persistent pain, since you may need surgery. Pelvic infections may occur in the first month or so – this is much more likely if you have an existing STI, so it will usually be recommended that you are screened for these first.
If your coil fails and you become pregnant, the risk of ectopic pregnancy (a fertilised egg implanting outside of the uterus, usually in the fallopian tubes) is increased, and the coil should be removed immediately. Ectopic pregnancies are usually categorised by having the normal signs of pregnancy and a persistent pain in one side of your tummy – although they are rare! If you are concerned, see your GP. If you have unbearable pain on one side of your tummy, then go to A&E.
Effectiveness
The IUS is more than 99% effective – less than 1 person in every 100 will become pregnant within the five-year life of the Mirena coil, or the three-year life of the Jaydess coil. The statistics for the IUD are similar – less than one person will fall pregnant each year while they have a copper coil. IUD’s with less copper are less effective.
None of the people we spoke to fell pregnant during the lifetimes of their coils.
Should You Get the Coil?
Out of the eight people we spoke to, five of them would use the coil again, or recommend it to a friend.
Before choosing any method of contraception, you should thoroughly research all your options and discuss with your doctor what the best option for you might be.
“Really research the side effects and weigh up your options,” warned GKD. “Condoms can be a faff, but compared to the pain of the IUD, it isn’t a bad method of contraception.”
Don’t let stories of severe pain put you off trying the coil if you feel it would be right for you, however. For many people, the IUD or IUS can be an extremely practical and effective method of contraception.
—
