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Non-hormonal coil (IUD)



The non-hormonal coil, also known as the IUD (intrauterine device) or ‘copper coil’, is a small T-shaped device that sits in your womb. It is long-acting but can be easily removed if you decide you want to become pregnant or use alternative contraception. It is also very effective emergency contraception.

It is 99% effective at preventing pregnancy.


How it works

How to use it

A clinician will insert the IUD into your womb (uterus).

Once the IUD is in place, you don't have to think about contraception for up to 5 or 10 years. It won't interrupt sex and your partner should not be able to feel it.

It can be removed at any time by a trained doctor or nurse, but you must use condoms as well or abstain from sex for 7 days prior to removal.

The IUD can be used as emergency contraception if it is inserted up to five days after you’ve had unprotected sex, to prevent pregnancy. It will not protect you against STIs so you should take an STI test if you think you may have been exposed.

What it does

The IUD does not contain a hormone, but instead slowly releases copper, which prevents sperm from surviving in your cervix, uterus or fallopian tubes. It may also stop fertilised eggs from implanting in the womb.



Pros and Cons

Pros

  • Once fitted, the IUD prevents pregnancy for between 5 and 10 years (depending on the type).
  • It can also be fitted as a method of emergency contraception.
  • It does not interrupt sex.
  • It protects you from pregnancy immediately.
  • Your fertility will return to normal after the IUD has been removed.
  • It can be used by people who cannot use contraception that contains hormones, such as the combined pill, progestogen-only pill, vaginal ring, IUS and contraceptive patch.
  • The IUD is not affected by vomiting, diarrhoea or other medicines like other methods of contraception.

Cons

  • It does not protect against STIs.
  • Periods may be heavier, more painful or last longer.
  • There is a small risk of getting an infection after the IUD is inserted.
  • There is a small risk of the IUD becoming pushed out or the IUD becoming displaced.
  • There is a very small risk of perforation of the uterus.
  • If you do become pregnant while you are using the IUD there is a small risk of ectopic pregnancy.

How is the IUD fitted?

Before you have the IUD fitted, you may be tested for any existing infections, such as STIs, so that any infections can be treated beforehand. If you are getting a new IUD fitted, or if your current IUD is out of date, it is very important that you use condoms and/or abstain from sex for the three weeks prior to your appointment. If your IUD is in date and is due to be changed or removed, you must use condoms and/or abstain from sex for the seven days prior to your appointment. If you do not follow this guidance you will be at risk of pregnancy, which may result in your coil not being fitted, changed or removed at your appointment.

Having an IUD fitted can be uncomfortable and painful but the pain shouldn't last long and is described as quite similar to period pains. A fitting is likely to be less painful if you have had natural birth (vaginal delivery) as your cervix will have previously been stretched.

  • Whilst you lie down, with your knees bent, a speculum will be used to hold your vagina open (the same instrument is used when having a smear test done). Local anaesthetic gel is applied to the cervix and this feels cold.
  • The clinician will then use forceps to hold the cervix steady in order to determine the size and position of your womb with a sterile probe.
  • The coil comes with its arms folded down packed inside a narrow tube. The clinician will insert the tube into the vagina, through the cervix and into your uterus (womb).
  • Then they will pull the plastic tube out, leaving the coil in place allowing the arms of the coil to fold open. Before the speculum is removed, the strings of the coil are cut, leaving 1 to 2 cm hanging down at the top of your vagina so that you can feel to make sure it is still in place.

The whole process should take about 5 minutes.

People normally have some cramping pain afterwards so it is recommended you take some pain killers just before your appointment.

Occasionally people feel nauseous or faint afterwards. They may need to lie down for 5-10 minutes but are usually fine after a short while. The clinician will always make sure you are recovered and happy to make your way home before letting you leave.

Some people prefer to have no plans after their appointment so that they can be relax at be comfortable at home afterwards.

It is fairly common for people to experience some slight cramping and / or spotting for a couple of days after a fitting. You will be asked to make an appointment after 6 weeks where the clinician will check your coil is in place and to see how you are getting on.

Questions?


How quickly does the IUD work after it’s fitted?

The IUD works for contraception immediately after it is fitted.


Will my partner feel the threads?

Your partner shouldn't be able to feel your IUD during sex. If they can feel the threads, get your GP or clinician to check your IUD is in place. They may be able to cut the threads a little.


Can I use tampons or a mooncup with an IUD?

Yes, whilst using the IUD you can use tampons, pads or a mooncup.


How will it affect my periods?

You may have irregular bleeding patterns during the first few months of using the IUD. For some people their periods are heavier, longer or more painful.


Does the IUD increase my risk of cancer?

There's no evidence that having an IUD will increase the risk of cervical cancer, cancer of the uterus or ovarian cancer.


Does IUD copper set off airport security metal detectors?

No, the IUD will not set off airport security metal detectors.


Is it possible for my body to reject the IUD?

The coil can be pushed out by your uterus or it can move, however this is not common. This is more likely to happen soon after it has been put in. This is why your doctor or nurse will teach you how to check your coil threads every month and also arrange to check it for you 6 weeks after your fitting.


Could the IUD get lost inside my body?

It is unlikely that the IUD would move, but the GP or clinician that fits your IUD will teach you how to feel for the threads and check that the IUD is still in place.

If you can't feel the threads or if you think the IUD has moved, you may not be fully protected against pregnancy. See your doctor or nurse straight away and use extra contraception, such as condoms, until your IUD has been checked. It will always be possible to have the IUD removed.


What if I become pregnant while I have a IUD?

Although it is unlikely that you would become pregnant while the IUD is fitted, if you do, there is a small increased risk of you having an ectopic pregnancy. The risk of ectopic pregnancy is less in people using an IUD than in people using no contraception at all.


Are there any serious risks associated with the IUD?

There is a very small chance of you getting an infection during the first 20 days after an IUD is put in. You may be advised to have a check for any possible existing infection before an IUD is fitted. You should see a doctor if you:

  • Have pain in your lower abdomen
  • Have a high temperature
  • Have a smelly discharge.

There is a very rare risk that an IUD might make a tiny hole in the womb or neck of the womb (cervix) when put in. This may cause pain but often there are no symptoms. Contact your GP straight away if you feel a lot of pain in the lower abdomen after having an IUD fitted. If there is a suspected perforation, go to A&E to see a specialist. If perforation occurs, you may need surgery to remove the IUD.


What if I want to have the IUD removed?

A coil can be removed at any time by a trained doctor or nurse.

If you're not going to have another coil put in and you don't want to get pregnant, use another method (such as condoms) for seven days before, as sperm can live for up to seven days inside the body.

Removal of a coil is a very quick procedure (about 30 seconds). It may be a little uncomfortable but is less uncomfortable than the fitting procedure.


Will I need to see the doctor again?

Once an IUD is fitted, it will need to be checked by a doctor after three to six weeks to make sure everything is fine. Speak to your GP or clinician if you have any problems after this initial check or if you want the IUD removed.


Can I use the IUD if I’m approaching menopause?

If you're 40 or older when you have the IUD fitted, it can be left until you reach menopause or you no longer need contraception.


Could I be allergic to the IUD?

The IUD contains copper and should not be used by those who are allergic to copper.


Can I use the IUD after childbirth/while breastfeeding?

Yes, the IUD is suitable for people who are breastfeeding, though you will need to wait four to six weeks after giving birth before you have it fitted.

Some services offer the option to have an IUD fitted immediately after delivery. This is called a post-partum IUD fitting.


Will the IUD affect my future fertility?

Fertility will return to normal when the IUD is removed.


What happens if I get an STI while I have an IUD?

If you get an STI while you have an IUD fitted, it could lead to pelvic infection. STIs and pelvic infections need to be treated as soon as possible. An IUD doesn't protect you against STIs, so you may also have to use condoms when having sex.


I’ve had a serious health condition. Can I use the IUD?

The IUD may not be suitable for you if you have or have had:

  • Problems with your womb or cervix or unexplained vaginal bleeding between periods or after sex
  • An untreated STI or pelvic infection
  • People who have had an ectopic pregnancy, or who have an artificial heart valve, need to consult their GP or clinician before having an IUD fitted.