Getting started with the non-hormonal coil

You’ll need to have the non-hormonal coil inserted by a doctor or a nurse practitioner with specialist training. The Faculty of Sexual and Reproductive Healthcare (FSRH) issues a qualification to show that your doctor or nurse has done the additional training to safely fit coils.

Some people find it painful, others don’t. We recommend you prepare for your appointment and make time to take it easy afterwards.

To get a non-hormonal coil:

To be sure it’s right for you, you’ll be asked about:

  • previous pregnancies

  • how regular your periods are

  • whether you bleed between periods

  • previous STIs (sexually transmitted infections)

  • serious illnesses or operations

  • any medications you’re taking

They’ll also explain the process and the risks, and give you a chance to ask questions.

Real contraception experiences

Insertion: not difficult at all. I go to the gym most days and was back on my normal routine within 2 days of the coil fit. I have started to get PMS again, which I never did on the pill. But I really appreciate not having to think about it, I was never very good at remembering to take the pill and so was constantly paranoid about pregnancy.

I found it very painful and I felt a bit sick afterwards. The good thing was that it didn't last more than 10 mins. I was a bit wobbly going home but it settled down with hot water bottles and paracetamol that evening. The next day I was a bit tender, but basically back to normal activities. For me, it was worthwhile as it will give me many years of contraception. But I would be wary of doctors who say it is ‘just a bit uncomfortable'.

The pain of insertion was terrible, but only for like 2 minutes. For 3-4 hours after I had mild cramping. After that I was fine.

When to get the coil fitted

You can have the non-hormonal coil fitted at any time as long as there’s no risk of pregnancy for more than 5 days beforehand. You should note that:

  • if you’ve had a baby, the non-hormonal coil can be fitted within the first 48 hours after giving birth (if you don’t have it fitted immediately after the delivery, you’ll need to wait at least 4 weeks)

  • if you’ve had an abortion, you can have a non-hormonal coil fitted immediately

  • if you’ve had a pregnancy risk in the 5 days before fitting (or less than 5 days after your earliest you may have ovulated that cycle) then you could have a non-hormonal coil fitted as a form of emergency contraception and keep it for ongoing contraception if you wish

Rare but important risks of fitting the coil

If you have an undiagnosed or untreated infection

Fitting the non-hormonal coil (IUD) does not cause an infection. But, if you already have an infection like chlamydia or gonorrhoea, the fitting may move the infection from the entrance of the womb into the womb itself. It may then become a more serious infection. 

You’ll be asked about your risk of infection when the coil is fitted (like whether you’ve had a recent change of sexual partner) and when you were last tested for STIs. 

If you haven’t been tested recently and have been at risk of infection, then you’ll usually be offered a test for infection at the time of fitting.

If you get any of these symptoms within a few weeks of having the non-hormonal coil fitted, you should see your GP:

  • pain in your lower abdomen

  • a high temperature

  • a smelly discharge

Risk of perforation

There’s an extremely rare chance – 2 in 1,000 people – that the hormonal coil may go through the wall of your uterus, so it sits in the abdomen outside the womb.  

It usually happens only when it’s fitted and may not be noticed at the time. If it's happened to you, you won’t be able to feel the coil’s threads. If you can feel the threads, that usually means everything's fine.

Risk of it falling out

The non-hormonal coil may fall out without you noticing, particularly during a heavy period. This happens with 1 in 20 non-hormonal coils. It’s important to check your coil threads after each period.

If the coil is partly out, then the threads might feel longer than usual or you may feel the lower tip of the coil in the vagina. If you notice this, use an extra type of contraception, like condoms, and visit your clinic or GP.

What should I do before my coil appointment?

Make sure to eat an hour before, so your blood sugar isn’t too low. This will mean there’s less chance you’ll faint. At the same time, take a painkiller, such as paracetamol or ibuprofen, as this will help with any pain.

It’s a good idea to take someone with you, too. They’ll help you on your journey home if you’re feeling unwell. It may also be a good idea to get a taxi or a lift with a friend rather than take public transport.

Will it be painful?

It can be painful but the pain shouldn’t last long. This pain is from stretching the entrance to the womb.

Some people also feel a little faint or sick for a short while afterwards. This is because stretching the cervix in some people can cause fainting.

Getting the coil fitted at the end of your period means your womb will be at its most open, and it’ll hurt less. But it can be fitted at any time.

It may be less painful if you’ve given birth vaginally as your cervix will have previously been stretched.

How is the coil fitted?

The procedure itself takes about 5 minutes, but you’ll need to prepare for your appointment and may want to take the rest of the day to recover afterwards.

  1. While you lie down on your back 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. A local anaesthetic gel is applied to the cervix, which will feel cold.

  2. The clinician will then use forceps to hold the cervix steady. They’ll work out the size and position of your womb using a sterile probe.

  3. The coil comes with its arms folded down, packed inside a narrow tube. The clinician will put the tube into the vagina, through the cervix and into your womb.

  4. Then they’ll pull the plastic tube out, leaving the coil in place and letting the arms fold open. Before the speculum is taken away, the threads of the coil are cut. This leaves 1 to 2 cm of the threads hanging down at the top of your vagina, you can feel these to make sure it’s still there. 

What happens afterwards?

You may want to lie down for a few minutes after the fitting and take it easy for the rest of the day.

Paracetamol, hot water bottles and warm baths can all help with period-type pain after a coil is fitted. It usually goes away in a few hours, but it can last a couple of days.

Check for coil threads after your period

1 in 20 coils fall out, most often in the first 3 months after it’s been put in. Check the threads after every period so you know it’s still there.

How to check the threads:

  • feel for your cervix with your fingers – it feels like a smooth lump at the top of the vagina – this is different from the rough walls of the vagina

  • as you try to run your fingers over the cervix you’ll feel the threads – they’re thicker than cotton threads, but thinner than normal household string (they’re often tucked up to the side of the cervix)

What do you do if you can’t feel the threads?

If you can’t feel your non-hormonal coil threads, see your healthcare professional. Start using other contraception (such as condoms) until you know for sure that your-hormonal is in the right place.

The threads may just be tucked up inside the neck of the womb, but it may also be a sign that your coil has fallen out. Your healthcare professional will check whether they can see the threads. If not, they’ll use an ultrasound scan to see whether or not it’s still there.

How do you get the coil removed?

The coil can be removed by a clinician without specialist training. This is a very simple procedure that lasts only a few minutes.

They’ll insert a speculum, so they can see the entrance to the uterus and the non-hormonal coil threads. Then they’ll use forceps to grasp the threads and gently pull the non-hormonal coil out of the uterus and down through the vagina.

Use another contraceptive 7 days before removal

There is a risk of pregnancy around the time you have a coil removed, so use another method of contraception or avoid sex in the 7 days before the removal.

You’ll need to do this because if there’s a fertilised egg moving down the fallopian tube, the coil won’t be there to prevent it from implanting once it has been removed.

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