Coil/IUD FAQ
I am having my period can I still have my IUD fitted?
Yes it is OK to fit a coil when you are on your period, so you do not need to cancel or rebook for this reason. Sometimes it can even make fitting easier.
What is the difference between a copper IUD and a hormonal IUD?
Intrauterine devices, often called coils, come in two main types. The IUD, also known as Copper IUD, copper coil or Cu-IUD works mainly by stopping the sperm from fertilising the egg. It starts working as soon as it has been fitted. This is the kind of coil that can be used as emergency contraception. The copper IUD is hormone-free and generally will not change the regularity of your periods. A leaflet about the copper IUD can be found here: https://www.nhsinform.scot/healthy-living/contraception/copper-coil-iud/
The Hormonal IUD (brand names include Mirena, Levosert, Kyleena and Jaydess) contains a hormone called levonorgestrel which is a progestogen hormone. This hormone makes the mucus at the neck of the womb thicker, so that sperm can’t get in, and also makes the lining of the womb thin which can make periods lighter. The hormonal IUD takes 7 days to start working effectively. There are several different types of hormonal IUD; some are licensed for contraception only, while others can also be used to treat heavy periods and as part of hormone replacement therapy (HRT) at the time of the menopause. At the moment the hormonal IUD cannot be used as emergency contraception. A leaflet about the hormonal IUD can be found here: Copper coil (IUD) | NHS inform
When can the IUD be fitted?
An IUD (copper or hormonal) can usually be fitted at any point in your cycle, as long as there is no risk of pregnancy. We therefore ask that you do not have unprotected sex after your last period, until your appointment. Please note a copper IUD can be inserted as an emergency contraceptive after unprotected sex, please contact us on 0131 536 1070 as soon as possible after any risk to see if it would be suitable for you to have this.
What is an emergency IUD?
A copper IUD can be fitted after an episode of unprotected sex or contraceptive failure. It is the most effective emergency contraceptive and can often be used at times when the emergency contraceptive pill (‘morning after pill’) might not be so effective. The timing of when an emergency IUD can be done depends on a number of things, such as where you are in your menstrual cycle and when the risk happened, so it is best to contact us to discuss this as soon as you have had any unprotected sex or contraceptive failure on 0131 536 1070.
Do I need any tests before having an IUD?
If you think you are at risk of having an STI such as Chlamydia or Gonorrhoea then we can usually offer a test at the same time as your insertion of an IUD. We would not recommend delaying insertion until the results of your tests are known, as long as we have contact details for you in case the results are positive.
Women with very heavy or unpredictable bleeding, particularly over the age of 45,may need additional tests, please discuss this with your GP, who can organise extra tests if they are needed, or refer you to have these done.
What will happen at the clinic?
At the clinic, you will meet the health professional who is fitting your copper or hormonal IUD. A clinical support worker/healthcare assistant may also be there to support you. The health professional will check your medical history and answer questions. We suggest that you have a light meal before coming to have your IUD fitted. We will examine you before fitting the IUD. This is an examination to look at the neck of the womb, similar to when you have a smear test. The IUD is then fitted into the womb, and we will cut the threads of the device so that they sit high up inside the vagina. The procedure can be uncomfortable, but half of people who have an IUD experience little or no pain, and there is the option for local anaesthetic to be used. The whole appointment usually lasts around 30 minutes.
How will I feel after the IUD fitted?
After the procedure, some women have cramping period-like pain, and you should take it easy for the rest of the day. Cramps usually settle after a few days, and simple painkillers can be taken. You may also have some light bleeding from the procedure itself.
What are the threads and how do I feel for them?
The threads of the IUD are attached to the end of the device and can be felt at the cervix which is at the top of the vagina. We ask women to check their own threads 6 weeks after insertion to ensure the device has not been expelled and that a perforation did not occur at the time of insertion. Your cervix is at the top of the vagina and feels firm like your nose, and you can feel the threads at the centre of it. If you cannot feel the threads, or aren’t sure about what you feel, contact us on 0131 536 1070, it is important to use additional contraception such as condoms until it has been checked. Also, don’t panic, on most occasions the threads can be seen when we look inside, and if not we can book an ultrasound scan appointment to make sure the IUD is in the right place.
How long does an IUD work for?
The various hormonal and copper IUDs work for different lengths of time and their effectiveness does not just switch off at their expiry date, so they will all provide some protection from pregnancy, but use of alternative contraception such as condoms is recommended form the time they expire.
All the copper IUDs we use in Chalmers will work for at least 5 years; there are a few copper IUDs that work for 10 years. The decision about which will suit you is generally made when the clinician assesses you in the clinic just before insertion, or your personal preference. Any copper IUD fitted in someone over the age of 40 will work for contraception until after menopause.
There are few different types of hormonal IUD, and the length of time they work can range from 3 to 8 years of use, so it is important that you keep any cards or leaflets from your insertion appointment so that you know when it needs to be replaced. A 52mg hormonal IUD (Mirena, Levosert, Benilexa) fitted at age 45 years or over will work to prevent pregnancy until after menopause. When a hormonal IUD that is being used as part of HRT it should be replaced every 5 years.
When should I have an IUD removed?
An IUD can be removed any time in your menstrual cycle but it is important that you have not had sex in the 7 days before removal or you may be at risk of pregnancy (sperm can survive at least 5 and possibly up to 7 days in the female body so after the device is removed they may still be able to cause a pregnancy). If you are planning to move to another form of contraception then it is OK to start this before your IUD is removed so that contraception is in place. If you start a new contraceptive on the day your IUD is removed then you will need to avoid sex or use condoms carefully for the first 7 days (or as advised by the clinician who removes your IUD)
If you are planning a pregnancy then information can be found here: https://www.lothiansexualhealth.scot/pregnancy-planning/planning-a-pregnancy/
Who can have an IUD?
Everyone! It is an urban myth that you have to have had a baby before you can have an IUD. They are very suitable, highly effective and convenient forms of contraception for anyone with a uterus. There are a few rare medical conditions that mean an IUD would not be a suitable option, so if you have any health issues you should let the clinician know.
Can I use tampons or a menstrual cup once I have an IUD?
Yes. We advise that you avoid using these for the first two weeks after fitting an IUD but they are safe to use. It is important to avoid catching the threads of the IUD when you remove a menstrual cup or tampon, so just ensure you remove your cup or tampon carefully, and check the threads of your IUD after your period finishes.
Will an IUD affect my fertility?
No, as soon as an IUD is removed your fertility starts to return to normal. In fact we ask that you do not have sex for 7 days before we remove an IUD so that you are not at risk of falling pregnant immediately.
Can the IUD come out or get stuck?
The IUD must be fitted by a specially trained clinician who carefully puts it in the correct position. There is a small risk (about 1 in 1000) at the time of insertion that it can go into or through the muscle of the uterus (perforation) and end up in your pelvis. There is also the possibility (1 in 20) that it will be pushed out of your uterus and come out of your vagina (expulsion) . We advise that women check that they can feel the threads of their IUD 6 weeks after it has been inserted (see how to do this above) and to seek medical advice if you experience unusual pain, bleeding or discomfort, particularly in the first month after insertion.