Essex Private Doctors are pleased to announce the expansion of our contraceptive services to include both copper and hormonal coils.
It is important to have robust contraception to prevent unplanned pregnancy.
We cover a full range of contraceptive options at the surgery including:
- Contraceptive pills
- Contraceptive depot injection
- Nexplanon® contraceptive implant
- Copper coils
- Mirena® and Jaydess® coils
In addition to contraception, the Mirena® coil can also be used to provide the progesterone component of Hormone Replacement Therapy (HRT) which is used for management of menopausal symptoms and also to treat heavy periods.
So what is a coil?
An intrauterine device (IUD), also known as a coil, is a device that is inserted into the womb to prevent pregnancy. It is T-shaped and slightly smaller than a hair grip.
Two types of IUDs are currently available:
- The hormone intrauterine system (IUS) – Mirena® or Jaydess® : These contain slow-release progesterone hormone. The Jaydess is effective for 3 years. The Mirena is effective for 5 years and, as well as preventing pregnancy, can also be used to help with heavy menstrual bleeding or as part of HRT.
- The copper IUD: This releases copper in the womb and is effective for either 5 or 10 years.
How does it work?
The hormone IUS works by thickening the mucous plug in the neck of the womb (cervix). This stops sperm getting through to the womb to fertilise an egg. It also thins the womb lining to make it unlikely that a fertilised egg would be able to implant there. The effect of this is to make your periods lighter or non-existent. In some women, it suppresses egg release (ovulation) too.
The copper IUD works by releasing copper ions into the womb which are toxic to sperm and stops the sperm from surviving. It also prevents a fertilised egg from implanting onto the wall of the womb. Periods and ovulation continue as normal.
Neither option will protect from sexually transmitted infections.
Both the hormone IUS and the copper IUD are very effective. For every 100 women with a IUD, fewer than 1 per year will become pregnant. However, if pregnancy does occur, there is an increased risk of that pregnancy being ectopic (a pregnancy that does not occur in the womb).
Hormone IUS: In the 3-6 months following IUS insertion you may have irregular, prolonged or frequent bleeding but menstrual bleeding patterns tend to improve with time. By 1 year, it is usual to have infrequent or no menstrual bleeding. Hormone side effects are uncommon but can occur due to the body absorbing small amounts of the hormone. These includes acne, breast tenderness, headaches and mood changes. These usually settle within 3-6 months.
Copper IUD: Periods can be heavier, longer and more painful. This often improves after the first few months after insertion.
Some discomfort or pain is possible during the insertion. You may wish to take a painkiller (e.g. paracetamol) prior to the appointment. The clinician will need to do an internal examination before the fitting. There will be an assistant present with the clinician.
The IUD is ideally fitted during your menstrual cycle when the cervix is slightly dilated. However, it can be fitted at any time in the menstrual cycle as long as the clinician is reasonably certain there has been no risk of pregnancy. This means using other contraception reliably 100% of the time up until the fitting, or abstaining from sex.
- PERFORATION OF THE UTERUS – This is a rare situation where the IUD makes a small hole in the womb and can escape into the pelvis. This happens in fewer than 2 women per 1000 insertions (it is approximately six times higher in breastfeeding women). It can cause pain, but not always. The main symptom is not being able to feel the coil threads. If a perforation occurs the coil usually needs to be retrieved by abdominal surgery. If you cannot feel the coil threads make an appointment to see your doctor.
- ECTOPIC PREGNANCY – The risk of pregnancy is small but if it occurs there is an increased risk of the pregnancy being ectopic. See a doctor urgently if you develop lower, one-sided tummy (abdominal) pain.
- EXPULSION – The risk of the IUD being pushed out of the womb through the cervix (expelled) is around 1 in 20 and is most common in the first three months after fitting. It is slightly more likely to happen if you have not had children or if the fitting was particularly uncomfortable. If you cannot feel the threads of the coil, make an appointment to see your doctor.
- INFECTION – There is a six times increase in the risk of infection in the first 20 days following insertion. If you develop heavy bleeding, vaginal discharge or pelvic pain you must see your doctor. The risk of infection is reduced if intercourse is avoided for 48 hours after insertion (this allows the protective plug of mucous at the cervix to reform).
- FAILURE TO FIT – Sometimes it is not possible to fit the coil in the surgery. This does not happen commonly but reasons for this include: an unusual shape of the womb or the presence of fibroids in the womb, the womb being too small for the coil, the neck of the womb being too narrow to pass the coil through or the patient finding the procedure too uncomfortable.
A hormone IUS will take 7 days to start working (prevent pregnancy), unless fitted within 7 days of the menstrual period starting (in which case it works straight away).
A copper IUD will start working (prevent pregnancy) straight away after fitting
If you are swapping from another method of contraception, double check with your clinician when you can start relying on the IUD for contraception.
There is no delay in the return of fertility once the IUD has been removed. Removal is generally a straight forward procedure that can be performed in the surgery.
Make an appointment with the clinician who fitted your IUD about 4-6 weeks after it has been fitted. This is to check the IUD is in place.
- Mirena 5 years
- Jaydess 3 years
- Copper IUD 5 – 10 years depending on the type used