Coils: Copper or Hormone Intrauterine Contraception
Sexual Health D&G offer insertion / changes of intrauterine devices (coils) for contraceptive reasons. If you wish to use a hormone coil for control of your bleeding or as part of a hormone replacement therapy regimen and you are not in need of contraception, please discuss this with your GP/ANP/practice nurse. Insertion of hormone coils for bleeding control and as part of hormone replacement therapy should be done in primary care; if that is not possible, the doctor or nurse you see in primary care should refer you to gynaecology.
There are 2 types of intrauterine contraception (IUC) which are small plastic devices placed in the womb by a trained clinician
- Copper intrauterine device (IUD) contains copper which prevents sperm from reaching an egg and it makes it difficult for a fertilised egg to settle in the womb (prevents implantation).
- Intrauterine system (IUS) releases the hormone progestogen, which prevents the sperm reaching an egg. It also prevents an egg settling in the womb (implantation). The levels of hormone reaching the blood stream are very low.
For information on intrauterine contraception we recommend that you watch this short film (from NHS Lothian), as it gives you all the information you need about intra-uterine methods. Alternatively read the information below.
Reliability
Intrauterine devices are very effective. Less than 1-2 women in 100 users will get pregnant over 5 years of use.
Possible Side Effects
- Partner may occasionally feel threads during intercourse
- The device may fall out (expulsion)
- There is a risk of ectopic pregnancy, if device fails
- Periods may change depending which type of device you choose
- IUS (hormone coil) - may have irregular bleeding in first few weeks / months before it settles
- IUD (copper) - Periods may be heavier, longer or more painful. This usually settles
- IUS (hormone coil) can occasionally cause breast tenderness, acne or headaches in the first few months
Possible risks at time of insertion
- There is a very small risk of perforating the womb
- There is a small risk of infection entering the womb
Advantages / Benefits
- reliable contraception
- no need to rely on memory
- fertility returns immediately once removed
Hormone IUS
- gives contraception for 5 years
- periods are lighter and shorter and occasionally can have no periods
- when fitted after age 45 years, it can be left in place until the menopause.
- it can form part of HRT
Copper IUD
- gives contraception for 5-10 years depending on the device
- can be used as emergency contraception (it is the most effective form of emergency contraception)
- is immediately effective
- is free from any hormones
- when fitted after age 40 years, it can be left in place until the menopause.
Suitability
- Not suitable for those with current pelvic infection or certain untreated sexually transmitted infections
- Suitable for family spacing
- Copper IUD is not an ideal choice for women with heavy, painful periods
Who can provide it?
Sexual Health Services and some GPs (see list) are trained to fit IUC
List of GP's who fit IUD/IUS. (PDF 52Kb)
Comments
If you are under 25, have a new sexual partner or more than one sexual partner in the last year then you will require testing for chlamydia and gonorrhoea before or at the time of insertion. If you have a discharge or any symptoms the IUD would not be put in until we have the results. Women are taught to feel the threads in their vagina to check the position. If there is a risk of pregnancy it cannot be inserted except the copper IUD can sometimes be inserted as emergency contraception
IUC Post Insertion Information
This video provides information for women who have recently had a coil inserted including what to expect, how to check for the threads and when to seek advice