Contraception

IMPLANTS – arm

COIL – Intra-uterine device (copper coil) & Intra-uterine systems

Preparing for your Coil-fitting Appointment

We strongly encourage you to watch the video found on the sexual health matters website which is linked below. This gives you a lot of useful information about intra-uterine methods:

www.yoursexualhealthmatters.org.uk/contraception/coil-fitting-appointment

You will then need to make a “10 minute pre-fit telephone consultation” with one of the coil fitting doctors (Drs Hewitt, Fenwick or Jennison) before you book in for a coil fit. This allows you to discuss your contraceptive needs, the pros and cons of the coil, and make an informed decision.

If you have any unusual discharge or have had a change in your sexual partner in the last 12 months you may need to have swabs taken with the nurse before the fitting appointment is booked.

You should print, read and sign the Coil Fit – Checklist Consent form above and bring this along to your fitting appointment.

Coil-fitting Appointment

A coil-fitting appointment usually takes about 30 minutes. Please make sure you have plenty of time for your appointment and that you have had something to eat beforehand. Where possible find childcare for small children.

Ideally a coil is fitted between day 3-12 of your cycle to ensure you are not pregnant and the neck of the womb (cervix) is more likely to be a little open and therefore the coil is easier to fit. It can be fitted outside these dates in some circumstances.  Your doctor will discuss this with you.

It is very important that there is no possibility that you are pregnant at the time of a coil-fitting

If you are having a new coil fitted please avoid having intercourse from the first day of your period or make sure you have used contraception very carefully for at least three weeks before your appointment.

If your appointment is for a coil change, you need to avoid intercourse for the week before fitting in case, for any reason, a new coil can’t be inserted once the old one has been removed. If your coil is out of date however, you should avoid intercourse for three weeks before the appointment.

Please take 1g Paracetamol (two tablets) and/or 400mg Ibuprofen about 1 hour before your appointment as you may experience abdominal cramps similar to period pain, post fit. Please bring a sanitary towel to your appointment as you may have some bleeding/spotting.

Before the coil is fitted, you will have an internal examination to determine the size and position of your womb. This is to ensure the coil can be put in the correct place. An internal measurement of the length of the womb is made and then the coil is inserted. The coil-fitting takes 15-20minutes. The vagina is held open with a speculum, like during a smear test, and the coil is fitted through the cervix into the womb.

After your Coil-fitting Appointment

You may get some crampy period type pains for a few days after a coil fit. You should avoid strenuous exercise for the rest of the day that the coil is fitted on. The pain should settle with simple pain relief such as Paracetamol and/or Ibuprofen as above. If it doesn’t, please call the surgery to speak to a GP.

It is quite normal to have unpredictable or sometimes heavier bleeding after a coil fitting, but if the bleeding is very heavy and prolonged or you develop smelly discharge or pain this could be a sign of infection, so please call us to discuss these symptoms.

Avoid using tampons for the first four weeks after the coil fit. After that it is fine to use them but be careful when you remove them not to pull the coil threads too.

With the hormone coil, it is normal to have some irregular bleeding for the first few months but if you are concerned about this at all, please contact one of the doctors.

If you have had a copper coil fitted you are protected from pregnancy as soon as the coil is in place.  If you have had a hormone coil fitted, (mirena/kyleena/jaydess) it needs to be in place for 7 days before you are protected.  We advise however that you should continue using condoms or continue contraceptive pills for four weeks. This is because the time of greatest risk of expulsion (the coil falling out) is in the first few weeks after fitting.

We do not ask you to return for a coil check, but you should have been taught how to check for your coil threads at the fitting appointment. You should perform this check 4 weeks after the coil is fitted. You can feel the threads by placing one leg on the side of the bath and inserting a finger into the vagina, upwards and backwards. You will be able to feel the threads (coarse hairs/soft wire consistency) around the cervix. (The cervix feels like the end of your nose with a dimple in it).  If you can’t feel the threads, please see a nurse or GP as soon as possible and use additional contraception such as condoms until your coil fit has been checked.

Removing the coil is a very simple and quick procedure that rarely causes much discomfort (even if the fitting was painful). You should avoid intercourse for seven days before a planned removal to avoid any risk of pregnancy.  Please contact the surgery to make an appointment if you would like to have your coil removed at any time.