Copper Coil (IUD)
The copper coil is a popular, safe and effective method of long-acting contraception, which lasts for ten years. It does not contain any hormones. You cannot feel the coil once it is in situ. The main drawback is that for some women it can make periods heavier, longer, or more painful.
Are you able to have a copper coil?
There are only a few contraindications to the copper coil. We cannot fit a copper coil if:
- You are pregnant
- You have a past history of the serious pelvic infection called Pelvic Inflammatory Disease (PID) - unless you have had a normal pregnancy since the infection
- You have an untreated pelvic infection now
- You have cancer of the uterus, cervix or breast
- You have unexplained bleeding from the vagina
- You have liver disease or a liver tumour
- You have a known condition that has changed the shape of the uterine cavity, such as large fibroids
Potential risks and complications
As with any medical device, there are risks associated with the use of the copper coil. These are outlined below and we will also go through them again at the time of your fitting appointment.
- Ectopic pregnancy: Very few pregnancies overall occur with a copper coil in place. This means that the OVERALL risk of ectopic pregnancy is reduced compared to using no contraception. However if a pregnancy does occur with a copper coil in situ up to half of those pregnancies will be ectopic. This is why it is very important to alert the doctor immediately if you think you may be pregnant.
- Pregnancy: A copper coil is an extremely effective method of contraception; however no method is perfect. If pregnancy does occur with a copper coil in place, the coil should be removed; and this removal or manipulation may cause pregnancy loss. It can cause complications if it remains in place throughout a pregnancy, for example by increasing the risk of septic miscarriage (miscarriage where the mother becomes ill from infection).
- Pelvic Inflammatory Disease: There is a risk of introducing any pre-existing or new infection into the uterus when a copper coil is inserted, or if you have a copper coil in place. PID can cause tubal damage leading to ectopic pregnancy or infertility or hysterectomy.
- Perforation: May occur during insertion and not be detected until some time later. Risk is about 1-2 per 1000 insertions. Perforation may allow a pregnancy to occur. You may require surgery to remove the coil. Delayed detection may result in migration outside the uterine cavity, with a risk of adhesions, internal infection, and/or perforation of intestine.
- Expulsion: The coil can fall out and sometimes women do not notice it has fallen out. The risk is around 1 in 20 and is most common in the first year of use, particularly within the first three months after insertion.
- Heavier and / or more painful periods
Do you need a swab before fitting?
The Faculty of Sexual and Reproductive Health (FSRH) states that any woman with the following risk factors must have a swab to check for sexually-transmitted infection prior to fitting a coil:
- Being sexually active and aged under 25
- Having a new sexual partner in the last three months
- Having more than one sexual partner in the last year
- Having a regular sexual partner who has other sexual partners
- A history of sexually-transmitted infections
If any of these apply to you, please request a self-test swab for chlamydia and gonorrhea from Bridge Street reception a week before your fitting is scheduled. Ask reception for a QUICK CHECK TEST. This is a simple vaginal swab, the instructions are in the packet. Drop it back to reception when you are done. (You are very welcome to pick up this test anyway if you would like, even if you don’t fit into any of the suggested categories).
Scheduling your fitting
Unfortunately we do have a waiting list for coil and implant clinics at Bridge Street - this is common nationwide as there is a shortage of fitters. After you have had a phone appointment with any clinician to assess your suitability for a coil and answer any questions, we can add you to the waiting list and reception will contact you as soon as the next appointment comes up.
We can fit a copper coil at any time in your cycle, including during menstruation, as long as your bleeding is not too heavy. However it is vital you are not pregnant at the time of fitting.
To ensure you are not pregnant before your appointment
- If you are not using any contraception, or are only using condoms: Do not have sex (even using condoms) from when your period starts until the fitting.
- If you take the contraceptive pill or have a contraceptive implant or injection: Make sure you continue to use your current method of contraception including on the day you attend to have the coil fitted.
- If you are having the coil removed and replaced: Do not have sex for 10 days before the fitting. This is to ensure there are no live sperm in your uterus, in case the new coil cannot be fitted once the old one has been removed.
Please ensure you have eaten prior to your appointment (ie, do not skip breakfast). We would recommend taking an anti-inflammatory painkiller, such as ibuprofen, about an hour before your appointment (as long as you are able to take this medication usually).
There will be a GP and a nurse present at your appointment. We will first review what we’re going to do and go through the consent form.
The GP will then do a pelvic examination to assess the size and shape of your uterus. The rest of the procedure is carried out using a speculum (the device that is used during a smear test). The fitting can cause some discomfort – the sensation has been described as like a sharp pinch, or a strong period cramp. We use anaesthetic gel to try and ease the experience, and we work hard to make everything as comfortable as possible for you. If you wish to stop at any time this is absolutely fine. Most women we fit here are suprised at how manageable they find the experience.
Fitting usually takes half an hour or less. Very rarely, some women can experience a vasovagal reaction during or after fitting and can faint. We have not had this happen at Bridge Street to date, but it is a known potential complication of the procedure so we must warn you about the possibility. If you become faint we will ask you to stay on the premises until we are sure you are feeling well enough to go home.
There is no obligation to have any formal follow-up, although we do ask that you are aware of your threads and check them regularly. If you wish to have f2f follow up then you are very welcome to book an appointment with the nurse at 3-6 weeks after insertion for a thread check (this is carried out by performing an examination with a speculum – it is quick!). If you don’t feel you want a vaginal examination please feel free to request a nurse phone call instead to go through any questions or concerns.
If any of the following occurs after fitting please contact Dr Harrison or your own GP urgently:
- pain or discomfort after 48 hours have passed since fitting
- severe pain or concerning bleeding at any time
- an unusual or odorous vaginal discharge or fever
- if you cannot feel your threads or if you think the copper coil has been expelled for any reason (use contraception until you can see the doctor or nurse in case the device has been expelled or perforated)
- if you have a positive pregnancy test
You can have a coil removed at any time. Taking it out is usually quick and easy (five minutes or less) and can be performed by the nurse. Occasionally we are unable to remove a coil at the surgery, in which case we will refer you to the Lime Tree sexual health clinic, or the gynaecology department at Addenbrookes. Please be aware you need to have abstained from sex for ten days prior to removal as otherwise there is a risk of pregnancy.
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