Before you have your coil or implant

Please make sure you have read and understand the information below before you attend your implant appointment.

Contraception, pregnancy and STIs

It is very important that there is no chance of you being pregnant when you have your implant fitted (or re-fitted).

1. Brook recommends that you use condoms every time you have sex for three weeks before your implant fitting. If you have had unprotected sex (sex without a condom or contraception) in the three weeks before you implant appointment, the nurse or doctor will not be able to fit your implant.
2. The ‘withdrawal method’ (pulling out) and natural family planning do not count as contraception ahead of an implant fitting.
3. If you are already using a method of contraception, keep using it up until your fitting. This means you should keep taking your pill or using your patch, have the implant inserted before your injection runs out, or keep your coil until after the fitting. It is safe to have both methods at the same time. You may need to keep using your current method for up to seven days after your fitting, too, so make sure you tell the nurse/doctor if you are running out of pills or patches.
4. If you think that your method of contraception may have failed, for example if the condom broke or if you missed a pill, make sure you tell the nurse/doctor before they start your implant fitting.
5. We may need to do a pregnancy test when you attend clinic, so please be prepared to provide a urine sample. If you do not do a pregnancy test when asked by the nurse/doctor, they may not be able to fit your implant.
6. You shouldn’t have the implant fitted if you are at risk of having a sexually transmitted infection (STI) like chlamydia or gonorrhoea. STIs are usually passed on through unprotected (without a condom) sex. Brook recommends you do an STI test before your appointment if you have had a new sexual partner since your last test. You can ask for a test at your local sexual health clinic or see if you can get a free one to do at home.
7. The implant may not be effective at preventing pregnancy straight away and you might need to avoid sex or use another method of contraception for the first seven days after your fitting. Condoms are a good idea – if you need some you can ask at the clinic and they’ll give you some for free. This will be discussed further with you at your appointment.

Implant risks

There are risks involved in all medical procedures. Please make sure you understand the below risks associated with the implant. You can ask the doctor/nurse to explain in more detail at your appointment if you want to.

1. No method of contraception is 100% effective. The implant has a very small risk of failure (less than 1 in 100 chance of pregnancy).
2. After having the implant fitted, there may be significant or noticeable bruising around the insertion area (usually the inside of the upper arm), though this should fade within a couple of weeks.
3. There may be a small scar in the insertion area.
4. There is a small risk of infection after the implant fitting and you should keep an eye on it to make sure the area does not become red, hot and swollen.
5. There is a rare risk of the implant moving (migration) into a vein rather than staying under the skin where it was fitted (intravascular insertion).
6. There is a rare risk of damage to blood vessels supplying blood to the brain and spinal cord (neurovascular damage).
7. It is possible that your bleeding pattern (periods) will change and that you may experience no periods, irregular bleeding or prolonged bleeding after the implant fitting.
8. Occasionally, implants can be difficult or uncomfortable to remove.

Preparing for your appointment

Make sure that you have had breakfast/lunch on the day of your appointment, and that you are well hydrated (have had enough to drink). Don’t drink alcohol or take drugs before your appointment.

Having the implant fitted shouldn’t be painful, though it could be a bit uncomfortable. If you are worried, a painkiller can be taken around an hour before your appointment.

If you have any questions about the implant or about the fitting procedure, make a note of these and make sure you ask the nurse/doctor before they start the procedure.

Be sure to follow any other guidance given to you at the time of booking your appointment.

If you want to bring someone with you to your appointment, please call the clinic beforehand to let them know. If you do bring someone with you, it’s important to understand that there might be times where the nurse/doctor has to ask you sensitive or personal questions – you might want the other person to leave the room whilst you answer these.

After your implant fitting

Make sure you know when your implant is due to expire. It might be good to add a reminder to your Google or Apple calendar for three years’ time.

If you have any worries about the implant, you can get back in touch with Brook and a nurse/doctor will be able to support you.

If you think you may have an infection (if your arm is red, hot or swollen) or feel unwell, you should seek medical advice immediately.

Remember: there may be some bruising to the implant site shortly after your fitting, and you may see changes to your periods.

Please make sure you have read and understand the information below before you attend your coil appointment.

Contraception, pregnancy and STIs

It is very important that there is no chance of you being pregnant when you have your coil fitted (or re-fitted).

1. Brook recommends that you use condoms every time you have sex for three weeks before your coil fitting. If you have had unprotected sex (sex without a condom or contraception) in the three weeks before you coil appointment, the nurse or doctor will not be able to fit your coil.
2. The ‘withdrawal method’ (pulling out) and natural family planning do not count as contraception ahead of a coil fitting.
3. If you are already using a method of contraception, keep using it up until your fitting. This means you should keep taking your pill or using your patch, have the coil inserted before your injection runs out, or keep your implant until after the fitting. It is safe to have both methods at the same time. You may need to keep using your current method for up to seven days after your fitting, too, so make sure you tell the nurse/doctor if you are running out of pills or patches.
4. If you think that your method of contraception may have failed, for example if the condom broke of you missed a pill, make sure you tell the nurse/doctor before they start your coil fitting.
5. You may need to do a pregnancy test when you attend clinic, so please be prepared to provide a urine sample. If you do not do a pregnancy test when asked by the nurse/doctor, they may not be able to fit your coil.
6. You shouldn’t have the coil fitted if you are at risk of having a sexually transmitted infection (STI) like chlamydia or gonorrhoea. STIs are usually passed on through unprotected (without a condom) sex. Brook recommends you do an STI test before your appointment if you have had a new sexual partner since your last test. You can ask for a test at your local sexual health clinic or see if you can get a free one to do at home.
7. The hormonal coil may not be effective at preventing pregnancy straight away and you might need to avoid sex or use another method of contraception for the first seven days after your fitting. Condoms are a good idea – if you need some you can ask at the clinic and they’ll give you some for free. If you are having a non-hormonal coil, it will be effective immediately.

Coil risks

There are risks involved in all medical procedures. Please make sure you understand the below risks associated with the hormonal and non-hormonal coil. You can ask the doctor/nurse to explain in more detail at your appointment if you want to.

1. No method of contraception is 100% effective. Both the hormonal and non-hormonal coil have a very small risk of failure (less than 1 in 100 chance of pregnancy).
2. In the unlikely event that you do get pregnant with a coil, there is a risk that it may be an ectopic (outside the womb) pregnancy.
3. There is a 1 in 1000 risk of the coil making a hole in the womb (perforation of the womb) at the time of insertion.
4. There is a 1 in 20 chance of the coil falling out.
5. There is a 1 in 100 risk of infection after the coil fitting.
6. It is possible that your bleeding pattern (periods) will change and that you may experience no periods, heavier bleeding, irregular bleeding or prolonged bleeding after the coil fitting.

Preparing for your appointment

Make sure that you have had breakfast/lunch on the day of your appointment, and that you are well hydrated (have had enough to drink). Don’t drink alcohol or take drugs before your appointment.

As the coil needs to be put into the womb via the vagina, having one fitted isn’t the nicest experience; it can feel invasive and uncomfortable, and some people will find it painful. The nurse/doctor will do their best to make you comfortable and will keep checking to make sure you are ok. Remember: they’ve done this loads of times so you don’t need to feel embarrassed about them seeing your bits!

A painkiller can be taken around an hour before your appointment – this is usually enough pain relief for most people. You can request a local anaesthetic, but not all services will be able to offer this so if you want one it’s best to check before you make your booking.

You might want to think about some relaxation techniques to help you stay calm and your muscles relaxed during the fitting. You can also request that a second member of staff is present during the fitting to support you – they can chat to you and/or (if you’re both comfortable with it) hold your hand.

If you have any questions about the coil or about the fitting procedure, make a note of these and make sure you ask the nurse/doctor before they start the procedure.

Be sure to follow any other guidance given to you at the time of booking you appointment.

If you want to bring someone with you to your appointment, please call the clinic beforehand to let them know. If you do bring someone with you, it’s important to understand that there might be times where the nurse/doctor has to ask you sensitive or personal questions – you might want the other person to leave the room whilst you answer these.

After your coil fitting

It’s important to look after yourself! Take it easy for the rest of the day (try to avoid any vigorous exercise) and if you have any pain or cramps you can use painkillers. A hot water bottle on your tummy can also help.

Make sure you know when your coil is due to expire. This will usually be in either five or 10 years. It might be good to add a reminder to your Google or Apple calendar.

If you have any worries about the coil, you can get back in touch with Brook and a nurse/doctor will be able to support you.

If you think you may have an infection or feel unwell, you should seek medical advice immediately.

Remember: you may see changes to your periods after having a coil fitted.