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Contraception

The Hormonal Coil

The hormonal coil is a small, T-shaped plastic device, which contains the hormone progestogen to control your fertility. The device is put into the uterus (womb) through the vagina by a specially trained doctor or nurse.

Quick guide

Hormones

Contains progestogen (low dose)

Mood/Emotions

Can help with feeling low or anxious

STIs

No protection against STIs

Visibility

No one else can see it

Periods

Good at making heavy periods lighter and less painful

Lasts for

Lasts up to 8 years

Acne/Skin

Can cause acne

Preventing pregnancy

More than 99% effective

Starting on this method

Can only be started if there is no chance of pregnancy. Requires an appointment with a specialist nurse or doctor to have it fitted. You may have to use additional contraception for seven days depending on when in your cycle you get the hormonal coil fitted.

How the hormonal coil works

A hand holding the IUS in it's palm next to it is a 50p coin, the IUS is slightly larger than the coin

The hormonal coil works in three ways to prevent the egg being fertilised by sperm. The hormonal coil interrupts this process by:

  • Thickening the mucus around the cervix, which makes it harder for sperm to get through and reach an egg
  • Makes the lining of the womb thinner so that a fertilised egg cannot implant
  • It can also stop ovulation (when ovaries release an egg), although most people who use it continue to ovulate.

The hormonal coil is a method long-acting reversible contraception (or LARC). These methods don’t rely on you remembering to take them, but they do need a trained doctor or nurse to administer or fit them for you.

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Pros and cons

Pros

  • 99% effective
  • Not visible and no interruption to sex
  • Prevents pregnancy for up to three or eight years depending on the brand of coil
  • Good at reducing heavy, painful periods
  • Fertility will return to normal after the hormonal coil has been removed
  • Can be used if you cannot use contraception that contains oestrogen
  • Contains less progestogen than other types of hormonal contraception meaning hormonal side effects are less common
  • Not affected by vomiting, diarrhoea or other medicines like some methods of contraception
  • Eco-friendly method due to its long duration

Cons

  • No protection against sexually transmitted infections (STIs)
  • Can cause temporary side effects such as skin problems, headaches, irregular bleeding or breast tenderness
  • Can cause small fluid-filled cysts on your ovaries – these usually disappear without treatment and often there are no symptoms
  • Comes with small risks of infection after insertion, the coil being pushed out or displaced. Very small risk of tearing of uterus and small risk of ectopic pregnancy is you do become pregnant while using the hormonal coil

Periods and the hormonal coil

It is common for periods to become lighter, less painful, shorter or stop altogether. However, you may experience some temporary irregular bleeding in the first few months.

If you get periods while on the hormonal coil, you can use any period products including tampons/menstrual cups.

How to get the hormonal coil

The coil needs to be fitted by a doctor or nurse who has been specially trained. It is available free from a range of services including contraceptive clinics, your GP and Brook. Find your nearest using our find a service tool.

Contraception and sexual health services such as Brook are free and confidential, including for people under the age of 16. Health professionals work to strict guidelines and won’t tell anyone else about your visit unless they believe you’re at serious risk of immediate harm. Find out more about Brook’s confidentiality policy.

Step 1: Appointment

You will need to book an appointment at a contraceptive clinic or with your doctor. This appointment will typically include:

  • A few questions about your medical and family history, to work out what method would suit you best.
  • You will need to have an internal examination – a doctor or nurse will look inside your vagina to check the position and size of your uterus before the coil can be fitted.
  • They will also check for any signs of infection, sometimes you may be asked to do an STI test or you may also be given antibiotics.
  • There also needs to be no chance that you could be pregnant so you may need to do a pregnancy test before the coil can be fitted.

Some services may be able to fit it at the same appointment, or you may need a second appointment.

Step 2: Fitting the coil

Fitting the coil (shouldn’t take longer than 5 minutes):

  1. You’ll be asked to remove the lower half of your clothing (e.g. trousers/skirt and underwear) and lay on the bed with your legs open and knees bent
  2. The doctor or nurse will use a speculum (instrument inserted into your vagina) to slightly widen your vagina this might feel uncomfortable but it shouldn’t be painful.
  3. The doctor or nurse will then insert the coil into the uterus through the cervix. You may feel some discomfort which may last a minute or two after the coil is inserted, for other people it may last longer.
  4. The doctor or nurse will then trim the strings and remove the speculum.

The coil fitting may be uncomfortable for some people. The doctor or nurse may discuss painkiller tablets and/or using local anaesthetic to make the fitting more comfortable. Learn more about support for survivors of sexual abuse, assault or trauma.

Currently there are four brands of hormonal coil- Mirena, Kyleena, Levosert and Jaydess. Some brands work for eight, four or three years.

Step 3: After the coil is fitted

T-shaped device with strings from the bottom

You may get period-type pain and possibly some light bleeding for a few days afterwards.

The coil has two threads which hang through the opening at the entrance of your uterus (cervix). You should check the threads a few times during the first month and then at least once a month.

You will then only need to go back when the coil needs to be replaced (3 to 8 years depending on the type of coil).

When to talk to a doctor

  • If you cannot feel the threads
  • If you can feel the coil itself
  • If you experience severe or prolonged abdominal pain, especially if you feel unwell, hot and clammy
  • If you experience heavy vaginal bleeding with or without clots

When to start the hormonal coil

The hormonal coil can be fitted any time in your cycle if it is certain that you are not pregnant. If fitted in the first seven days of your menstrual cycle you will be immediately protected against pregnancy. If it is fitted at any other time, you will need to use an additional method of contraception (such as condoms) for the first seven days.

If you have a short menstrual cycle, where your period normally comes every 23 days or less, you will have to start the coil in the first six days (because you might ovulate early in your menstrual cycle).

Getting the hormonal coil after pregnancy

You can get a hormonal coil fitted after a birth, abortion or miscarriage but when you can get it fitted does vary.

After giving birth

You can become pregnant from as little as three weeks after giving birth.
The hormonal coil can sometimes be fitted 48 hours after giving birth. However, in most cases you will have to wait four weeks meaning you will need to use alternative contraception, such as condoms, from week three (21 days) after the birth until the coil is fitted. The hormonal coil is safe to use whilst breastfeeding.

After an abortion or miscarriage

You can become pregnant from two weeks after an abortion or miscarriage.
The hormonal coil can be inserted straight away after an abortion or miscarriage and you will be protected immediately from pregnancy.

Speak to your midwife, GP or a nurse at a sexual health clinic to find out if this method is right for you

How the hormonal coil is removed

The coil must be removed by a trained doctor or nurse. The procedure should be less painful and quicker than when the coil was inserted. If you are not going to have another coil you’ll need to use additional contraception, such as condoms, for the seven days before the coil is taken out if you do not want to become pregnant.

Your fertility should return to normal as soon as the coil is removed.

FAQs

Does having a coil fitted hurt?

Some people may find the fitting painful but you can have pain relief (local anaesthetic) to help. If this is something you would like, it’s a good idea to talk to the nurse or doctor beforehand. For most people pain only lasts a couple of minutes and then you don’t have to worry about contraception for the next five years!

Can I only get a coil fitted during my period?

You can get a coil fitted at any time during your cycle. There is no medical evidence to prove that having it fitted during your period has any additional benefits.

Can you get the hormonal coil while you are pregnant?

No, the hormonal coil is used to prevent pregnancy so should not be used if there is any chance of pregnancy as this may cause an ectopic pregnancy.

At your contraception appointment, you may be asked to do a pregnancy test to confirm that you’re not pregnant. If you’ve recently had unprotected sex (sex without a condom), you may have to wait until a pregnancy test can accurately determine that pregnancy definitely hasn’t occurred before you can have a coil fitted.

More FAQs

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