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Contraception

The Non-Hormonal (Copper) Coil

The copper coil (also known as IUD, intrauterine device, or non-hormonal coil) is a small, T-shaped plastic device which contains copper. It is put into the uterus (womb) through the vagina by a specially trained doctor or nurse. 

Quick guide

Hormones

No hormones

Mood/Emotions

No effect on mood

STIs

No protection against STIs

Visibility

No one else can see it

Periods

May make periods heavier or last longer

Lasts for

Lasts up to 10 years

Acne/Skin

Skin will stay the same

Preventing pregnancy

More than 99% effective

Starting on this method

Requires an appointment with a specialist nurse or doctor to have it fitted. It works immediately, meaning you won’t need to use any other contraception once it’s fitted.

What is the copper coil?

The copper coil or IUD is a small T-shaped flexible plastic and copper device, slightly bigger than a 50p coin, which is put into the uterus through the vagina by a trained doctor or nurse.  

The copper coil is a method of 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.

It works by releasing copper into the uterus which prevents sperm from surviving long enough to fertilise an egg, as copper is toxic to sperm. The coil may also stop a fertilised egg implanting in the uterus.  

The copper coil is one of the most effective methods of contraception. It starts working immediately, is over 99% effective and lasts up to 10 years (or until it is removed).

Unlike the IUS, the copper coil IUD does not contain any hormones.

It doesn’t protect against STIs so condoms are still needed. 

Emergency Contraception

The non-hormonal copper coil can also be used as a form of emergency contraception if fitted within five days of unprotected sex.
More about the non-hormonal coil as emergency contraception

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Pros & cons

Pros

  • Immediate protection from pregnancy – method of emergency contraception
  • Not visible and no interruption to sex
  • Newer versions are over 99% effective at preventing pregnancy
  • Unaffected by vomiting, diarrhoea or other medicines 
  • Eco-friendly due to its long duration
  • Don’t have to think about taking it every day (like the pill)
  • Fertility will return to normal once removed
  • Lasts for 5-10 years (or until removed)
  • The only long-acting method without hormones

Cons

  • No protection against sexually transmitted infections (STIs)
  • Periods may be heavier, more painful or last longer
  • Small risk of getting an infection after IUD is inserted
  • Small risk of the IUD being pushed out or displaced
  • Very small risk of tearing of the uterus
  • If you become pregnant whilst using the IUD, there is a small risk of an ectopic pregnancy
  • The fitting can be painful for some people

Side effects of the non-hormonal copper coil

Cramping: Many people experience some cramping for a few days after insertion.
Heavier periods: periods may become heavier, longer, or more painful. This may improve after a few months.
Bleeding between periods: some people experience breakthrough bleeding or spotting (bleeding between periods).

The copper coil is very safe, however there are rare risks including pelvic infection shortly after insertion and the coil moving or becoming displaced.

While using the copper coil, your provider may recommend you don’t use menstrual cups or tampons for the first few weeks of use.

If you are experiencing side effects that are manageable, it’s worth giving it at least three months as they may settle down after this time. If something doesn’t feel right, always see a doctor.

How to get the non-hormonal copper coil

The non-hormonal copper coil needs to be fitted by a doctor or nurse who has been specially trained. It is available free of charge from a range of services including contraceptive clinics, your GP and Brook.

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.

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.
  • An internal examination – a doctor or nurse will look inside your vagina to check the position and size of your uterus before the copper coil can be fitted
  • They will also check for any signs of infection. Sometimes you may also be given antibiotics.

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

The doctor or nurse may discuss painkiller tablets/using local anaesthetic to make the fitting more comfortable. You can also bring someone with you for support.

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.

Most people feel well enough to leave straight after the appointment.

You may get some 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 (5 to 10 years depending on the type of non-hormonal 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 copper coil

The copper coil can be fitted at any time in your cycle if it is certain that you are not pregnant. It may also be possible to fit the copper coil as emergency contraception. Check the emergency contraception calculator to work out if it is not too late to fit a non-hormonal coil.

As soon as the non-hormonal copper coil is fitted then you will be protected immediately. You will be asked to take a pregnancy test before the non-hormonal coil is fitted and another three weeks later if there is a pregnancy risk.

Getting a copper coil after pregnancy

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

The copper coil can sometimes be fitted 48 hours after giving birth. However, in most cases you will need to wait four weeks. As you can get pregnant from as little as 3 weeks (21 days) after giving birth, you will need to use alternative contraception from week three (21 days) after the birth until the coil is fitted. The copper coil is safe to use whilst breastfeeding.

The copper coil can be inserted immediately after an abortion or miscarriage and you will be protected immediately from pregnancy. Be aware that you can become pregnant from two weeks after an abortion or miscarriage, so if you are having the coil fitted later, you should use alternative contraception from two weeks after an abortion or miscarriage.

How the coil is removed

The coil must be removed by a trained doctor or nurse. The procedure should be less painful and quicker than having the coil fitted. If you are not going to have another coil you will need to use additional contraception, such as condoms, for 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.

Common questions

FeatureCopper Coil (Copper IUD)Hormonal IUS
HormonesNoneReleases a small amount of progestogen (levonorgestrel)
How it worksCopper prevents sperm from fertilising an eggThickens cervical mucus, thins the womb lining, and sometimes stops ovulation
How long it lasts5–10+ years (depending on the type)3–8 years (depending on the type)
EffectivenessOver 99%Over 99%
PeriodsOften become heavier, longer, or more painful (especially in the first few months)Usually become lighter, shorter, and less painful; some people stop having periods altogether
Hormonal side effectsNonePossible (e.g. acne, breast tenderness, headaches, mood changes), though hormone levels are much lower than with the pill
Best forPeople wanting hormone-free contraceptionPeople wanting lighter periods or treatment for heavy menstrual bleeding
Emergency contraceptionCan be fitted up to 5 days after unprotected sexNot used as emergency contraception
Fertility after removalReturns immediatelyReturns within a week
InsertionSimilar procedure for bothSimilar procedure for both
Common reasons to chooseAvoid hormones; long-lasting; emergency contraception optionLighter or absent periods; helps with painful or heavy periods; long-lasting

The copper coil is better for those who:

  • Want to avoid hormones
  • Need emergency contraception
  • Are happy with your current periods (or don’t mind if they’re a bit heavier)

The hormonal IUS is better for those who:

  • Have heavy or painful periods
  • Would like lighter periods or none at all
  • Don’t mind using a small amount of hormone

Always speak to your midwife, GP or nurse at a sexual health clinic to check this is the right method for you.

The copper coil or IUD can last for up to 10 years. After 10 years, you should book an appointment with your doctor or sexual health clinic to get it removed.

You can get a copper coil or a hormonal 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.

No. This is a common myth based on the fact that copper coils can be used as emergency contraception even if ovulation has occurred (unlike emergency contraceptive pills also known as the morning after pill). However, emergency contraception does not cause an abortion but prevents a pregnancy from taking place. In the case of the IUD, the copper in the coil kills the sperm before it reaches the egg and is fertilised.

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

It can sometimes be uncomfortable but not normally painful. Local anaesthetic gel can be used if necessary. You might experience some stomach cramps after fitting, similar to period pains. Taking paracetamol or ibuprofen might help to ease pain. The important thing to remember is to tell the nurse or doctor if it becomes painful during fitting or removal.

Not really. Fitting can sometimes be uncomfortable but rarely painful. It all depends on the individual and age. Whether the woman has had children or not is not necessarily a factor in the overall experience.

There may be occasions where the coil can perforate the uterus. However, this is rare and the uterus usually repairs itself without any major issues, including infertility.

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