The intrauterine device (IUD) and intrauterine system (IUS) are two types of contraception. They are often called coils. They sit inside the womb and are very effective in preventing pregnancy.
Read on to find out what happens before and after getting an IUD or IUS coil fitted, problems to look out for, and details about getting yours removed or replaced.
What should I do before getting a coil fitted?
Before your coil fitting appointment, you will have an initial consultation with your doctor. They will discuss your choice with you as well as your medical history.
If you decide to go ahead with a coil fitting, your doctor will want to make sure that you’re not pregnant. So you will need do the following.
- Make sure you’re using any current contraception correctly.
- If you already have a coil, you should not have unprotected sex 7 days before the fitting.
- If you’re not using any contraception, you can only be fitted within the first five days of your cycle or if you haven’t had sex since your last period.
- If you have a coil or implant that’s out of date, don’t have sex, or if you do wear a condom. You’ll likely need to wait 21 days since the last time you had unprotected sex before the coil can be fitted.
There might be discomfort during the fitting. Taking a painkiller such as ibuprofen an hour before the fitting can reduce this. If you can’t have ibuprofen, your doctor can discuss other options.
What happens after the coil is inserted?
You may experience some vaginal bleeding after you have the coil fitted and the bleeding may carry on for a few days. It is best that you wait three days after fitting before you use tampons or have sex, This will help to reduce the risk of infection. It is safe to use tampons with your next period, but change them with care.
You may have no pain, but it is common to have period-like cramps. This may continue for a day or two. Simple pain relief such as paracetamol or ibuprofen may help, as well as using a hot-water bottle or heat pad. If you have continuous pain in your lower abdomen or any sudden severe pain, seek medical advice.
When will the coil start working?
If you have had a copper coil (IUD) fitted, it will be effective immediately in preventing pregnancy. The copper in the IUD is toxic to eggs and sperm.
If you have had an IUS fitted on the first seven days of your period, you’ll be protected immediately against pregnancy. If it is fitted at any other time, you will need to use an extra contraceptive method for the first seven days as advised by a doctor.
The IUS coil is copper free and releases a set amount of progestogen hormone (levonorgestrel) each day. This thickens the mucus in your womb to stop sperm from getting in.
If you miss a period, or you think you may be pregnant, talk to a doctor. You may need to be seen by a gynaecologist. You will need to use a condom to protect against sexually transmitted infections (STIs) – the coil doesn’t protect from STIs.
How do I check my threads?
You’ll have two loose threads that you can feel at the opening of your cervix. The doctor uses these to remove the coil.
You’ll need to check that you can feel your coil threads about four-to-six weeks after a coil fit and regularly thereafter. The best time to check your threads is once a month after your period.
The most likely time for an IUD to fall out is during a heavy period. When checking your threads, if you notice that:
- you can’t feel the threads
- the threads suddenly feel a lot longer
- you can feel a hard plastic stem
then, there may be a problem. For example, the coil may no longer be protecting you from pregnancy. You need to temporarily use alternative contraception such as condoms, and contact the centre you had the coil fitted for advice.
Will I notice any changes to my periods?
If you’ve had a copper coil (IUD) fitted, you may notice that your period becomes heavier and lasts longer. This is normal.
If you have an IUS, it is normal to expect irregular bleeding during the first three-to-six months. This is usually spotting and rarely heavy. It usually settles with time to light, infrequent periods or no bleeding at all.
If you are worried about your bleeding, speak to a doctor or nurse for advice.
What are the signs of infection from a contraceptive coil?
Signs of infection from an IUS or IUD include:
- strong lower abdominal (tummy) pain
- abnormal vaginal discharge (for example discharge that smells or is discoloured)
- fever, feeling unwell, shivering
- pain during sex
You should seek medical advice if you have any of these symptoms.
How easy is it to remove or replace your coil?
The coil can stay in for between 5 and 10 years, or even longer depending on the type and your age when it’s fitted. You can have the coil removed at any time, but this needs to be done by a trained healthcare professional. You need to avoid having sex for seven days before having the coil removed or changed, or make sure to use a condom.
Sperm can remain active in your body for up to seven days, so there is a risk of pregnancy if a coil is removed within that time.
Where do you get an IUS or IUD?
You can get an IUS or IUD from:
- contraception and sexual health clinics
- GP surgeries
- young person’s clinics
Different contraceptives work in different ways and have different benefits for different people. It’s important to find out what options are available because no single type of contraception will suit everyone.
We offer a range of sexual health services within our Bupa Health Centres. So whether you have symptoms and need to speak to a GP or don't have symptoms but want a check to see if you currently have an STI we have a check to suit you. Any customers who test positive receive a follow up with a GP and support from our 24/7 Nurse HealthLine. Learn more today.
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Sources Sources
- Contraception – IUS/IUD. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised February 2021
- Intrauterine Contraceptive Device. Patient. patient.info/doctor, last edited May 2019
- Intrauterine system. Patient. patient.info/doctor, last edited August 2020
- Contraception. BMJ Best Practice. bestpractice.bmj.com, last updated August 2022
- FSRH Guideline Intrauterine Contraception. The Faculty of Sexual and Reproductive Healthcare. fsrh.org, published March 2023
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