Contraception guide

IUD (intrauterine device)

A woman can get pregnant if a man’s sperm reaches one of her eggs (ova). Contraception tries to stop this by keeping the egg and sperm apart or by stopping eggs being produced. One method of contraception is the intrauterine device, or IUD (sometimes called a coil).

An IUD is a small T-shaped plastic and copper device that’s inserted into your womb (uterus) by a specially trained doctor or nurse. 

The IUD works by stopping the sperm and egg from surviving in the womb or fallopian tubes. It may also prevent a fertilised egg from implanting in the womb.

The IUD is a long-acting reversible contraceptive (LARC) method. This means that once it's in place you don't have to think about it each day or each time you have sex. There are several types and sizes of IUD.

You can use an IUD whether or not you've had children.  

At a glance: facts about the IUD

  • There are different types of IUD, some with more copper than others. IUDs with more copper are more than 99% effective. This means that fewer than one in 100 women who use an IUD will get pregnant in one year. IUDs with less copper will be less effective. 
  • An IUD works as soon as it's put in, and lasts for five to 10 years, depending on the type.
  • It can be put in at any time during your menstrual cycle, as long as you're not pregnant.
  • It can be removed at any time by a specially trained doctor or nurse and you'll quickly return to normal levels of fertility.
  • Changes to your periods (for example, being heavier, longer or more painful) are common in the first three to six months after an IUD is put in, but they're likely to settle down after this. You might get spotting or bleeding between periods. 
  • There's a very small chance of infection within 20 days of the IUD being fitted. 
  • There's a risk that your body may expel the IUD.
  • If you get pregnant, there's an increased risk of ectopic pregnancy (when the egg implants outside the womb). But because you're unlikely to get pregnant, the overall risk of ectopic pregnancy is lower than in women who don't use contraception. 
  • Having the IUD put in can be uncomfortable. Ask the doctor or nurse about pain relief.
  • An IUD may not be suitable for you if you've had previous pelvic infections.
  • The IUD does not protect against sexually transmitted infections (STIs). By using condoms as well as the IUD you'll help to protect yourself against STIs.

How the IUD works

How it prevents pregnancy

Having an IUD fitted

How to tell whether an IUD is still in place

Removing an IUD

How it prevents pregnancy

The IUD is similar to the IUS (intrauterine system) but works in a different way. Instead of releasing the hormone progestogen like the IUS, the IUD releases copper. Copper changes the make-up of the fluids in the womb and fallopian tubes, stopping sperm surviving there. IUDs may also stop fertilised eggs from implanting in the womb.

There are types and sizes of IUD to suit different women. IUDs need to be fitted by a trained doctor or nurse at your GP surgery, local contraception clinic or sexual health clinic.

An IUD can stay in the womb for five to 10 years depending on the type. If you're 40 or over when you have an IUD fitted, it can be left in until you reach the menopause or until you no longer need contraception.

Having an IUD fitted

An IUD can be fitted at any time during your menstrual cycle, as long as you are not pregnant. You'll be protected against pregnancy straight away.

Before you have an IUD fitted, you will have an internal examination to find out the size and position of your womb. This is to make sure that the IUD can be put in the correct place.

You can get contraception at:

  • most GP surgeries
  • community contraception clinics
  • some GUM clinics
  • sexual health clinics
  • some young people's services

Find a clinic near you

You may also be tested for infections, such as STIs. It's best to do this before an IUD is fitted so that you can have treatment (if you need it) before the IUD is put in. Sometimes, you may be given antibiotics at the same time as the IUD is fitted.

It takes about 15 to 20 minutes to insert an IUD. The vagina is held open, like it is during a cervical screening (smear) test, and the IUD is inserted through the cervix and into the womb.

The fitting process can be uncomfortable and sometimes painful. You may get cramps afterwards. You can ask for a local anaesthetic or painkillers before having the IUD fitted. An anaesthetic injection itself can be painful, so many women have the procedure without.

You may get pain and bleeding for a few days after having an IUD fitted. Discuss this with your GP or nurse beforehand.  

The IUD needs to be checked by a doctor after three to six weeks. Speak to your doctor or nurse if you have any problems before or after this first check or if you want the IUD removed.

Also speak to your doctor or nurse if you or your partner are at risk of getting an STI. This is because STIs can lead to an infection in the pelvis.

See your GP or go back to the clinic where your IUD was fitted as soon as you can if you:

  • have pain in your lower abdomen
  • have a high temperature
  • have a smelly discharge

These may mean you have an infection.

How to tell whether an IUD is still in place

An IUD has two thin threads that hang down a little way from your womb into the top of your vagina. The doctor or nurse who fits your IUD will teach you how to feel for these threads and check that it is still in place.

Check your IUD is in place a few times in the first month, and then after each period or at regular intervals. 

It's very unlikely that your IUD will come out, but if you can't feel the threads or if you think the IUD has moved, you may not be fully protected against getting pregnant. See your doctor or nurse straight away and use an extra method of contraception, such as condoms, until your IUD has been checked. If you've had sex recently you may need to use emergency contraception.

Your partner shouldn't be able to feel your IUD during sex. If he can feel the threads, get your doctor or nurse to check that your IUD is in place. They may be able to cut the threads to a shorter length. If you feel any pain during sex, go for a check-up.

Removing an IUD

An IUD can be removed at any time by a trained doctor or nurse.

If you're not going to have another IUD put in and you don't want to get pregnant, use another method (such as condoms) for seven days before you have the IUD removed. This is to stop sperm getting into your body. Sperm can live for up to seven days in the body and could make you pregnant once the IUD is removed.

As soon as an IUD is taken out, your normal fertility should return. 

Who can use an IUD

Most women can use an IUD. This includes women who have never been pregnant and those who are HIV positive. Your doctor or nurse will ask about your medical history to check if an IUD is the most suitable form of contraception for you.

You should not use an IUD if you have:

  • an untreated STI or a pelvic infection 
  • problems with your womb or cervix 
  • any unexplained bleeding from your vagina, for example between periods or after sex

Women who have had an ectopic pregnancy or recent abortion, or who have an artificial heart valve, must consult their GP or clinician before having an IUD fitted.

You should not be fitted with an IUD if there's a chance that you are already pregnant or if you or your partner are at risk of catching STIs. If you or your partner are unsure, go to your GP or a sexual health clinic to be tested.

Using an IUD after giving birth

An IUD can usually be fitted four to six weeks after giving birth (vaginal or caesarean). You'll need to use alternative contraception from three weeks (21 days) after the birth until the IUD is fitted. In some cases, an IUD can be fitted within 48 hours of giving birth. An IUD is safe to use when you're breastfeeding and it won't affect your milk supply.

Using an IUD after a miscarriage or abortion

An IUD can be fitted straight away or within 48 hours after an abortion or miscarriage by an experienced doctor or nurse, as long as you were pregnant for less than 24 weeks. If you were pregnant for more than 24 weeks, you may have to wait a few weeks before having an IUD fitted. 

Advantages and disadvantages of the IUD

Although an IUD is an effective method of contraception, there are some things to consider before having one fitted.

Advantages of the IUD

  • most women can use an IUD, including women who have never been pregnant
  • once an IUD is fitted, it works straight away and lasts for up to 10 years or until it's removed
  • it doesn't interrupt sex
  • it can be used if you're breastfeeding
  • your normal fertility returns as soon as the IUD is taken out
  • it's not affected by other medicines

There's no evidence that having an IUD fitted will increase the risk of cancer of the cervixendometrial cancer (cancer of the lining of the womb) or ovarian cancer. Some women experience changes in mood and libido, but these changes are very small. There is no evidence that the IUD affects weight.

Disadvantages of the IUD

  • Your periods may become heavier, longer or more painful, though this may improve after a few months. 
  • An IUD doesn't protect against STIs, so you may have to use condoms as well. If you get an STI while you have an IUD, it could lead to a pelvic infection if not treated.
  • The most common reasons that women stop using an IUD are vaginal bleeding and pain.

Risks of the IUD

Complications after having an IUD fitted are rare. Most will appear within the first year after fitting.

Damage to the womb

In fewer than one in 1,000 cases, an IUD can perforate (make a hole in) the womb or neck of the womb (cervix) when it's put in. This can cause pain in the lower abdomen but doesn't usually cause any other symptoms. If the doctor or nurse fitting your IUD is experienced, the risk of this is very low.

If perforation occurs, you may need surgery to remove the IUD. Contact your GP straight away if you feel a lot of pain after having an IUD fitted as perforations should be treated immediately.

Pelvic infections

Pelvic infections can occur in the first 20 days after the IUD is fitted. The risk of infection is very small. Fewer than one in 100 women who are at low risk of STIs will get a pelvic infection.

Rejection

Occasionally the IUD is rejected (expelled) by the womb or can move (this is called displacement). This is more likely to happen soon after it has been fitted, although this isn't common. Your doctor or nurse will teach you how to check that your IUD is in place.

Ectopic pregnancy

If the IUD fails and you become pregnant, your IUD should be removed as soon as possible if you're going to continue with the pregnancy. There's a small increased risk of ectopic pregnancy if a woman becomes pregnant while using an IUD.

Where to get an IUD

Most types of contraception are available free in the UK. Contraception is free to all women and men through the NHS. Places where you can get contraception include:

  • most GP surgeries – talk to your GP or practice nurse
  • community contraception clinics
  • some genitourinary medicine (GUM) clinics
  • sexual health clinics – these offer contraceptive and STI testing services
  • some young people’s services (call the sexual health line on 0300 123 7123 for details)

Find your nearest sexual health clinic by searching by postcode or town.

If you're under 16 and want contraception, the doctor, nurse or pharmacists won't tell your parents or carer as long as they believe you fully understand the information you're given, and your decisions.

Doctors and nurses work under strict guidelines when dealing with people under 16. They'll encourage you to consider telling your parents, but they won't make you. The only time that a professional might want to tell someone else is if they believe you're at risk of harm, such as abuse. The risk would need to be serious, and they would usually discuss this with you first.  

Page last reviewed: 15/01/2013

Next review due: 15/01/2015

Ratings

How helpful is this page?

Average rating

Based on 264 ratings

All ratings

Add your rating

Comments

The 7 comments posted are personal views. Any information they give has not been checked and may not be accurate.

louisedav said on 30 March 2014

Hello I currently had the mirena coil put in 4 days ago.iv had no bleeding and everything normal apart from the pain is still mild at the moment even tho im on paracetamol but its my stomach thats worrying me the most its really bloated and hasnt gone down.is this normal??

Report this content as offensive or unsuitable

Zzeno said on 13 March 2014

Personally I have found the coil to be really good.
It has been in place for nine months and I
would say the heaviness of periods has
now started to settle. There is more pain before
hand but it's not too bad, I rarely take pain
killers.
I have to say the Doctor and Nurse that I saw
at the surgery were very helpful and gave
lots of information regarding costs and benefits.
My experience is great as it saves the hassle
of remembering to take pills and health wise
it seems like the safer option.
There was some discomfit on fitting but not too
bad at all. Short and sharp.

Report this content as offensive or unsuitable

jennifer334 said on 27 February 2014

Overall I was satisfied with the Mirena Coil. I wasn't given much advice about the risks and put my faith in the GP/Nurse that this was the best of a limited number of options left as birth control for me. I had it fitted age 30 after the birth of my second child. Despite 2 natural births the Mirena hurt like heck being fitted. The GP said I should have been advised to take Ibuprofen beforehand (great). That was the worst part and beyond that I had no major issues during the 5 years I used it.

The only symptoms I have to note are mild tummy bloating around 3-5days prior to my period as well as a couple of small spots always next to my eyebrow (random but became predictable). Each period was very light, usually lasting from 2-4 days with only very mild period pains to indicate that I had started. My cycle was predictable to the day after the initial month.

My husband never complained about feeling the strings during intercourse which is another common complaint if the strings havent been cut short enough.

Finally had it removed 3 weeks ago as I was at the maximum 5 year point. I expected all of the scary symptoms that are mainly described on American reviews to kick in (often referred to a Mirena Spike). I haven't had any major issues with bleeding or mood changes.
Removal is much less uncomfortable and was much like the feeling of removing a tampon.

I had an acceptable level of bleeding for 2 days which began the same day as it was removed. Following this I bled again 4 days later (for 3days) which I think is to be the start of my usual 'non mirena' cycle. I say this as I had ovulation signs around 14 days afterwards. I will keep a diary of dates for now so that I can time what will be normal for me in the future.

Good luck!

T

Report this content as offensive or unsuitable

sarahbee2014 said on 06 February 2014

I had the copper nova T coil for nearly 3 years then I fell pregnant which I then lost then fell again and had to get the coil removed. Not reliable and was meant to be effective for 5 years obviously not. my scan also showed the coil was in the right position so looks like copper failed. this will be my third baby and will get sterilised to be 100% sure I wont fall pg again. beware ladies!!!!

Report this content as offensive or unsuitable

Donnak45 said on 02 February 2014

I had a hysteroscopy, Novasure Ablation and Mirena coil fitted on 23/1/14. It is 10 days on and the cramps are back...they did tail off after about a week and the bleeding is as bad if not worse than day 1..... Does anyone know if this is normal???

Report this content as offensive or unsuitable

mumfour said on 30 January 2014

I recently suffered an ectopic pregnancy, even though I had this IUD that should have prevented it, in the first place (more detail in my blog: http://mum4x2.blogspot.co.uk/2014/01/against-oddsheshe-baby-almost-made-it.html).

The pregnancy was terminated and my fallopian tube was taken out. Traumatic experience. I now feel so bad that I chose the coil and maybe if I'd used a different method, the pregnancy wouldn't have been ectopic. Of course, we can't be sure of this because some people suffer this without having a coil.

It works for some, but not for others. This has been my experience and I wish others better luck with it.

Report this content as offensive or unsuitable

User794308 said on 09 August 2013

Is it ok to have laser hair removal with the copper IUD fitted? I can't seem to find a straight answer anywhere?!

Report this content as offensive or unsuitable

Services near you

Which method suits me?

Things to think about when you're considering which contraceptive method to use

Sexual health services

Find out where you can go if you need advice about STIs, contraception or pregnancy

Where to get contraception

Find out where you can go to get information about contraception, and to get the method you choose

IUS

The IUS is a hormonal contraceptive inserted into the uterus to prevent pregnancy