The IUD, traditionally known as the coil, is a more effective contraception than the combined contraceptive pill. Having the device fitted is a long-term, hormone-free way of preventing pregnancy.
We asked family doctor Sarah Jarvis what she would want to know if she was thinking of having an IUD fitted.
What is the difference between an IUD and an IUS?
Both the intrauterine system (IUS) and intrauterine device (IUD) are T-shaped contraceptive devices, about one-and-a-half inches long, that are fitted inside the womb. An IUD (the coil) is made with copper and doesn't contain any hormones. The IUS (the Mirena) releases a very tiny amount of the hormone progesterone into your womb. They generally work in the same way. With the IUD, it's the copper, along with having the device in your womb, that stops you from getting pregnant.
Which is better for me?
Most women can have either fitted.
- Women who haven't had children usually prefer to have an IUD fitted because the IUS is slightly larger.
- If you like having regular periods because it reassures you, consider having an IUD fitted.
- If you like the idea of having no periods, consider an IUS. An IUS can cause fairly irregular periods up to the first three to six months. But after a year, periods are more than 90% lighter and at least a third of women won't have periods at all.
How effective is the IUD as a contraceptive?
About 99.9% (as effective as sterilisation) and completely reversible.
Where do I go to have an IUD fitted?
There's likely to be a GP at your surgery who can fit one. Alternatively, phone your local family planning clinic and check whether they provide this service.
Does it hurt and can I feel it once it's inside?
Having an IUD fitted is slightly more uncomfortable than a smear test and takes a bit longer. Sometimes, the doctor will use local anaesthetic while fitting it. Once it's in, you will usually get some period-type cramps. These tend to settle down within two to three days. After that, most people don't even know it is inside.
Will my partner be able to feel it during sex?
It's highly unlikely. However, he may be able to feel the little wire threads that we leave outside the womb (so we can pull the coil out). If that's the case, when you go back for your coil check ask your GP if they can trim those threads. We like to keep them slightly longer for the first few weeks in case the womb pulls the device further up inside.
Can it ever fall out or dislodge?
It's very unlikely, but it is worth getting into the habit of putting a finger inside and checking you can still feel the threads. It occasionally falls out within the first few months of having it inserted, but after that it's highly unlikely.
Can it cause any health problems, like infections?
If you already have a low-grade infection, fitting a coil can increase the chance of the infection going up into your womb and into your tubes. This can cause quite nasty problems. That's why your doctor or nurse will usually do some swab tests before you have the coil fitted. They will only fit the coil if your results are negative. Just having a coil fitted shouldn't cause infection.
Can I use tampons?
Absolutely, just as normal.
How long should I keep it in?
Most coils can be kept in for at least five years. Some can be kept in for 10 years. If you have an IUD fitted after the age of 40 or an IUS after the age of 45, you can keep it in until you have gone through the menopause and no longer need contraception.
Is it easily removed?
It's very easy to remove and much easier than it is to put in. It takes a few seconds. When we fit the coil, we leave little wire threads outside the womb so we can just pull it out.
Will I be fertile as soon as it is removed?
Yes. As soon as it is taken out, your fertility returns immediately.
Can I have one fitted if I haven't had children yet?
Yes. Some women find it slightly more uncomfortable to have fitted if they haven't had children, but there's no reason why you shouldn't have one.
Will my periods be affected?
The IUD can cause heavier and more painful periods, but that's often only for a few months, after which they settle and become regular.
