IUS/IUD coil fitting: what to expect

Reviewed: June 28, 2021
iud-ius-coil-fitting-the-lowdown
If you have decided that the coil is the right contraception for you, then it may feel like there is a minefield of information when it comes to knowing what to expect from an IUD/IUS fitting. 

Where can you get it fitted? How is it fitted? Can you exercise straight after? Will it hurt?

In this article we outline everything you should expect from your coil fitting.

Jump to sections including:

 

But first up, what’s the difference between the copper coil (IUD) and the hormonal coil (IUS)? Read our blog on IUD vs. IUS to find out.  

What to know before your coil fitting

Where can I get the coil fitted near me?

IUDs and IUSs are available from contraception clinics, some GP practices and sexual health clinics. This sexual health service locator can help you find where your closest service is to have the coil fitted.  

When can I get my coil fitted?

If you are having the coil fitted, then many clinics will ask you to avoid sex from the first day of your last period (or for 3 weeks before if you’re not having regular periods) until the fitting and do a pregnancy test on the day to ensure there is no risk of pregnancy. This may not be necessary if you are using another form of contraception consistently and reliably but clinics may have their own protocols and should be able to advise you beforehand.  The IUD and IUS can both be fitted at any time during your menstrual cycle. 

Can I have a coil fitted when pregnant?

No you cannot have a coil fitted when pregnant as you are at risk of miscarriage.  

How long after coil fitting are you protected from pregnancy?

If an IUS is fitted in the first five days of your menstrual cycle you will be immediately protected from pregnancy. But if the IUS is fitted at any other time in your cycle, then you will be advised to use another form of contraception such as condoms, or abstain from sex for seven days after fitting. If you switched from another contraceptive method, whether you need to use condoms for seven days after fitting will depend on the type of contraception you were using, if you were using it reliably, and if you’ve had sex in the last seven days, so discuss this with your healthcare professional. You may also find our blog on changing your contraception helpful. 

The copper IUD is effective at preventing pregnancy straight after it is fitted. .

Can I have the coil fitted as a form of emergency contraception?

The copper IUD can work as a form of emergency contraception, meaning it can be fitted after sex to prevent pregnancy. In fact it is the most effective method of emergency contraception, more effective than the morning after pill.  The IUD can be inserted up to five days after sex, or up to five days after the earliest time you could have ovulated. 

Can I ask for pain relief for my coil fitting?

Yes. You can ask to have a local anaesthetic spray or gel which is applied to the cervix (the neck of the womb through which the coil is fitted) before the coil is inserted.  The local anaesthetic will be sprayed on and then the doctor will then wait three minutes before inserting the coil.

There has been lots of discussion in the media around the issue of pain relief offered during coil fittings. We at The Lowdown want women to know our data shows the hormonal IUS and copper IUD have the highest overall satisfaction rating of any method on our site (4,500+ reviews and counting) and once it’s fitted 54-61% of women report saying the coils are ‘very good’ or ‘excellent’ – which is over double the proportion that state that for the combined pill or mini pill.

For years The Lowdown have been telling women about the wonders of sprays, gels and anaesthetic injections – and trying to educate them that they can ask for these things during their appointment. Lidocaine sprays and even EMLA cream, an anaesthetic used to numb children’s hands prior to drawing blood, has been proven to reduce pain significantly with just 1 gram of us. A survey of UK clinicians reported that approximately one-quarter of health professionals who undertook the survey routinely used local anaesthetic for IUS/IUD  insertion, with around one-quarter of health professionals never, or rarely, offering it, and the remainder doing so sometimes. Guidelines from the Faculty of Sexual and Reproductive Health (last updated in 2019) advise that local anaesthetic block administered by cervical injection is not routinely required for IUS/IUD insertion but should be offered when cervical dilatation is required or difficult insertion or removal is anticipated or experienced. 

Can I get the coil fitted on my period?

Yes, the coil can be fitted any time during your menstrual cycle. 

Can I have a coil fitted with thrush?

Yes, you can have a coil fitted if you have thrush. 

Preparing for your coil fitting

Pre-fit consultation

Before having the coil fitted, it’s important that you have a pre-fit consultation, this will help to determine which type of coil is suitable for you, or if you are changing the type of IUD/IUS you currently have. This may be on the same day as your fitting or beforehand. This will be a chance for your doctor to describe the differences between the IUD and IUS and if there is a more suitable one for your medical history and requirements. This is also a great chance to voice any concerns you may have and ask any questions.  At this point you may be asked to have  STI (sexually transmitted infection) screening for infections such as chlamydia.  You can have an STI and be symptomless. If you have a coil fitted when you have an STI this may lead to a pelvic infection which can be dangerous and cause symptoms such as pain, bleeding and a fever.  If an STI is picked up on screening you will be offered treatment and your coil fitting can be scheduled once treatment is complete.  

On the day of your coil fitting

How to prepare on the day of your coil fitting?

On the day of your coil fitting some clinics  recommend  you take a painkiller about an hour before you are due to have the coil fitted. Despite being widely advised, there is no evidence it significantly helps reduce pain during insertion. It may however help to reduce pain or discomfort experienced after the insertion. Non steroidal anti-inflammatory drugs such as ibuprofen may be best for this. Similarly, when The Lowdown interviewed Professor Guillebaud, he recommended using Naproxen.

It is recommended that you have your breakfast or lunch before the appointment as you would normally. Sometimes after the coil fitting you may feel nauseous, lightheaded or faint, and this can feel worse if you’ve not eaten.  

What do you wear to a coil fitting?

We would recommend wearing loose, comfortable clothes to the fitting that are easy to change in and out of.

What to expect at your coil fitting appointment

Before your coil is fitted, your GP or healthcare professional will have a short consultation with you and may ask you to do a pregnancy test. Often there will be an assistant in the room to help your doctor or nurse make sure they have everything they need, and to chat with you and help you during the procedure. 

Your doctor or nurse will then check your vagina to see the size and position of your womb, and use a speculum to see the cervix (the neck of the womb at the top of the vagina). A local anaesthetic spray can be used at this point to help numb the cervix and make the IUD fitting procedure less uncomfortable. Some healthcare professionals may use a local anaesthetic injection. During this time your vagina will be held open using the speculum. Once the local anaesthetic has had time to work, your doctor or nurse will use an instrument to hold the cervix so they can measure the length of the womb, and following this  the IUD/IUS can be inserted into the womb. This may be uncomfortable but should only last a short time.The tube  used to insert the coil is removed and the coil is left in place. The IUD/IUS has two threads that hang through the neck of the womb into the vagina. Your doctor or nurse may trim these for comfort. 

It is important to be aware that all procedures like this can trigger what is known medically as a ‘vaso-vagal response’. This means your heart rate and blood pressure drop and you may feel nauseous, light-headed and even faint. If you feel like this, your doctor or nurse may check your heart rate and blood pressure. These symptoms don’t last long and your healthcare professional will be trained in how to manage this.

Check out The Lowdown’s interview on our Instagram Stories with Professor John Guillebaud (Emeritus Professor of Family Planning and Reproductive Health at University College London) on his advice on having a coil fitted. 

 You can also listen to the Hormonal IUS episode of our podcast ‘The Lowdown on contraception where we speak to a GP who fits coils regularly and a The Lowdown user who has a Mirena IUS.

Our very own Dr Fran, also discusses her experience of having the mirena coil fitting in our Sunday Surgery on Instagram Stories

After your coil fitting

Pain after coil fitting, is this normal? 

Having pain after your coil fitting is normal. Some women may experience cramping like pains, which are similar to as if you are on your period. You can take painkillers before having the coil fitted, or afterwards to ease any associated discomfort. 

How long does the pain after a coil fitting last?

It is perfectly normal to have some cramping that lasts a few hours after the IUD/IUS has been inserted. You may experience some pain that is on and off in the first few weeks after having the coil inserted. 

Severe pain after coil fitting

If you have severe pain after having your coil fitted, or a pain that gets worse or lasts longer than three days then contact your GP or sexual health clinic  immediately. 

How do I know if the coil is fitted correctly?

At your coil fitting appointment the health professional will teach you how to feel if the coil is fitted correctly. The IUS/IUD has two thin threads that will hang down through the neck of the womb into the top of your vagina. If you feel for these threads, you can feel that it is in place. It’s advised to check this regularly, i.e once a month after your period or at regular intervals if not experiencing monthly periods.  If your bleeding pattern changes from what might be expected or a period is missed when using the copper IUD, you should consider returning to your healthcare professional to have your coil checked.

What to do if my coil has moved?

If you can’t feel the two threads from your coil and you think it may have moved, then you should see a GP or nurse as soon as possible. If the IUD/IUS has moved then you may not be protected from pregnancy so it is recommended that you use additional contraception such as condoms until the health professional has checked that the IUD/IUS is back in place. 

How long after the coil fitting can I exercise?

The NHS  recommends that you wait up to 48 hours before exercising after having a coil fitted. 

Sex after coil fitting – How long should I wait?

You should refrain from having sex after a coil is inserted for 24 hours, to help the coil to settle. If the IUD or IUS was fitted after day five of your menstrual cycle you will also need to use extra protection, such as condoms for seven days. 

How long after having the coil fitted can I wear a tampon?

The advice on how long to wait before using a tampon after having a coil fitted varies and is based on reducing the risk of infection. It is sensible to avoid tampons for the first 24 to 48 hours and use sanitary towels for bleeding during this time, although some NHS clinics recommend avoiding tampons for the first 4 weeks after fitting. 

Can you use a mooncup after having an IUD fitted?

The Mooncup manufacturer states that whilst many IUD/IUS users are able to easily use a mooncup alongside their coil, there have been some cases when the IUD/IUS has been dislodged. They recommend to ensure that you keep checking for the strings of the coils after each period, and to discuss with a medical professional if you think the IUD/IUS has moved. 

Bleeding after copper coil / IUD fitting

You may find that you bleed for a few days after a copper coil/IUD fitting.  It is normal to have light bleeding after a coil insertion, but it’s recommended to speak to  your doctor if you have heavy bleeding or worsening pain. 

What to expect from your periods with a copper coil or hormonal coil

You may find that after having a coil fitted that your periods change and  you may also find that you get spotting that occurs in between periods. 69% of our contraceptive reviewers (data retrieved 21.06.21) stated that the copper coil gave them heavier periods, with 51% of The Lowdown reviewers stating that the IUS (hormonal coil) stopped their periods. 

What are the risks of having a coil fitted?

  • There is a small risk of getting an infection after the IUD/IUS is fitted. Seek medical advice if you have pain in your tummy, a high temperature or unusual discharge.
  • There is a small risk that your body may expel the IUD/IUS. This occurs more commonly within the first few weeks of the coil being fitted. It is important you know how to check your coil is in place and if you can’t feel your threads use condoms and return to where your coil was fitted for it to be checked. 
  • In rare cases the IUD/IUS may perforate the uterine wall. This is very unlikely if you have an experienced doctor or nurse fit your coil, but if you have pain or cannot feel the threads make sure you seek medical advice. 

What are the side effects of having a coil fitted?

IUD (copper coil)

  • Your periods may become heavier, longer or more painful (69% of The Lowdown copper coil reviews stated heavier periods as a side effect)
  • Womb cramps (31% of our copper coil reviewers said they had womb cramps as a side effect)

IUS (hormonal coil)

  • Your periods may stop or you may have spotting in between periods
  • Mood swings
  • Breast tenderness
  • Skin problems
  • 28% of our hormonal coil reviewers stated loss of sex drive as a side effect (data retrieved 21st June, 2021) whilst 10% had an increased sex drive. 

To find out the experiences of our reviewers of the copper coil and hormonal coil then read our IUD reviews and IUS reviews. Also check out The Lowdown’s podcast episode where our founder Alice talks to a GP on fitting an IUS and a friend on what it’s like to have one. 

Sources

NHS

Oxford University Hospitals

Patient

FSRH clinical guideline. Starting and switching methods of contraception. Update March 2021

FSRH clinical guideline. Intrauterine Contraception. April 2015, amended September 2019.

Akintomide H, Sewell RDE, Stephenson JM. The use of local anaesthesia for intrauterine device insertion by health professionals in the UK. J Fam Plann Reprod Health Care 2013; 39: 276–280.

Tavakolian S et al. Lidocaine-Prilocaine Cream as Analgesia for IUD Insertion: A Prospective, Randomized, Controlled, Triple Blinded Study Global Journal of Health Science. 2015 Jan 27;7(4):399-404. doi: 10.5539/gjhs.v7n4p399.

Mooncup

Sexual Health Dorset. Advice for intrauterine device users. Post insertion advice for users FP6. 2018.

Devon sexual health. What to expect following your contraceptive coil fit.

This guide was brought to you by The Lowdown. We are the world’s first contraception review platform, providing real-life experiences from thousands of reviews collected from our community of men and women.

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