Hormonal coil (IUS)

What

An IUS is a small T-shaped device that's inserted into your womb (uterus). It releases a hormone that prevents the egg from being fertilised and implanting in the uterus. This keeps you from getting pregnant. There are two types: Mirena® and Kyleena®.

How reliable is the IUS?

The IUS is very reliable. On average, 2 out of 1000 women become pregnant every year. However, the coil must be fitted properly in the uterus by a doctor. The doctor at the Centre for Sexual Health will check whether the coil is fitted properly using an ultrasound immediately after insertion.

When is the IUS reliable?

In some cases, the IUS is reliable immediately after insertion, but it can sometimes take a week. You need to use another contraceptive during that week to remain protected from pregnancy. This is explained below.

The coil is reliable immediately after insertion if:

• This is within 7 days of the first day of a period.
• You used the pill, patch or ring, and there were no more than 7 days between the placement of the IUS and the use of the previous method.

The coil is not reliable immediately after insertion if:

• This is more than 7 days after the first day of a period.
• It was inserted following the removal of a copper IUD.

The uterus can sometimes expel the IUS. This will then usually happen in the first few months after insertion. You will be given an appointment for a follow-up at the Centre for Sexual Health. During the check-up, another ultrasound will be taken to check whether the coil is still positioned correctly.

What should I be aware of after a coil insertion?

It is easier to get infections immediately after insertion. We advise you not to use tampons or have sex for the first two days. Do not have a bath or swim either. You can use sanitary pads and take a shower.

Side effects of inserting a coil

The uterus has to get used to the coil. Because of this, you may experience abdominal pain or cramps during the first few weeks. If necessary, you can take a painkiller for the pain.

You may also experience light bleeding or brown discharge during the first few weeks or months. This is normal and will go away by itself. Some women's periods stop immediately or after a few months. The hormone in the IUS causes the endometrium to become so thin that periods no longer occur. There is no need to worry about this.

If you have a fever, severe abdominal pain or feel sick after the coil insertion, it is best to contact your GP or the Centre for Sexual Health.

How do I tell if it's still in place?

You can check whether the coil is still properly positioned in your uterus. You should do this now and then to make sure you are protected. To check it:

• Wash your hands.
• Crouch down and insert one finger into your vagina.
• Find the cervix with your finger; it feels like a smooth lump.
• Two threads of about 2 centimetres protrude from the cervix. It often feels like one thread.

If the threads are longer than last time, you no longer feel the threads or you feel a plastic leg, the coil may not be positioned properly. Contact your GP. They can check this.

Removing the coil

The Mirena® coil can stay in place for 8 years. The Kyleena® coil can stay in place for 5 years. After that time, you can have it replaced or removed.

You can have the coil removed before this, for example, if you want to become pregnant or have side effects. We advise you to use condoms during sex the week before the coil removal. After removal, the menstrual cycle generally recovers within two months.

If you do not want to get pregnant, you should use another contraceptive method immediately after removal.