Non-hormonal coil (IUD)

Benefits

  • Works for 5 or 10 years (depending on type used)
  • You don’t have to prepare for or interrupt sex
  • You don’t have to remember to take a pill everyday
  • Not affected by other medicines
  • More effective form of emergency contraception than ‘morning after’ pill
  • Your fertility returns to normal once the IUD is removed
  • The IUD is a hormone free method.

The non-hormonal coil, also known as the IUD (intrauterine device) or ‘copper coil’, is a small T-shaped device that sits in your womb. It is long-acting but can be easily removed if you decide you want to become pregnant or use alternative contraception. It is also very effective emergency contraception. It is particularly popular amongst 20-34 year olds.

Read what other people think of the non hormonal coil on our contraception forum.

How it works

How to use it

A clinician will insert the IUD into your womb (uterus).

Once the IUD is in place, you don't have to think about contraception for up to 5 or 10 years. It won't interrupt sex and your partner should not be able to feel it.

It can be removed at any time by a trained doctor or nurse, but you must use condoms as well or abstain from sex for 7 days prior to removal.

The IUD can be used as emergency contraception if it is inserted up to five days after you’ve had unprotected sex, to prevent pregnancy. It will not protect you against STIs so you should take a test if you think you may have been exposed to an STI.

Why it works

The IUD does not contain a hormone, but instead slowly releases copper, which prevents sperm from surviving in your cervix, uterus or fallopian tubes. It may also stop fertilised eggs from implanting in the womb.

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Things to consider

The IUD does not protect you from STIs. You should use a condom as well if you think you are at risk of an STI.

Some women find the procedure to insert the IUD uncomfortable or painful.

What if?

The IUD doesn’t stay in place:

An IUD has two thin threads that hang down a little way from your womb into the top of your vagina. You will be taught how to feel for the threads and check the IUD is still in place. If you can't feel the threads or if you think the IUD has moved, you may not be fully protected against pregnancy. See your doctor or nurse straight away and use extra contraception, such as condoms, until your IUD has been checked.

It is unlikely that your IUD will come out. This is most common in the first three months after insertion and happens in 1 out of 20 cases.

Suitability

Most women can use the IUD, but your clinician will ask about your family and medical history to determine whether or not it is the best method for you.

It is a good alternative for women who can’t take the hormones oestrogen or progestogen.

It may not be suitable for women who have:

  • Heavy periods
  • Allergy to copper
  • Pelvic infection
  • Unexplained vaginal bleeding
  • Fibroids.

Side effects & risks

Common Rare
Short term:

May get cramps and spotting/bleeding for a few days after fitting.

Periods may become heavier or more painful, though this should settle after a few months.

Small risk of infection within 20 days of fitting.

Long term:

You may have irregular bleeding for six months.

Questions?

Before you have a coil fitted, you may be tested for any existing infections, such as STIs, so that any infections can be treated beforehand.

The coil can be fitted at any time during your monthly menstrual cycle, as long as you're definitely not pregnant.

Having a coil fitted can be uncomfortable and painful but the pain shouldn't last long and is described as quite similar to period pains. A fitting is likely to be less painful if you have had natural birth (vaginal delivery) as your cervix will have previously been stretched.

Whilst you lie down, with your knees bent, a speculum will be used to hold your vagina open (the same instrument is used when having a smear test done). Local anaesthetic gel is applied to the cervix and this feels cold.

The clinician will then use forceps to hold the cervix steady in order to determine the size and position of your womb with a sterile probe.

The coil comes with its arms folded down packed inside a narrow tube. The clinician will insert the tube into the vagina, through the cervix and into your uterus (womb).

Then they will pull the plastic tube out, leaving the coil in place allowing the arms of the coil to fold open. Before the speculum is removed, the strings of the coil are cut, leaving 1 to 2 cm hanging down at the top of your vagina so that you can feel to make sure it is still in place.

The whole process should take about 5 minutes.

People normally have some cramping pain afterwards so it is recommended you take some pain killers just before your appointment.

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The IUD works for contraception immediately after it is fitted.

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Having a coil fitted can be uncomfortable and painful but the pain shouldn't last long and is described as quite similar to period pains. A fitting is likely to be less painful if you have had natural birth (vaginal delivery) as your cervix will have previously been stretched.

The clinician doing the fitting will use a speculum to hold your vagina open (the same instrument is used when having a smear test done). Local anaesthetic gel is applied to the cervix and this feels cold.

Read more about the coil fitting process.

Occasionally people feel nauseous or faint afterwards. They may need to lie down for 5-10 minutes but are usually fine after a short while. The clinician will always make sure you are recovered and happy to make your way home before letting you leave.

Some people prefer to have no plans after their appointment so that they can be relax at be comfortable at home afterwards.

It is fairly common for women to experience some slight cramping and / or spotting for a couple of days after a fitting. You will be asked to make an appointment after 6 weeks where the clinician will check your coil is in place and to see how you are getting on.

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Once an IUD is fitted, it will need to be checked by a doctor after three to six weeks to make sure everything is fine. Speak to your GP or clinician if you have any problems after this initial check or if you want the IUD removed.

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A coil can be removed at any time by a trained doctor or nurse.

If you're not going to have another coil put in and you don't want to get pregnant, use another method (such as condoms) for seven days before, as sperm can live for up to seven days inside the body.

Removal of a coil is a very quick procedure (about 30 seconds). It may be a little uncomfortable but is much less uncomfortable than the fitting procedure.

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Yes, the IUD is suitable for women who are breastfeeding, though you will need to wait four to six weeks after giving birth before you have it fitted.

Some services offer the option to have an IUD fitted immediately after delivery. This is called a post-partum IUD fitting.

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There is a very small risk of infection. If you have any of the following symptoms within a few days of having an IUD fitted, you should see your GP (or clinician who fitted the IUD) straight away:

  • Have pain in your lower abdomen
  • Have a high temperature
  • Have a smelly discharge.

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There's no evidence that having an IUD will increase the risk of cervical cancer, cancer of the uterus orovarian cancer.

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There is a very small chance of you getting an infection during the first 20 days after an IUD is put in. You may be advised to have a check for any possible existing infection before an IUD is fitted.

There is a very rare risk that an IUD might make a tiny hole in the womb or neck of the womb (cervix) when put in. This may cause pain but often there are no symptoms. Contact your GP straight away if you feel a lot of pain in the lower abdomen after having an IUD fitted. If there is a suspected perforation, go to A&E to see a specialist. If perforation occurs, you may need surgery to remove the IUD.

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Although it is unlikely that you would become pregnant while the IUD is fitted, if you do, there is a small increased risk of you having an ectopic pregnancy. The risk of ectopic pregnancy is less in women using an IUD than in women using no contraception at all.

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The coil can be pushed out by your uterus or it can move. This is not common. This is more likely to happen soon after it has been put in. This is why your doctor or nurse will teach you how to check your coil threads every month and also arrange to check it for you 6 weeks after your fitting.

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IUD may not be suitable for you if you have or have had:

  • Problems with your womb or cervix or unexplained vaginal bleeding between periods or after sex
  • An untreated STI or pelvic infection
  • Women who have had an ectopic pregnancy, or who have an artificial heart valve, need to consult their GP or clinician before having an IUD fitted.

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If you're 40 or older when you have the IUD fitted, it can be left until you reach menopause or you no longer need contraception.

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No, the IUD will not set off airport security metal detectors.

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The non-hormonal coil IUD releases copper that creates an environment where sperm do not survive.

The hormonal coil IUS releases a progestogen hormone, which thickens the mucus from the cervix (opening of the womb), making it harder for sperm to move through it and reach an egg. It also causes the womb lining to become thinner and less likely to accept a fertilised egg. In some women, the IUS also stops the ovaries from releasing an egg (ovulation), but most women will continue to ovulate.

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Your partner shouldn't be able to feel your IUD during sex. If he can feel the threads, get your GP or clinician to check your IUD is in place. They may be able to cut the threads a little.

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Fertility will return to normal when the IUD is removed.

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The IUD contains copper and should not be used by those who are allergic to copper.

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It is unlikely that the IUD would move, but the GP or clinician that fits your IUD will teach you how to feel for the threads and check that the IUD is still in place. If you can't feel the threads or if you think the IUD has moved, you may not be fully protected against pregnancy. See your doctor or nurse straight away and use extra contraception, such as condoms, until your IUD has been checked.

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Yes, whilst using the IUD you can use tampons, pads or a mooncup.

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You may have irregular bleeding patterns during the first few months of using the IUD. For some women their periods are heavier, longer or more painful. While using the IUD you can use tampons, pads or a mooncup.

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If you get an STI while you have an IUD fitted, it could lead to pelvic infection. STIs and pelvic infections need to be treated as soon as possible. An IUD doesn't protect you against STIs, so you may also have to use condoms when having sex.

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Where can I get it?

The IUD is free on the NHS. It can be given by most sexual health clinics and some GPs. Talk to your clinician about whether it’s right for you. Your clinician will be able to tell you where you can get the IUD nearby, if they can’t do it themselves.

It can be inserted at most sexual health clinics and by some GPs.