Contraception: What is a coil and how does it work?

·4 min read
Contraceptive coils, or intra-uterine devices (IUD), are inserted into the womb to prevent pregnancy (Getty Images/iStockphoto)
Contraceptive coils, or intra-uterine devices (IUD), are inserted into the womb to prevent pregnancy (Getty Images/iStockphoto)

BBC presenter Naga Munchetty and journalist Caitllin Moran have spoken out this week about their experiences when having contraceptive devices fitted, and called for women to be offered pain relief during similar gynaecological procedures.

Writing in The Times on Saturday, Moran described her experience of getting a contraceptive coil, also known as an intra-uterine device (IUD), inserted as having to “carry your broken cervix out of the building in a carrier bag”.

Following the article, Munchetty shared her own traumatic experience with Radio 5 Live and said it was so painful that she fainted twice, but was not offered sedation or anaesthetic at any point.

Scores of women responded to both Moran and Munchetty on social media and spoke about their own painful experiences while getting an IUD fitted.

We take a closer look at what a contraceptive coil is and whether it is always painful to get one:

What is a contraceptive coil?

The coil, or IUD, is a small T-shaped device made from plastic and copper that is inserted into the uterus to prevent pregnancy. There are two types of IUD, a copper IUD and a hormonal IUD.

It falls under the category of Long Acting Reversible Contraceptives, which also include implants and injectable contraceptives. They can protect against pregnancy for between five to 10 years.

IUDs are more than 99 per cent effective at stopping pregnancy once fitted correctly.

According to data from the NHS, as of April 2019, 41 per cent of women contacting sexual and reproductive health services in England were using Long Acting Reversible Contraceptives.

An IUD can be removed at any time and it is possible to get pregnant as soon as it is taken out. If your IUD has expired, it will have to be removed and replaced.

The device can also be fitted as an emergency contraception, which the NHS says is more effective than the emergency pill at preventing pregnancy after unprotected sex.

How does it work?

Copper IUDs work by releasing copper into the womb, which thickens the cervical mucus. This makes it more difficult for sperm to reach an egg and survive. The device can also stop a fertilised egg from being able to implant itself.

Hormonal IUDs, such as Mirena, contain a small amount of progestogen that is released into the reproductive system. This does the same thing as the copper and prevents sperm from entering the uterus.

The IUD does not inhibit ovulation like some other forms of birth control, including the pill. The effectiveness of the device will not be impacted by whether or not a user ovulates.

Are there any risks involved?

Yes, there are several small risks involved when getting an IUD. You may get an infection after it’s been fitted and there is also a small risk your body may push out the IUD or it will move while inside you.

Your doctor or nurse will teach you how to check it’s still in place.

People who have had previous pelvic infections may not be prescribed an IUD as it might not be suitable for them

According to the NHS, you may also experience heavier, longer or more painful periods in the first three to six months after getting an IUD fitted. You might also get spotting or bleeding between periods.

How painful is it to get an IUD?

The NHS warns that it can be “uncomfortable” to put an IUD and advises people to take painkillers after the procedure if they need.

Women who have had a vaginal delivery report less discomfort and pain during an IUD insertion compared to those who have never been pregnant, as the latter would not have had their cervix dilated before.

People who normally experience a lot of pain during pelvic exams or speculum placement might also be more likely to feel pain when getting an IUD.

GP and broadcaster Dr Dawn Harper told the BBC that experiences such as the one described by Munchetty are not typical.

She said: “For most women, it’s a little bit uncomfortable. It’s a bit like period pain.

“We absolutely should be taking any kind of pain… very seriously and we should be offering appropriate relief,” she added.

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