Considering a Coil for Contraception?
The contraceptive coil is a small device which sits inside the womb to prevent pregnancy. Coils have been used by women for many decades and are very effective at preventing pregnancy. Consultant Gynaecologist, Miss Meg Wilson, often speaks to women about their contraceptive options and helps them decide which method will suit them best. Here she answers some frequently asked questions about the coil as an option for contraception.
Why do women choose the coil?
The biggest appeal of the coil is that once it is fitted, there is no need to think about contraception for at least 5 years. This is much easier that taking a pill every day or attending clinics to pick up prescriptions or make appointments for depo injections.
Most women are keen to choose a contraceptive that they can rely on, the coil is a very reliable choice. The protection from pregnancy each year is 99.4%. For some women, there are added benefits to the coil as you can choose a coil that contains the hormone progesterone. The protection from pregnancy from hormonal coils is even more reliable at 99.8%. Coils are more protective than other methods including the pill, condoms and hormonal coils are even slightly more protective than a sterilization procedure.
If your life changes and you want to fall pregnant or change contraceptive, it can be easily removed by a gentle internal examination to pull on some very thin threads which can be seen at the opening of your womb (cervix). When the coil is removed, your ability to fall pregnant will be restored to normal. Coils do not protect from sexually transmitted infections and therefore you may need to use condoms to protect from infection as well.
What types of coil are there to choose from?
Broadly speaking there are two types of coil to choose from, the copper coil and the hormonal coil. Both work in a similar way to prevent pregnancy by acting as a barrier to a pregnancy implanting in the womb. The hormonal coil has an added effect of releasing progesterone to the womb, this has the added effect of making the lining of the womb thin and making the mucus blocking the opening of the womb thicker. This is how the chance of falling pregnant is even lower with the hormonal coil.
The progesterone released from the hormonal coil has the added effects of making periods very light and some women will not experience periods at all. This is because the lining of the womb becomes very thin with progesterone and this is entirely healthy. It can also make periods less painful and some women have a hormonal coil fitted to treat their heavy and painful periods alone.
At London Gynaecology we offer the ‘Nova T380’ copper coil or hormonal coils called ‘Mirena’ or ‘Jaydess’. The Nova T380 and Mirena coil can stay in for up to 5 years, the Jaydess coil is a slightly smaller coil and has less hormone, it can stay in for up to 3 years.
Choosing a non-hormonal or hormonal coil.
If you suffer with heavy or painful periods, it is worth thinking about having a hormonal coil fitted. Some women really enjoy the convenience of not having their period or having very light periods and chose the hormonal coil for this reason. No periods on holiday and saving money on sanitary products makes this a very popular option. However, some women like the reassurance of seeing their period to know they are not pregnant, so it is not for everyone.
Some women know that they ‘don’t get on with hormones’ from previous experience of taking the contraceptive pill. They may have felt emotionally low, gained weight or had some skin changes with taking the pill and in a few cases, similar side effects are experienced with the progesterone in the hormonal coil. It may be better to have the copper coil if these side effects have been very debilitating, otherwise try the hormonal coil and consider having it changed if you develop side effects.
Can anyone have the coil?
There are only a few women who are not suitable for a coil. It is not suitable for women who have previously suffered with an ectopic pregnancy, this is a pregnancy which was located outside the womb. The coil prevents pregnancy implanting inside the womb and therefore it can’t stop ectopic pregnancy and women who are already susceptible to this should avoid the coil. The coil needs to be fitted into the cavity of the womb, if the cavity is an abnormal shape (this may be the case for women with fibroids or previous surgery) it may not be possible to fit it or it is at risk of falling out.
What side effects or symptoms can I expect?
Thankfully, there are no serious side effects with a correctly inserted coil. With the hormonal coil, we advise women that they may experience irregular bleeding and this usually settles down over the first 2-3 months. Some women have side effects from progesterone which may affect mood, skin or bloating from fluid retention. For women choosing the copper coil, they may find their periods are slightly heavier. If a woman is unhappy with any side effects of the coil we offer to remove the coil and consider a different type of contraception.
How is the coil fitted?
We advise that you take some painkillers before your coil fitting and it is preferable if you time the appointment during or just after you have had a period. Otherwise there is no special preparation required and a coil can be fitted in a routine gynaecology appointment.
The fitting requires a speculum to be placed inside your vagina and anaesthetic gel applied to your cervix. Sometimes a local anaesthetic injection is also used. The coil is pushed inside the cavity of the womb in a tube which is the size of a very thin cocktail straw. This tube is then removed leaving the coil in place. The insertion takes only a few seconds. We offer an ultrasound scan to confirm that the coil is safely in the correct position. It is normal to have some cramping pains afterwards and some women may need to take some painkillers. Most women are absolutely fine for the rest of the day but it is advisable to have the opportunity to take it easy for the rest of the day if needed.
Is fitting a coil painful?
Having a coil fitted can be uncomfortable, but most people tolerate it very well with the use of local anaesthetic gel and sometimes an injection. Women who have had a vaginal birth may find it even easier as their cervix has been ‘stretched open’ in the past. For young women or those who have not had a baby, they may opt for the Jaydess coil as it is slightly smaller.
If you have a lot of anxiety about having a coil fitted, let your doctor know in advance so they can listen to your concerns and make the experience as easy as possible for you. I find that women with a lot of anxiety are often pleasantly surprised it was ‘not as bad as expected’.