IUDs - or coils - have proven a popular form of contraceptive in recent years - but what do we really know about them?
TV presenter Davina McCall has revealed that having a coil fitted was a “game-changer” and that before she had it, her PMT was “quite severe”. In a new one-off Channel 4 documentary Davina will be shown having her coil changed on screen.
This is in a bid to dispel misinformation around contraception, 60 years on from the introduction of the pill. Davina McCall’s Pill Revolution premieres on Thursday, June 8 at 9pm on Channel 4 and All4.
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Below, Dr Paula Briggs, consultant in sexual and reproductive health at Liverpool Women’s NHS Foundation Trust and co-author of Contraception: The Answers You’ve Been Looking For has shared everything you need to know about IUDs.
What is the coil?
Coils are intrauterine devices that include copper coils (hormone-free) and intrauterine systems (with differing levels of hormone), including Kyleena, Mirena, Jaydess and Benilexa.
Unlike the combined contraceptive pill, hormonal coils only contain progesterone (not oestrogen). Mirena, for example, has a high level of levonorgestrel (a progesterone), while Jaydess and Kyleena contain smaller amounts.
Briggs said: “Mirena has a licence for contraception, to manage heavy menstrual bleeding, and also can be used as the progestogenic arm of HRT” – meaning it can help women going through menopause to manage those symptoms too.
Depending on the brand, and what it’s for (contraception versus endometrial protection or heavy periods), she would recommend coils stay in for four or five years.
Where does the coil go?
Briggs added: “It sits right inside the womb. The womb is the size of a small pear. The intrauterine device will sit very nicely with the arms where the opening to the fallopian tubes is, and then the stem sits within the body of the uterus.
“And then there are threads, which come down through the cervix, which is about 4cm long, and they just protrude into the top of the vagina, and they’re just there to help get it out when the time comes.”
It is possible to feel the threads, to check the coil is in the right place – but you don’t have to feel them yourself if you don’t want to: She said: “It’s not within everyone’s comfort zone. So if somebody’s really uncomfortable, I’d say it doesn’t really matter.”
Does having a coil fitted hurt?
Briggs said: “For most women, it is uncomfortable, but not horrendous”. However, the procedure may feel “odd” and it’s usual to experience “referred pain in your upper abdomen.”
Although the whole appointment could be half an hour, the fitting itself usually only takes a couple of minutes.
In some cases, people may experience a drop in pulse rate or blood pressure due to a response called cervical shock. She said: “That can make people feel really unwell” but added that it’s important for women to know this is a possibility, although a lot of the time it’s fine.
It’s important to tell your nurse if you are concerned, however. She said: “If you want gas and air, please ask, if you want a local anaesthetic block, please ask.”
What about afterwards?
Briggs added: “Once it’s in, you might get a bit of cramping but that usually settles down. By the next day, most women wouldn’t know that really anything had happened to them.”
What are the advantages over the pill?
She said: “[Coils are] more than 99% effective. The pill is also more than 99% effective if it’s taken properly, but that is the problem” – because it may be easy to forget to take the pill every day, whereas the coil is “fit and forget.
“It’s not a reflection on somebody’s intelligence if they struggle to remember something, but we’re all busy, and things that you don’t have to think about are obviously going to be more reliable than pills, which you have to take on a daily basis.”
What are the disadvantages?
There are also some ways in which the pill offers more advantages than the coil. Briggs added: “Coils wouldn’t have the same beneficial effect on acne. In fact, levonorgestrel intrauterine systems can make some woman’s skin worse.
“Certain combinations can also improve premenstrual mood disorders, and reduce [the risk of] gynaecological cancer, cancer of the ovary and the uterus.”
Are there any myths about IUDs?
Common misconceptions include that if you lose the threads, is means the coil has gone missing; that only women, or those assigned female at birth, who’ve had babies can use the coil; and that if you didn’t get on with pills then you shouldn’t have a progesterone coil – all of which aren’t true.
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