Coil Fitting: Patient Information

Coming to your coil insertion appointment

You will have a 45-minute appointment but please ensure that you arrive in good time and ideally 10 minutes before your appointment time. 

Make sure that you have eaten and that you are wearing clothes that are easy to remove. 

We will provide sanitary products if you need them as you may have some light bleeding after the procedure. 

You may wish to bring earphones to listen to music/calming sounds during the procedure.

It is OK to have your coil fitted if you are bleeding so please attend your appointment as usual.

The fitting of a coil can be uncomfortable/painful so you might wish to take a painkiller that is safe for you one hour before your appointment (eg Ibuprofen/paracetamol). The clinician fitting your coil will discuss the option to use a local anaesthetic gel or spray although for most women this is not necessary.

Occasionally women feel nauseous or light-headed after the procedure so you may wish to bring someone with you who can take you home afterwards. 

Your coil cannot be fitted if there has been any recent risk of pregnancy. Therefore, unless you are postmenopausal, you should avoid sex from the start of your period until your appointment or ensure that you are using a method of contraception reliably and consistently. If there is a chance that you could be pregnant your appointment will be postponed until a time when pregnancy can be reliably excluded. Please note that HRT is not considered to be contraceptive. 

If you are having a coil removed and a new coil inserted you should avoid sex for 7 days before your appointment if your existing coil is still in date. If your coil is out of date and you are not using any other form of contraception you will need to avoid sex for 21 days (3 weeks) before your appointment so that a pregnancy test can reliably exclude pregnancy.

You may have been offered a vaginal swab test to check for chlamydia and gonorrhoea infections prior to your coil fitting appointment. This will not be necessary for all women but is recommended for anyone under the age of 25 years or those with possible symptoms of infection or a recent change in sexual partner. If you have not had a test but would like one then this can be done at the time of your coil fit if you are not experiencing any symptoms of infection.

Things to consider before you have a coil

All procedures carry some risk, having a coil fitted is a low risk procedure which most women tolerate well.

Please remember you can ask to stop the procedure at any time.

Risks of having a coil fitted

Perforation:
There is a small risk that the procedure may perforate your womb. This is rare and occurs in 1-2 cases/1000. The risk is higher in breast feeding women or if the coil is inserted within 4 weeks of giving birth.

Infection:
Having a coil fitted is not likely to cause an infection but it can exacerbate a pre-existing infection which is why we screen higher risk women. If you are worried you could have an infection or have any symptoms please let us know before you attend for your procedure. Infection is most likely to become apparent in the first 20 days following an infection so if you think you have an infection, please contact the clinic or seek medical attention as soon as possible. Symptoms may include the following: persistent or worsening lower abdominal pain, abnormal vagina discharge, fever, feeling unwell or shivering or pain during sexual intercourse.

Bacterial Vaginosis (BV) and Thrush(candida):
BV and is associated with the use of coils particularly copper (non hormone) coils.  All coils may also be a risk factor for thrush, although the data is less clear. So a copper coil may not be the best option for you if you experience either of these conditions regularly.

Expulsion:
1 in 20 coils will be spontaneously expelled from the womb, this is most common in the first 3 months after insertion. There is a slightly increased risk if the insertion is immediately after a termination or vaginal delivery and menstrual cup users may have a slightly higher risk. This is why it is important to check the threads of your coil 4 weeks after your insertion and then once a month or after each period.

Ectopic Pregnancy:
Coils reduce the occurrence of pregnancy, therefore ectopic pregnancies are lower in coil users than the general population, however if a women falls pregnant with a coil in place there an increased risk of it being ectopic. A previous ectopic pregnancy is not a contraindication to a coil.

Procedure is unsuccessful and we are not able to fit your coil:
It is not always possible to fit a coil despite the skill and expertise of our coil fitters. If that is the case you will still be charged for the appointment and the coil if it has been purchased through us. 

You will be counselled on the right coil for you before your appointment but it is important to remember that not all methods suit all people. Many side-effects will settle within the first 3-6 months but your coil can be removed, if that is your wish.

The copper coil is non hormonal so will not change the frequency of your periods but they may become heavier. If you already have heavy periods it may not be the best option for you.

The hormonal coil may change the frequency and reduce the heaviness of your periods or stop them completely. 90% of women will have more acceptable periods with this method. Intermittent bleeding is common in the first 3-6 months and normally settles.

The coil fit procedure

The treatment room at Clinic51 is designed to be calm and peaceful. It is completely private with a comfortable couch, a screen to get changed and paper roll to use as a modesty cover. It is maintained at a comfortable temperature, there are no windows and the door is lockable but we also use a Do not Disturb sign on the door to avoid any disruption. You may wish to bring earphones to listen to music/calming sounds during the procedure.

Your procedure will be carried out by a highly experienced female doctor assisted by a female nurse or health care assistant.

The nurse or doctor will ask you to undress from your waist down (or just remove your underwear if you are wearing a loose skirt) and lie on a bed with your knees bent and apart. You will have a paper sheet or towel to cover your stomach and hips.

Before fitting your coil, you will have an internal examination to check the size and position of your womb. This involves the coil fitter inserting 2 fingers into your vagina and placing a hand on your lower abdomen. . 

The vagina is then held open by inserting an instrument (speculum) inside, similar to when you have a cervical smear test.  An instrument (tenaculum) is attached to your cervix to stabilise the position of your womb and a narrow measuring device is inserted through your cervix to measure the length of the womb cavity after which the coil is inserted and then the threads are cut. 

After the coil insertion

You will need to continue to lie down for a few minutes after the procedure. We will then help you to sit up and as long as you are not feeling faint you can then get up and get dressed. We will provide you with a sanitary pad as you may have some light bleeding after the procedure.

The doctor will be available to answer any questions you have after the procedure; they will give you product information and a card detailing the expiry date of the device.  You will be given a post insertion patient information sheet which the doctor will talk you through, as well as explaining how to check your threads which you should do 4 weeks after insertion then monthly or after each period.

You may feel lightheaded or nauseous after the procedure; you are welcome to relax in our waiting room, after the procedure but you may wish to bring someone with you who can take you home afterwards. 

You may notice some light bleeding immediately after the procedure. It is common to feel some period-like discomfort for the first 24-48 hours  which usually settles although for some women it can last for a few days. Simple painkillers or a heat pad (eg a hot water bottle) applied to the lower abdomen can be helpful. Depending on the type of coil, you may experience a change to your usual bleeding pattern – the doctor fitting your coil will explain this to you. 

We do not offer any routine follow-up after coil insertion, you can have a thread check at the Clinic at 4-6 weeks but there will be an additional charge for this appointment.

If you have any further questions please contact the Clinic before your procedure, our admin team are here to help.