Unwinding the coil: It’s not as painful as you think

It’s a great alternative to traditional forms of hormonal contraception


If you're a woman actively choosing to have sex with men, it's highly likely that you've considered some form of contraception during your life.

However, with myriad options, all of which threaten side-effects ranging from weight-gain to stroke, it can be a minefield to navigate.

When I decided to bite-the-bullet and have the Mirena Coil (IUS) fitted in May last year, the main question my friends asked me was: does it hurt?

With so many horror stories and worrying Instagram captions discussing the effects of contraception, it can be difficult to know what to do.

So, after speaking with gynaecologist Dr Sarah White from Bupa UK, I've decided to debunk some of the myths surrounding the coil to hopefully make your contraceptive experience a little less confusing.

What is the coil?

There are two different forms of coil: the IUS and the IUD (intrauterine device).

Both coils involve the insertion of a T-shaped device into the womb, to cause the cervical mucus to thicken and prevent sperm from fertilising an egg.

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How the two contraceptives differ lies in how they cause the cervical mucus changes: the IUS releases localised hormones to thicken the cervical mucus, whereas the IUD changes the mucus by releasing copper into the womb.

When fitted correctly, the copper IUD protects against pregnancy immediately and can work for up to ten years.

The hormonal IUS can be effective against pregnancy for up to five years and, if correctly fitted within the first seven days of your period, provides immediate protection against pregnancy.

The copper coil can be used by most women, but hormonal coils aren’t suitable for women with any history of breast, cervical or womb cancer; liver disease; heart disease; strokes; arterial disease or migraines.

How do the hormones work in the IUS?

The IUS, or hormonal coil (Mirena is the most widely known brand, but there are others), releases levonorgestrel, a form of the progesterone hormone.

IUSs prevent pregnancy in two different ways: the device thickens mucus in the cervix to block sperm from reaching or fertilising an egg and also thins lining of your uterus, meaning an egg is less likely to be able to implant itself.

Because the hormones in the IUS are localised and, therefore, don't have to travel throughout your body to reach your cervix, many women report experiencing fewer hormone-related side-effects.

What about periods?

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In women with already heavy periods, the IUS may be preferable because this may improve these, and in some the IUD can make periods heavier still.

With the IUS, your periods can become lighter, shorter and less painful – they may stop completely after the first year of use.

However, some women, including myself, experience spotting and occasional heavy bleeding for up to 12 months after their IUS fitting.

With the IUD, your periods can be heavier, longer or more painful in the first 3 to 6 months after insertion. You might get spotting or bleeding between periods.

As soon as any form of coil is removed it’s possible get pregnant, meaning your periods will return to how they were before you had it fitted.

Each experience of the coil is personal and while most people report reduced bleeding with the IUS, if you have any worries or concerns regarding bleeding or periods, you should consult your GP immediately.

What are the side-effects?

As the IUS is hormone-based, some women may develop acne, headaches, mood swings, breast tenderness or cramps; however these side effects usually subside after a few months.

Additionally, some women can feel small changes to their mood and libido.

The IUD has the advantage of no hormonal side-effects but it is worth noting that up to 50% of women discontinue use of the copper coil within five years, most commonly due to either bleeding or cramps.

Does the fitting hurt?

Prior to my coil fitting, I'd been toying with the idea for over a year.

The thought of an intrusive procedure, which some had compared to the pain of giving birth, wasn't the most inviting prospect.

But after one-too-many paranoid pregnancy tests, I couldn't take the judgemental stares of the cashiers in Boots anymore and finally decided to suck-up the pain instead.

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So, after all my worrying and fretting, was the procedure really the Dante's Inferno of pain I was expecting?

Short answer: no.

The procedure certainly wasn't comfortable (especially with the addition of a hangover) but on the pain scale, it's no worse than a period cramp.

For both the IUS and IUD, you'll be offered local anaesthetic to ease the pain and throughout the fitting a nurse is there to hold your hand and make you as comfortable as possible.

You will probably experience period-type cramps afterwards, but they're nothing a hot water bottle and some ibuprofen can't fix.

Once the device is fitted, you may have some short-lived light bleeding but this shouldn’t last any longer than a week.

What happens afterwards?

Once your coil is fitted, it'll need to be checked by a GP after 3 to 6 weeks to make sure everything is fine.

The coil has 2 thin threads that hang down a little way from your womb into the top of your vagina but, don't worry, you'll only be able to find them if you need to check and they don't interfere with sex.

The GP or nurse that fits your coil will teach you how to feel for these threads and check that the IUS/IUD is still in place.

It's very unlikely that your coil will come out, but if you can't feel the threads or think it's moved, you may not be protected against pregnancy.

If this is the case, see a GP or nurse straight away and use additional contraception, such as condoms, until your coil has been checked.

However, for the most part, the coil is incredibly low-maintenance and you'll quickly forget it's even there.

Should I get the coil?

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There's no one-size-fits-all when it comes to contraception and it’s really important to discuss all possible contraceptive choices with your GP before making a decision, as they can help establish what’s best for you based on your health and lifestyle.

The coil is a great alternative to traditional forms of hormonal contraception due to its lack of side-effects and longevity, but the bleeding can put some women off.

Ultimately, if you're prepared to tolerate a 15-minute procedure followed by a few hours of cramps in exchange for five to ten years of protection, then the coil might be the option for you.