How should I feel afterwards?
Most women experience some period-like discomfort/cramps for 24-72 hours after fitting, which then usually settles. For some people there can be mild intermittent cramps continue for 1-2 weeks.
There may be some bleeding or spotting for a few days. If an IUCD is fitted during a period, the period may be heavier and last slightly longer than usual.
If the pain is severe, is not being relieved by simple painkillers, gets worse, does not settle fully after 1 week or you are bleeding heavily, you should contact your GP or Practice Nurse (or call 111 if the Practice is closed).
What should I do afterwards?
Avoid using tampons and menstrual/moon cups for 7 days after the coil fit, just use pads. You can use tampons again if needed after 7 days, but please be aware menstrual cups can dislodge the coil if the threads are caught and can be pulled out with the cup – ensure the seal is fully released.
Take simple painkillers such as Paracetamol and/or Ibuprofen (as long as you are not allergic to these products). Take what you usually would to manage period pains.
Rest for several hours after fitting and avoid strenuous activity for the rest of the day.
Using a hot water bottle and sometimes gentle walking might help.
When can I resume sex?
A copper IUCD is effective straight away as contraception.
An IUS (Mirena/Levosert/Kyleena or Jaydess) will not work as contraception for the first 7 days and you should abstain from sex or use another contraceptive method at the same time.
Otherwise, you can resume sexually activity whenever you feel comfortable. IUCDs do not protect you against sexually transmitted infections so additional barrier protection such as condoms may still be advisable, especially in the 1st week due to the higher infection risk and with any new sexual partner (it would be advised they have an infection screen prior to unprotected sex).
Is there anything I should look out for?
A change in bleeding pattern occurs frequently after your coil insertion, you can bleed lightly for a few days, sometimes up to 1 week. With a new copper coil, you will likely have heavier and more painful bleeding. Irregular bleeding and a dark brown ‘stringy’ discharge is particularly common with an IUS device but should settle after 3-6 months to possibly no period or a light period most months. The hormonal side effects such as headaches, breast tenderness, oily skin or mood changes are rare and may settle within 8 weeks (this is as slightly more hormone is released in the 1st 6-8 weeks after it is fitted). See your GP if the side effects are persisting and bothering you.
With a copper IUCD periods can become heavier, longer and more painful but then often improve after the first 3 months, you can also get a small light bleed in the middle of your cycle, after sex and exercise for the first 3 months. If you are concerned about bleeding, please speak to your Practice Nurse or GP.
If you think you may have an infection, please contact the GP Practice as soon as possible.
Symptoms of an infection may include:
- Persistent or worsening lower abdominal pain
- Abnormal vaginal discharge
- Fever
- Pain during sexual intercourse
When does the coil need changing?
All intrauterine devices are effective for at least 5 years (except Jaydess which is 3 years) and some for up to 10 years. You should have been advised of the date for replacement at the time of fitting; if not, please ask. It is then your responsibility to attend your GP or local sexual health clinic before this date to have your coil removed or changed.
If you have had an IUS (Mirena or Levosert) fitted after the age of 45, (or a copper IUCD fitted after the age of 40), you can continue to use the same device for contraception until no longer required (usually at age 55).
Removing a coil
A coil can be removed at any time by a trained nurse or doctor gently pulling on the threads, this can cause some very brief cramps. We recommend trying the method for at least 3 to 6 months to see if it suits you before having it removed. If irregular or heavy bleeding is a problem, there are medication options that can be prescribed for a few months which may help. If you don’t want to be pregnant, avoid sex or make sure to use a condom in the 7 days before your coil is removed or changed for another coil. This is to avoid any risk of unintended pregnancy.
If you are planning for a pregnancy, please speak to your GP, it is advised to start folic acid and vitamin D 3 months prior to trying for a baby. You may also find the following information useful: https://www.nhs.uk/pregnancy/trying-for-a-baby/planning-your-pregnancy/
Checking your threads
We recommend that you check for your coil threads ideally once a month (after your period if you have them) – some people do not want to feel for the threads, or simply cannot ever feel them – we would advise you to seek a review if your bleeding pattern changes, you are having new abdominal pains or discharge so your coil can be checked.
- Wash your hands and sit or squat down.
- Gently put your finger inside your vagina (as if inserting a tampon).
- Feel for your cervix (which feels firm, like the end of your nose).
- Gently roll your finger over your cervix and you should feel your threads. (Although there are two threads they usually stick together and you will only be able to identify them as one thread; this is fine).
- It is unlikely that your coil will fall out, but if you cannot feel your threads or if you feel something hard and plastic other than the threads, please abstain from sex or use condoms, check a pregnancy test and make an appointment to have the device checked.
If you think you may have had sex since the coil has moved, you may need emergency contraception. Please check a pregnancy test and seek advice as soon as possible from your GP or 111. If the threads cause discomfort to you or your partner, they can be trimmed, please contact the practice for a routine appointment.
Additional advice
We do not routinely see patients for follow up after a coil fit, but we are always very happy to see you if you have any concerns. Please contact the Practice for an appointment.
If you are aged 25 or over, make sure you have regular cervical smears as part of the National Cervical Screening Programme (you will receive a letter about this about 6 months before your 25th birthday).
We recommend regular sexual health checks for everyone (check if you are eligible for the free postal kits https://sh24.org.uk/ ), but especially if you have a new partner or believe you may be at risk.
Please contact your GP or the local sexual health clinic if requiring sexual health testing https://www.nuh.nhs.uk/sexual-health-clinics