Information for Patients requesting a coil to be fitted at Sheen Lane Health Centre
There are two different types of coil available: the hormone free/ copper coil ( Cu- IUD) and the progesterone hormone coil (Mirena or Jaydess).
The copper coil usually used is Nova-T which is licenced for 5 years unless you have it fitted after your 40th birthday when it can be used for contraception indefinitely. It is possible that your periods become heavier, more prolonged and possibly more painful but this often settles after 2-3 months after fitting. This coil prevents fertilisation of the egg and may also prevent implantation.
The Mirena coil releases 20mcg/24 hours of the progesterone only hormone Levonorgestrel. It is licensed for 5 years unless you have it fitted after your 45th birthday when it can be used for contraception indefinitely. Most women have irregular bleeding/ spotting for the first 2-3 months after fitting this coil; but it may persist for up to 6 months. After this time approximately 1/3 of women have no periods at all; 1/3 have light regular periods; 1/3 have light irregular periods. There is approximately 95% reduction in menstrual blood loss at 3 month.
>60% of women ovulate with Mirena; it works by preventing sperm penetration into upper reproductive tract and implantation.
The Mirena is licensed for contraception for 5 years and for endometrial protection with HRT for 4 years currently.
Progesterogenic side effects (breast tenderness, acne, headaches, mood swings and bloating) are rare and usually settle after the first 3 months. These side effects are commonest in the first 2-3 weeks after fitting. Systemic absorption of the hormone is roughly equivalent to taking a progesterone only pill twice a week.
The Jaydess coil releases 6mcg/24 hours of Levonorgestrel. It is licensed for 3 years. As it has less hormone it is less likely to cause no periods but it is likely to reduce to heaviness of your periods. It is more likely that you will have regular light periods. Some women can have no periods at all. At 3 years most women will have 8 days on average of light bleeding or spotting every month.
Almost 100% of women ovulate with Jaydess; it works by preventing sperm penetration into the upper reproductive tract and implantation.
The Jaydess is not licensed for heavy periods or endometrial protection.
Progesterogenic side effects ( breast tenderness, acne, headaches, mood swings and bloating) are very rare and usually settle in the first 3 months. Systemic absorption is similar to less that one progesterone only pill per week. It does not cause any weight gain.
Timing of fitting of coil
A coil can be fitted at any time in your cycle as long as you could not be pregnant. We usually ask that you have the hormone coil fitted in the first week of your cycle ( the first day or your period is Day 1) as it is then effective immediately. If it is fitted at another time of your cycle please ensure that you use an alternative form of contraception for before fitting and for 1 week after fitting.
Please ensure that you use condoms for 7 days prior to a change of coils. This is especially important when switching from a Cu-IUD to a Mirena or Jaydess; or if you are coming in for a change of Copper coil.
No additional contraception is needed if you are just coming in for a change of Mirena or Jaydess.
Failure rates of the coils are very low: 2% for Cu-IUD; 1% for Mirena at 5 years; <1% for Jaydess at 3 years.
The Coil as an Emergency Contraception
The Cu-IUD can be used as an emergency contraception up to 5 days after unprotected sexual intercourse ( UPSI). If the timing of ovulation can be estimated, the insertion of Cu-IUD can be beyond 5 days of UPSI as long as it does not occur beyond 5 days after estimated date of ovulation.
Mirena or Jaydess are not suitable for emergency contraception.
Perforation risk 0-2 per 1000 insertions. This is higher if breast feeding and insertion of a coil should be delayed in the breast feeding woman until after 3 months post partum and counselling given regarding the increased risk of perforation.
Expulsion risk is 1 in 20 and the woman should feel for the strings 3 days after insertion. If she cannot feel the strings then she should use condoms and book an appointment with the nurse to check for the strings.
No delay in return to fertility post removal although there may be a delay in return of regular periods with women using Mirena or Jaydess.
6x risk of pelvic infection in first 3 weeks of fitting.
Booking a coil fitting or change
Please ask reception for a swab which you do yourself: the instructions are on the swab packet. This should be done at least one week prior to the fitting.
Book a double appointment with Dr Jukes or Dr Grayson. Please make sure that you have followed the instructions under ‘timing of fitting the coil’ section above.
You might benefit from taking 400mg ibuprofen one hour before fitting.
The fitting typically takes 20-25 minutes.
You may feel some period like pains which should settle after an hour or so.
You may have some vaginal bleeding which may last several days.
You will be instructed as to post insertion advice at the time of fitting but you should avoid using tampons or having sex for 3 days after fitting. You may be advised to use condoms for 7 days after fitting depending on the timing of your fitting.
You will be invited for a coil check at 6 weeks post fitting with the Dr or nurse.
SEJ November 2016