https://www.youtube.com/watch?v=XHRYE2FsXmcMirena (Coil) InformationThe Intra-Uterine System (IUS) ‘Mirena Coil’ Patient InformationThis section aims to answer your questions about the intra uterine system (IUS), known as Mirena. It explains the benefits, risks and alternatives, as well as what to expect when you come to the surgery.
What is the IUS?The Mirena IUS is a small plastic T-shaped device containing progestogen hormone (levonorgestrel).
It is fitted into the womb where the hormone is released slowly over 5 years. It has two fine threads that come through the cervix (neck of the womb) opening and rest at the top of the vagina, in order to be checked and removed when necessary.
There are alternate IUS devices available in the practice, which you may wish to discuss.
What is the IUS used for and what are the benefits?Long term contraceptionThe Mirena is widely used as a long term reversible contraceptive and can be left in place for up to five years (or longer if you are over the age of 45). It is one of the best forms of contraception, with only two in 1,000 women getting pregnant (0.2%)
However, should you wish to get pregnant, fertility returns to Normal when the Mirena is removed.
Heavy, painful periodsIt is used as a treatment for heavy periods and can reduce period bleeding by up to 90%. In addition, up to 50% of women will have no periods after one year of use.
The Mirena coil has been successfully used to reduce period pains and is a known treatment for conditions such as endometriosis.
HRTIt can be used as part of HRT to provide womb lining protection. Most benefits of HRT come from oestrogen, however, if given alone, it causes thickening of the lining of the womb leading to irregular bleeding and other problem.
Many women are unaware that they may still need contraception even if they are taking HRT (this should be discussed with your GP). A further advantage is that the Mirena coil is the only ‘progesterone part’ of HRT that can double up as contraception.
Avoiding surgeryIt is much safer to insert a Mirena than to have surgery for heavy periods, or a sterilisation for contraception.
Medication interactionThe Mirena coil is not affected by other medicines and is safe to use whilst breastfeeding.
What are the risks?Difficulty with insertionOccasionally, there can be difficulties for example if your cervix is tightly closed. This is more common in those who have had surgery to the cervix, or not had children vaginally. Your doctor may be able use equipment to help open the cervix. If this is not possible you may need to be referred to the hospital to have it fitted.
PerforationRarely, the Mirena coil might go through the wall of the womb. This risk may be higher if breastfeeding. One sign maybe pain, but often there are no symptoms and the womb will heal by itself.
ExpulsionRarely, the Mirena may be pushed out of the womb or displaced. Your nurse will teach you how to check your threads are in the correct place, which you should do every few months.
InfectionThere’s a small chance of getting a pelvic infection during the first few weeks after an IUS is put in.
Ectopic pregnancyThe Mirena is very effective and it is unlikely you’ll get pregnant. If you do, there’s a small increased risk of it developing outside the womb.
Are there side effects?Side effects are more common within the first few months and generally settle after continued use.
HormonalThese may include breast tenderness, headaches, acne and symptoms similar to PMS.
Bleeding problemsSome women may experience changes to their bleeding patterns. This usually settles by 3-6 months. We encourage you persevere and speak to your GP if you find this difficult.
Ovarian cystsOccasionally, women may develop functional or simple ovarian cysts (small fluid filled sacs on the ovaries), which are not dangerous. They usually cause no symptoms and go away on their own.
Am I suitable for the Mirena Coil?There are some women for whom the IUS is not suitable. This will be assessed at the time of counselling.
In particular, please inform us if you have any of the following:– allergy to progesterone/levonorgestrel
– suspected pregnancy
– unexplained vaginal bleeding
– pelvic inflammatory disease (current or within the last three months)
– changes to the shape of the womb.
How can I prepare for having an IUS fitted?Timing of fittingAn IUS can be put in at any time in your menstrual cycle. If fitted in the first seven days of your menstrual cycle, you do not require any further contraception. If fitted at any other time, you will need additional contraception for the first seven days.
Ensuring you are not pregnantPrior to having your IUS fitted, you will need to ensure you use adequate, reliable contraception or do not have sexual intercourse from your last period. Please inform us if there is a possibility you are pregnant.
Previous infectionsYour nurse will check if you are at risk of infections including previous sexually transmitted infections or a new partner within the last 12 months. We may recommend you have a sexual health screen/ vaginal swabs prior to/at the time of your coil fitting.
Heart conditionsTell your nurse/doctor if you have an abnormal heart valve, as you might need antibiotics to cover the insertion procedure.
Pain reliefYou may feel pain during and after the fitting. We would suggest that you take some painkillers about an hour before you have the IUS fitted.
ContraceptionIt is important to have prior alternate contraception arranged in case the device cannot be fitted.
What happens during the IUS fitting?Your appointment will last 20–30 minutes. We will check that you have understood all the information provided and you will be asked to sign a consent form. The doctor will examine you internally to check the position and size of your uterus before inserting your coil. You may be offered swabs/a smear at the same time.
Before you leave, you will see the nurse and be given an aftercare leaflet. You may want to bring a chaperone as some women experience cramps and slight bleeding after the procedure.
If you have any further questions, please phone the surgery to arrange a telephone consultation with the well woman nurse or your own GP.
The Intra-Uterine Coil Device (IUCD) ‘Copper coil’ Patient InformationThis section aims to answer your questions about having the Intra Uterine Coil Device (IUCD). It explains the benefits, risks and alternatives, as well as what you can expect when you come to the surgery.
What is the IUCD?The intra uterine system is a small plastic T-shaped copper device that is fitted into the womb to prevent pregnancy. It does not contain any hormones. It has one or two very fine threads that come through the cervix (neck of the womb) opening and rest at the top of the vagina, so that it can be checked and removed when necessary.
What is the IUCD used for and what are the benefits?Emergency contraceptionThe IUCD is the most effective emergency contraceptive option (if suitable),and can be kept in the uterus to be continued as long term contraception.
Long term contraceptionThe IUCD is widely used as a long term reversible contraceptive. There are different types and sizes, which can be left in place for up to five or 10 years (or until after menopause if you are over the age of 40). It is one of the best forms of contraception, with only two in 100 women getting pregnant (2%)
It works by: preventing sperm from surviving; altering cervical mucus to prevent sperm from reaching an egg; and preventing an egg implanting in the womb.
However, should you wish to get pregnant, fertility returns to normal when the coil is removed.
Avoiding surgeryIt is much safer to insert an IUCD than to have surgery for sterilisation.
Medication interactionThe IUCD is not affected by other medicines and is safe to use whilst breastfeeding.
What are the risks?Difficulty with insertionOccasionally, there can be difficulties for example if your cervix is tightly closed. This is more common in those who have had surgery to the cervix, or not had children vaginally. Your doctor may be able use equipment to help open the cervix. If this is not possible you may need to be referred to the hospital to have it fitted.
PerforationRarely, the IUCD might go through the wall of the womb. This risk may be higher if breastfeeding. One sign maybe pain, but often there are no symptoms and the womb will heal by itself.
ExpulsionRarely, the IUCD may be pushed out of the womb or displaced. Your nurse will teach you how to check your threads are in the correct place, which you should do every few months.
InfectionThere’s a small chance of getting a pelvic infection in the first few weeks after an IUCD is put in.
Ectopic pregnancyThe IUCD is very effective and it is unlikely you’ll get pregnant. If you do, there’s a small increased risk of it developing outside the womb.
What are the side effects?Bleeding problemsSome women may experience heavier, longer, or more painful periods. This may improve after a few months. It is important that you are aware of this risk and speak to the nurse or GP before consenting for this procedure. They may be able to suggest other, more suitable intra uterine contraception such as the Mirena coil.
Am I suitable for the IUCD?There are some women for whom the IUCD is not suitable. This will be assessed at the time of counselling.
In particular, inform us if you have any of the following:– allergy to copper
– suspected pregnancy
– unexplained vaginal bleeding
– pelvic inflammatory disease (current or within the last three months)
changes to the shape of the womb.
How can I prepare for having an IUCD fitted?Timing of fittingAn IUCD can be put in at any time in your menstrual cycle. It is effective immediately.
Ensuring you are not pregnantThe IUCD can be used as emergency contraception if you have had unprotected sexual intercourse in the past 5 days (or up to 5 days after the earliest time of ovulation). It can then be kept in to use for long term contraception.
However, multiple episodes of intercourse or episodes outside of this window can result in pregnancy. Therefore, prior to having your IUCD fitted, we strongly advise you ensure you use adequate, reliable contraception or do not have sexual intercourse from your last period.
Previous infectionsYour nurse will check if you are at risk of infections including previous sexually transmitted infections or a new partner within the last 12 months. We may recommend you have a sexual health screen/ vaginal swabs prior to/at the time of your coil fitting.
Heart conditionsTell your nurse/doctor if you have an abnormal heart valve, as you might need antibiotics to cover the insertion procedure.
Pain reliefYou may feel pain during and after the fitting. We would suggest that you take some painkillers about an hour before you have the IUCD fitted.
ContraceptionIt is important that you have prior alternate contraception arranged in case your device cannot be fitted.
What happens during the IUCD fitting?Your appointment will last 20–30 minutes. We will check that you have understood all the information provided and you will be asked to sign a consent form.
The doctor will examine you internally to check the position and size of your uterus before inserting your coil.
You may be offered swabs/a smear at the same time if this has already been discussed.
Before you leave, the nurse will check any further questions and give you an aftercare leaflet. You may want to bring a chaperone as some women experience cramps and slight bleeding after the procedure.
