The Contraceptive Coil (IUD): Risks and Disadvantages

Written by Hammad Sadiq

* How does the Contraceptive Coil work?

* What are the disadvantages of the contraceptive coil?

* Are there any risks associated with it?

What is a Contraceptive Coil (IUD)?

Contraceptive coils are referred to more commonly now as IUDs or Intrauterine Devices. Intrauterine means literally ‘inside the womb’ as this is where your IUD sits when placed. The reason you may hear them widely referred to as coils is due to the original devices in the 1960’s being coil-shaped, however, modern devices are T-shaped with a length of copper around the base.

An IUD will also have two threads which hang down from the womb so that the position and location can be checked both by the patient or a relevant health practitioner. These are not, as some mistakenly note, to be able to remove the device yourself, which is highly risky, as all IUDs must be removed by a professional such as a GP or qualified nurse.

It’s a fairly common form of contraceptive in the UK, with around 140,000 women a year using it. However, this is a small number compared with the 3.5 million British women who use the contraceptive pill.

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How Does The Contraceptive Coil Work?

It is often touted as one of the most common non-hormonal forms of long term contraception and its 99% effectiveness means that it’s around the same level as the mini-pill in terms of its ability to prevent pregnancy. However, the lack of hormones doesn’t stop it from having risks or quite uncomfortable side effects.

The IUD relies mainly on its shape and on copper ions released from the device which affect the environment inside the reproductive system. There are three primary ways that the IUD works as an effective form of contraception:

  1. Stops sperm from surviving
  2. Makes cervical mucus hostile for sperm
  3. May also prevent a fertilised egg from implanting in the uterus

Can any Woman have a Contraceptive Coil?

The majority of healthy women will have no problems with an IUD. However, you shouldn’t have one if you fall into any of the following categories:

  1. You have a copper allergy or Wilson’s Disease
  2. You have an STD or had a recent pelvic infection
  3. You’re pregnant or think you may be pregnant.
  4. You have cancer of the cervix or uterus.
  5. You have unexplained vaginal bleeding.

What is the Disadvantage of the Contraceptive Coil?

As mentioned earlier, many people see the contraceptive coil as an ideal option if they have had adverse reactions or experienced side effects from hormonal contraceptives such as the pill or if they are unable to take other forms of contraceptive due to certain health conditions or other medications they’re taking.

It’s also important to note that the IUD will not protect you from STD’s, therefore, it’s important that it’s combined with a barrier method such a condom in cases where it’s required.

Some women see the lack of hormones in the copper coil as indicative of a lack of side effects, however, this isn’t the case as there are a number of related issues that may arise from IUD’s. These usually last between 3-6 months as your body adjusts itself to the foreign body.

The most common of these are:

  • Pain

The coil most commonly causes pain during insertion, especially if the patient hasn’t had a child before, as the uterus won’t be as open. There’s also associated back pain and abdominal cramps which many patients report can continue for a few days after the IUD is inserted.

  • Expulsion

Often listed as the most common disadvantage of contraceptive coils in the first three months, is the ability for the uterus to expel the IUD. This may refer to partial expulsion which is when the coil moves further down from its ideal position at the top of your uterus, which is especially common around the time of the menstrual period. The less common form is when the IUD is almost completely expelled and goes higher up, or much further down and becomes ineffective as a result. If you are unable to locate your strings or suddenly notice they are shorter or longer than usual, contact your GP/Nurse as a matter of urgency. 

  • Cramping

The IUD can cause abdominal pain immediately after insertion, as well as for a number of days after. However, the IUD is also known to exacerbate cramping during the pre-menstrual and menstrual periods, so if you are already prone to quite a severe cramping, let your GP/Nurse know before you have the IUD fitted as they may recommend an alternative. The intense menstrual cramps associated with the IUD are often cited by patients who discontinue use as one of their main motivating factors for having the device taken out. 

  • Bleeding

The coil also has a reputation for causing spotting, irregular periods and, more commonly, heavier and more intense bleeding during periods. The heavier periods tend to peak in the first 3-6 months and may level out again after that, however, the heavy periods associated with the IUD are another common reason for women to have the device removed. If you already suffer from very heavy periods or low-iron levels caused by heavy periods, your GP/Nurse may recommend the Mirena Coil, which is a hormonal IUD that used progesterone to regulate heavy periods as well as having a contraceptive effect. 

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Are There Any Risks Associated With the Contraceptive Coil?

  • Infection

An infection can be a serious result of having an IUD fitted, either through bacteria introduced at the time of insertion or if an STI is present when the IUD is fitted. The most serious infection, which a coil can slightly increase the risk of, is Pelvic Inflammatory Disease (PID) which is an infection that causes inflammation of the uterus lining, fallopian tubes or ovaries. It’s important that PID is diagnosed and treated urgently as extended or repeated episodes can potentially lead to fertility problems. 

  • Ectopic Pregnancy

IUDs are primarily used to prevent intrauterine pregnancies, and therefore there is a very small, but slightly raised, risk of having an ectopic pregnancy which is when a fertilised egg implants in the Fallopian tubes as opposed to the uterus. Ectopic pregnancies are potentially very harmful to the mother and therefore are classed a serious medical emergency. Symptoms include severe pain in the lower abdomen, spotting or heavy vaginal bleeding and vomiting. 

  • Perforation

The coil also has the potential, although very rare, to perforate or puncture a hole in the uterus and migrate. This, if it occurs, will usually lead to severe abdominal pain alongside heavy bleeding, persistent nausea or even fainting.

6 weeks after your IUD has been inserted, you’ll be checked over by a GP who will ensure it’s been fitted correctly and there are no problems. However, if you experience any of the above symptoms or feel generally unwell at any point after an IUD insertion, don’t hesitate to contact your GP/Nurse so that they can advise you on the best course of action.

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