The hormonal coil, also known as the LNG-IUD is a small T-shaped plastic device that sits in your womb and releases the progestogen hormone. It is long-acting and reversible, so you can have it removed if you want to get pregnant or change your method.
It is the sixth most popular method of contraception in the UK, and is becoming more popular, particularly amongst women over 25.
Sexual Health Dorset follow national clinical guidance for the lifespan of all contraceptive methods. The Mirena LNG-IUD has had its licence extended to 8 years for contraceptive use. Please see additional information here.
Once the LNG-IUD is in place, you don't have to think about contraception. It won't interrupt sex and your partner should not be able to feel it. The Kyleena, Mirena, Benilexa and Levosert coils all contain the hormone levonorgestrel (a form of progestogen) which works to prevent pregnancy. For contraception the Kyleena is licensed for use for up to 5 years, the Benilexa and Levosert for up to 6 years and the Mirena for up to 8 years.
It can be removed at any time by a trained doctor or nurse, but you must use condoms as well or abstain from sex for 7 days prior to removal.
The LNG-IUD releases a progestogen hormone which prevents pregnancy by:
An LNG-IUD has 2 thin threads that hang down a little way from your womb into the top of your vagina. You will be taught how to feel for the threads and check the LNG-IUD is still in place. If you can't feel the threads or if you think the LNG-IUD has moved, you may not be fully protected against pregnancy. See your doctor or nurse straight away and use extra contraception, such as condoms, until your LNG-IUD has been checked.
It’s highly unlikely that your LNG-IUD will come out.
Most women can use an LNG-IUD , but your clinician will ask about your family and medical history to find out whether it’s right for you.
The LNG-IUD is suitable for women who can’t take the hormone oestrogen (which is in the combined pill).
LNG-IUD may not be suitable for you if you have or have had certain health conditions.
Short term:
Common:
Irregular bleeding and spotting in the first 6 months. This is not harmful and usually decreases with time.
Rare:
Some women experience headaches, acne and breast tenderness after having the LNG-IUD fitted.
Pelvic infections may occur in the first 20 days after the LNG-IUD has been inserted. Fewer than 1 in 100 women will get an infection.
Long term:
Rare:
Minor changes in mood and libido.
Irregular vaginal bleeding and pain.
Small fluid-filled cysts on the ovaries – these usually disappear without treatment.
There's no evidence that an LNG-IUD will affect your weight.
If it is fitted in the first 5 days of your menstrual cycle, you will be immediately protected against pregnancy. If it is fitted at any other time, you will need to use additional contraception for the first 7 days.
Yes, whilst using the LNG-IUD you can use tampons, pads or a mooncup.
Your partner shouldn't be able to feel your LNG-IUD during sex. If he can feel the threads, get your GP or clinician to check your LNG-IUD is in place. They may be able to cut the threads a little.
There's no evidence that having an LNG-IUD fitted will increase the risk of cervical cancer, cancer of the uterus or ovarian cancer.
Before you have a coil fitted, you may be tested for any existing infections, such as STIs, so that any infections can be treated beforehand. We offer postal STI screening via our digital partner, SH:24.
The coil can be fitted at any time during your monthly menstrual cycle, as long as you're definitely not pregnant.
Having a coil fitted can be uncomfortable and painful but the pain shouldn't last long and is described as quite similar to period pains. A fitting is likely to be less painful if you have had natural birth (vaginal delivery) as your cervix will have previously been stretched.
Whilst you lie down, with your knees bent, a speculum will be used to hold your vagina open (the same instrument is used when having a smear test done). Local anaesthetic gel spray is applied to the cervix and this feels cold.
The clinician will then use forceps to hold the cervix steady in order to determine the size and position of your womb with a sterile probe.
The coil comes with its arms folded down packed inside a narrow tube. The clinician will insert the tube into the vagina, through the cervix and into your uterus (womb).
Then they will pull the plastic tube out, leaving the coil in place allowing the arms of the coil to fold open. Before the speculum is removed, the strings of the coil are cut, leaving 1 to 2 cm hanging down at the top of your vagina so that you can feel to make sure it is still in place.
The whole process should take about 5 minutes.
We advise you to take some of your usual pain relief such as paracetamol before your appointment and make sure that you have eaten.
Having a coil fitted can be uncomfortable and painful but the pain shouldn't last long and is described as quite similar to period pains. A fitting is likely to be less painful if you have had natural birth (vaginal delivery) as your cervix will have previously been stretched.
The clinician doing the fitting will use a speculum to hold your vagina open (the same instrument is used when having a smear test done). Local anaesthetic spray or gel is applied to the cervix and this feels cold.
Read more about the coil fitting process.
Occasionally people feel nauseous or faint afterwards. They may need to lie down for 5-10 minutes but are usually fine after a short while. The clinician will always make sure you are recovered and happy to make your way home before letting you leave.
Some people prefer to have no plans after their appointment so that they relax and be comfortable at home afterwards.
It is fairly common for women to experience some slight cramping and/or spotting for a couple of days after a fitting.
Most women can use an LNG-IUD, but your GP or clinician will ask about your family and medical history to find out whether it’s right for you.
The LNG-IUD is suitable for women who can’t take the hormone oestrogen (which is in the combined contraceptive pill).
LNG-IUD may not be suitable for you if you have or have had certain health conditions:
If you're 45 or older when you have the LNG-IUD fitted, it can be left until you reach menopause or you no longer need contraception which is age 55 years. The LNG-IUD can also be used as part of HRT.
The clinician that fits your LNG-IUD will teach you how to feel for the threads and check that the LNG-IUD is still in place. If you can't feel the threads or if you think the LNG-IUD has moved, you may not be fully protected against pregnancy. See your doctor or nurse straight away and use extra contraception, such as condoms, until your LNG-IUD has been checked.
There is a very small risk of infection. If you have any of the following symptoms within a few days of having an LNG-IUD fitted, you should see your GP (or clinician who fitted the LNG-IUD) straight away:
Fertility will return to normal when the LNG-IUD is removed.
If you decide to have your LNG-IUD taken out, but you don’t want to get pregnant, you will need to use condoms for 7 days before you have it removed. This is because sperm can live for up to 7 days inside the body.
The non-hormonal coil, CU-IUD, releases copper that creates an environment where sperm do not survive.
The hormonal coil, LNG-IUD, releases a progestogen hormone, which thickens the mucus from the cervix (opening of the womb), making it harder for sperm to move through it and reach an egg. It also causes the womb lining to become thinner and less likely to accept a fertilised egg. In some women, the LNG-IUD also stops the ovaries from releasing an egg (ovulation), but most women will continue to ovulate.
A coil can be removed at any time by a trained doctor or nurse.
If you're not going to have another coil put in and you don't want to get pregnant, use another method (such as condoms) for 7 days before, as sperm can live for up to 7 days inside the body.
Removal of a coil is a very quick procedure (about 30 seconds). It may be a little uncomfortable, but is much less uncomfortable than the fitting procedure.
Although this is unlikely, if the LNG-IUD fails and you become pregnant, you should have it removed as soon as possible if you are continuing with the pregnancy. You should also have a scan to ensure the pregnancy is not ectopic.
In fewer than 1 in 1,000 cases, an LNG-IUD can make a tiny hole in the womb or neck of the womb (cervix) when put in. The risk of perforation is extremely low. Contact the clinic where you had the coil fitted if you feel a lot of pain in the lower abdomen after having an LNG-IUD fitted. If there is a suspected perforation, go to A&E to see a specialist. If perforation occurs, you may need surgery to remove the LNG-IUD.
The coil can be pushed out by your uterus or it can move. This is not common. This is more likely to happen soon after it has been put in. This is why your doctor or nurse will teach you how to check your coil threads every month.
If you get an STI while you have an LNG-IUD fitted, it could lead to pelvic infection. STIs and pelvic infections need to be treated as soon as possible. An LNG-IUD doesn't protect you against STIs, so you may also have to use condoms when having sex.
Yes, you can fit the LNG-IUD more than 28 days post-delivery.
An LNG-IUD can be used safely while you are breastfeeding and will not affect your milk supply.
