A coil is fitted in one appointment of about 30 minutes. The hormonal coil usually makes periods lighter and the copper coil usually makes them heavier, and both cause unpredictable bleeding for the first 6 months. The fitting, the device and the 6 week check are £1,095.
Message the clinic and a doctor replies within 24 hours.
Any of these needs to be seen the same day. If you are severely unwell, go to your nearest emergency department or call 999.
A coil is a small device placed inside the womb. The hormonal one releases levonorgestrel into the lining and usually makes periods lighter or stops them. The copper one contains no hormone and works by making the womb hostile to sperm, and it usually makes periods heavier. Both are among the most reliable methods available and both can be taken out whenever you want.Faculty of Sexual and Reproductive Healthcare FSRH clinical effectiveness unit, 2023
Choosing between them is rarely about how well they prevent pregnancy. It is about what you want your periods to do and whether you want a hormone involved at all. A woman with heavy periods and a woman who wants nothing hormonal are pointed in opposite directions by the same conversation.NICE NG88, 2021
Most women come for contraception. A large minority come because their periods are heavy, and for them the hormonal coil is the first line treatment for the bleeding itself rather than a contraceptive that happens to help. It is offered ahead of tablets and well ahead of surgery.NICE NG88, 2021
The reason women stop is almost always bleeding. In the studies of copper devices, unwelcome bleeding accounted for 11 to 26% of all discontinuations, and between 8.5 and 22% of women had the device out for that reason inside 12 months. For the hormonal device the same figure is under 5%.BMC Women’s Health Costescu, 2022
Nearly all of that happens in the first year and much of it in the first 6 months. Knowing the pattern before it starts is what separates a woman who waits it out from a woman who has a device she wanted removed in week 9.BMC Women’s Health Costescu, 2022
Send us what you are seeing and we will tell you what it is likely to be.
The appointment opens with which device rather than with the fitting. What your periods do now, what you want them to do, what you have used before and what happened, and your medical history and medicines read against the eligibility criteria, because a small number of conditions change the answer.Faculty of Sexual and Reproductive Healthcare UKMEC, 2016
Then an examination. The size and the direction of the womb are established by hand before anything passes through the cervix, because fitting a device without knowing which way the womb sits is how a perforation happens. A pregnancy test is done, and infection screening where it is indicated.Faculty of Sexual and Reproductive Healthcare FSRH clinical effectiveness unit, 2023
The fitting itself takes a few minutes inside a 30 minute appointment. Local anaesthetic to the cervix is offered rather than assumed. Cramping like a strong period during it and for a few hours afterwards is normal, and you stay in the building until that has settled.Faculty of Sexual and Reproductive Healthcare FSRH clinical effectiveness unit, 2023
The hormonal coil
Levonorgestrel released locally into the lining of the womb. Periods usually become much lighter, and around 20% of women have at least one 3 month stretch with no bleeding at all during the first year. It also treats heavy periods in its own right, which is two problems answered by one device.American Journal of Obstetrics and Gynecology Sergison, 2019
The copper coil
No hormone at all and effective from the moment it is in. It is also the method used for emergency contraception, where a randomised trial of more than 700 women found no pregnancies among the 321 given a copper device. Periods usually become heavier and more painful, at least for the first few months.New England Journal of Medicine Turok, 2021
The contraceptive implant
Placed under the skin of the upper arm in about 20 minutes, with nothing passed through the cervix. Bleeding is unpredictable with this one too. It is the alternative for a woman who does not want an internal procedure, and we fit and remove it here.Faculty of Sexual and Reproductive Healthcare UKMEC, 2016
The pill, the patch or the ring
Reliable when they are used exactly and less so when life gets in the way, which is the difference that matters. A method whose effectiveness does not depend on remembering anything is a different proposition, and that is the case for either device.Faculty of Sexual and Reproductive Healthcare UKMEC, 2016
A fitting here, with the check in the fee
One appointment of 30 minutes. The conversation about which device, the device itself held in stock, local anaesthetic offered, the fitting, and the 6 week check that confirms it is sitting where it should. £1,095, with removal at £395 and a removal with a new device fitted at the same visit at £1,195.Faculty of Sexual and Reproductive Healthcare FSRH clinical effectiveness unit, 2023
Expect unpredictable bleeding for the first 6 months whichever device you choose. With the hormonal one it usually settles into much lighter periods, and around 20% of women have at least one 3 month stretch with none at all inside the first year. With the copper one periods usually stay heavier than they were before.American Journal of Obstetrics and Gynecology Sergison, 2019
A device can come out on its own. Across 326,658 insertions the risk of expulsion was 2.3% in the first year and close to 1 in 20 by 5 years, with almost no difference between the hormonal and the copper device. That is why you are taught to feel for the threads and why the 6 week appointment exists.Obstetrics and Gynecology Fassett, 2023
Perforation of the womb at fitting happened in 1.3 per 1,000 insertions in the European surveillance study, and the risk was 6 times higher in women who were breastfeeding at the time. No perforation in that study caused serious illness or injured anything inside the abdomen.Contraception Heinemann, 2015
Infection is uncommon and the window is short. The risk of pelvic infection sits under 1% and belongs to the 3 weeks after fitting rather than to the whole time a device is in place, which is why pain with a temperature in those weeks is seen the same day.Faculty of Sexual and Reproductive Healthcare FSRH clinical effectiveness unit, 2023
Keep a bleeding diary for the 3 months before the appointment and carry it on for 6 months afterwards. Days of bleeding, days of spotting and a pain score out of 10. It is the only reliable way to tell an unsettled first 6 months from a device that does not suit you at all, and the decision at 6 months should rest on a record rather than on a bad fortnight.BMC Women’s Health Costescu, 2022
Learn to find the threads and check once a month after a period. Wash your hands, reach up to the cervix and feel for two fine threads coming through it. Threads you cannot find have usually curled up rather than gone, but together with new pain or unexpected bleeding they are worth a same day appointment.Faculty of Sexual and Reproductive Healthcare FSRH clinical effectiveness unit, 2023
If a heavy period is what took you to a doctor rather than contraception, ask for the hormonal device by name. It is the first line treatment for heavy menstrual bleeding on its own merits, ahead of tablets and ahead of any operation, and a great many women are offered it third when it should have been offered first.NICE NG88, 2021
Do not buy a fitting from a clinic that will not see you again. Placing the device is the straightforward part and the 6 months afterwards are where a woman is either carried through a bleeding pattern or has a £1,095 device removed in week 9. Ask who you speak to at week 6 and at week 12 before you book anywhere.BMC Women’s Health Costescu, 2022
Do not choose a copper device if your periods are already heavy. It usually makes them heavier, that is the commonest reason it comes out early, and the hormonal one is the treatment for the problem you already have. This costs us nothing to say and it saves a woman a wasted year.NICE NG88, 2021
Do not pay for a removal and a refit as two separate appointments. Removal on its own is £395. A removal with a new device fitted at the same visit is £1,195 and it leaves no gap in cover, which the two appointment version does not manage.
Step 1
What your periods do now, what you want them to do, what you have used before, and your history read against the eligibility criteria. The answer is often not the one you arrived with.
Step 2
Both devices are held in stock, local anaesthetic to the cervix is offered rather than assumed, and placing it takes a few minutes. You stay until the cramping has settled.
Step 3
Threads found, position confirmed and the bleeding pattern talked through while it is still early. A telephone review at 3 months where the pattern has not settled.
Ask before you book if you are not sure this is the right appointment.
£1,095 here, and that covers the consultation about which device, the device itself, local anaesthetic, the fitting and the 6 week check. There is no separate consultation fee and the coil is not billed on top. Removal on its own is £395, and a removal with a new device fitted at the same visit is £1,195.
Most women describe strong period cramping for a few minutes while it is placed and for a few hours afterwards. Local anaesthetic to the cervix is offered rather than assumed. It tends to be harder for a woman who has not given birth, and you stay in the building until the cramping has settled.
Yes, and this is the part women say nobody warned them about. Both devices cause unpredictable bleeding for the first 6 months. The hormonal one then usually makes periods much lighter, and around 20% of women have at least one 3 month stretch with none at all in the first year. The copper one usually leaves them heavier.
If your periods are heavy, the hormonal one, because it treats the bleeding as well as preventing pregnancy. If you would rather have no hormone and your periods are manageable, the copper one. If you are undecided, the question to answer is what you want your periods to do, not which device is more reliable.
It can. Across 326,658 insertions the risk of expulsion was 2.3% in the first year and close to 1 in 20 by 5 years, with almost no difference between the hormonal and the copper device. That is why you are taught to feel for the threads and why the 6 week check exists.
Perforation of the womb happened in 1.3 per 1,000 insertions in the European surveillance study, and it was 6 times more likely in women who were breastfeeding at the time. No perforation in that study caused serious illness or injured anything inside the abdomen, and the risk is why the womb is examined first.
Yes. In a randomised trial of more than 700 women seeking emergency contraception there were no pregnancies among the 321 given a copper device and one among the 317 given a hormonal device. Both then leave you with ongoing contraception in place, which a tablet does not.
Usually within 6 months, and nearly all the stopping for bleeding happens inside the first year. Keep a record of bleeding days and pain scores from the start so the decision at 6 months rests on a pattern rather than on a bad fortnight. A telephone review at 3 months is part of the fee.
Small, and the window is short. The risk of pelvic infection sits under 1% and belongs to the 3 weeks after fitting rather than to the years the device is in place. Pain low in the abdomen with a temperature or an unusual discharge in those first weeks needs seeing the same day.
This page is general information about a condition and it is not a diagnosis. Treatment depends on what a doctor finds when they examine you, and no outcome is guaranteed. If you are severely unwell, or if any of the warnings at the top of this page apply to you, go to your nearest emergency department or call 999.
American Journal of Obstetrics and Gynecology
Levonorgestrel intrauterine system associated amenorrhoea, a systematic review and meta analysisSergison, 2019
BMC Women’s Health
Discontinuation rates of intrauterine contraception due to unfavourable bleeding, a systematic reviewCostescu, 2022
Contraception
Faculty of Sexual and Reproductive Healthcare
UK medical eligibility criteria for contraceptive useUKMEC, 2016
Faculty of Sexual and Reproductive Healthcare
Intrauterine contraception, clinical guidelineFSRH clinical effectiveness unit, 2023
New England Journal of Medicine
Levonorgestrel versus copper intrauterine devices for emergency contraceptionTurok, 2021
NICE
Heavy menstrual bleeding, assessment and managementNG88, 2021
Obstetrics and Gynecology
Risks of uterine perforation and expulsion associated with intrauterine devicesFassett, 2023
Written by the clinical team at The Wellness. Awaiting clinical sign off.
Tell us what is going on and a doctor will say what to book, or whether you need to be seen today.