The Coil: Myths and Methods

The Coil: Myths and Methods

When it comes to contraception, there’s no one-size-fits-all solution and yet, few methods spark as much confusion, curiosity, and myth as the contraceptive coil.  

Often referred to as the IUD (intrauterine device), the coil is a small but powerful tool in the world of long-acting reversible contraception.  

Despite its effectiveness and widespread use, misinformation still clouds public understanding, leading many women to hesitate or overlook it altogether. 

The Coil – Copper vs Progesterone 

Intra- uterine contraception has been around for decades and has progressed to include copper or progesterone, from its humble beginnings as a purely plastic device that exists in the uterus to prevent a pregnancy. 

Around 160 million women worldwide use these devices, but it seems we only hear about the few women that have problems as they speak louder than the millions that have excellent contraception and carry on with the rest of their lives. 

The Facts about the Copper Coil 

Both the copper and hormonal coils are 99% effective at preventing a pregnancy and the copper device is also the best way to prevent a pregnancy when other methods have failed or unprotected sex has occurred.  Copper devices can remain in the womb from five to ten years, depending on the license, and can be safely removed for a planned pregnancy. 

Having a copper device fitted after the age of 40 means it can remain until menopause, which on average is at age 52-53 years. The copper on the coil makes the whole reproductive environment toxic for eggs and sperm, so they are less likely to survive. If they do survive and the egg becomes fertilised, the device and the environment make it difficult for the fertilised egg to implant and continue as a pregnancy.  

As this is a non-hormonal method, copper coil users will experience their own menstrual cycle that is usual for them. Periods can become heavier, more prolonged and more painful, but generally after a period of time this settles and becomes an acceptable method of contraception. 

The Facts about the Hormonal Coil 

The hormonal coil works differently but slowly releasing progesterone into the uterus, to stop ovulation, means that the lining of the womb then becomes thickened with cervical mucus. The majority of users have very few, if any, bleeding days.  

Knowing the difference between the doses 

There are 2 different doses of device, 52 micrograms, which is licenced for contraception, heavy periods and HRT (Hormone replacement therapy). This can be used for 8 years as a contraceptive method and 5 years for bleeding and HRT.  

A lower dose is also available at 19.5 micrograms, and this has a contraceptive license for only 5 years.  

If a 52 mcg device is fitted after the age of 45 years old, it can remain until the age of 56 years old, when we can expect menopause has been reached. 

These devices can produce side effects such as  

• headaches,  

• skin changes,  

• breast tenderness 

• bloating  

• bleeding pattern changes 

Since the hormone progesterone is working directly where it needs to be, there are less systemic side effects, so hopefully any side effects would be temporary for the patient.  

Reassuring our patients 

Together with any side effects, the worry of an intimate procedure and pain can put people off having these devices.  

In the 21st century, individuals undergoing coil insertion should be provided with clear, comprehensive information about the procedure, including relevant anatomical context and available pain relief options. 

Ensuring informed consent and patient comfort is a fundamental aspect of good clinical practice. 

Editorial note:

Ultimately, the contraceptive coil is not just a device; it is a symbol of autonomy, choice, and control over one's reproductive journey. As clinicians, it is our duty to move beyond myths and misconceptions, offering clarity, compassion, and confidence to those exploring their options. When women are equipped with accurate information and supported through sensitive care, the coil becomes more than a method of contraception—it becomes a means of empowerment, enabling them to live their lives with freedom, assurance, and dignity.

Author - Julie Milson, Women's Health Specialist.