What it is

• An IUS (intrauterine system), also called a hormonal coil, is a small plastic T-shape that a doctor or nurse puts into your womb (uterus). It stops pregnancy by releasing the hormone progestogen into your womb.
• An IUS is not suitable for everyone.
• An IUS is over 99% effective and lasts for 3 to 8 years, depending on the type.
• An IUS is safe to use while breastfeeding and can usually be fitted soon after giving birth.
• After an IUS is removed your fertility returns to previous levels straight away.
• An IUS can make periods lighter, shorter, and less painful. It can be an effective treatment for heavy periods.
• An IUS can be used as part of hormone replacement therapy (HRT) for menopause symptoms.
• This information is about the hormonal coil. For information about the copper coil, see intrauterine device (IUD).
• You can compare different methods, including how well they work and side effects, when choosing a method of contraception.

An IUS does not stop you getting or passing on sexually transmitted infections (STIs). Use a condom every time you have sex to protect you and your partner against STIs including HIV.

Where can I get it?

Contraception services are free and confidential on the NHS.

You can get an IUS (intrauterine system), also called a hormonal coil, for free from:

• sexual health clinics, also called family planning or contraception clinics
• some GP surgeries
• some young people's services (call the national sexual health helpline on 0300 123 7123 for more information)

Find contraception services

Getting contraception if you’re under 16

Contraception is free and confidential, including for young people under the age of 16.

The doctor or nurse will not tell anyone, including your parents or carer, unless they think you or someone else is at risk of harm.

Who can get it

A doctor or nurse will ask about your medical history to check if you can get an IUS (intrauterine system), also called a hormonal coil.

An IUS may not be suitable if you have:

• breast cancer, or have had it in the past
• cervical cancer or womb (uterus) cancer
• a liver condition
• unexplained bleeding between periods or after sex
• a history of serious heart disease or stroke
• a sexually transmitted infection (STI) or pelvic infection
• problems with your womb or cervix, such as fibroids

If any of these apply to you, speak to the doctor or nurse about your contraception options.

Getting an IUS after giving birth

An IUS can sometimes be fitted within 48 hours of giving birth. But you'll usually be advised to wait until 4 weeks after birth to have an IUS fitted.

It's possible to get pregnant from 3 weeks (21 days) after giving birth. It's important to use another form of contraception, such as condoms, until your IUS is fitted.

Breastfeeding with an IUS

It's safe to have an IUS when you're breastfeeding, and it will not affect your baby or your milk supply.

Getting an IUS after a miscarriage or abortion

You can get an IUS straight after an abortion or miscarriage. You'll be protected against pregnancy straight away.

Getting an IUS during menopause

An IUS can be used as part of hormone replacement therapy (HRT) to treat symptoms of menopause. It is also effective as contraception when used for this reason.

IUS and medicines

An IUS is not affected by most other medicines, including prescription medicines or herbal remedies.

Getting it fitted or removed

You can usually have an IUS (intrauterine system), also called a hormonal coil, fitted by a specially trained doctor or nurse at a GP surgery or sexual health clinic.

An IUS can be fitted any time in your menstrual cycle, as long as you're not pregnant.

If it's fitted in the first 5 days of your cycle (day 1 is the first day of your period), you'll be protected against pregnancy straight away.

If it's fitted at any other time, use another type of contraception, such as condoms, for 7 days afterwards.

Having an IUS fitted should take about 5 to10 minutes, but allow at least 30 minutes for the appointment.

Before your IUS is fitted

Before your IUS is fitted you might be offered:

• a test for sexually transmitted infections (STIs)
• a pregnancy test (an IUS cannot be fitted if you might be pregnant)

Most people have some pain when having an IUS fitted. You may want to take some painkillers like paracetamol or ibuprofen an hour before.

If you're concerned about pain during the fitting, speak to the nurse or doctor. They may be able to offer you extra pain relief, such as local anaesthesia.

The procedure

During the procedure:

• a nurse or doctor will gently put a smooth, tube-shaped tool (a speculum) into your vagina so they can open it, like a cervical screening (a smear test)
• they will insert the IUS into your womb through your cervix

Tell the person fitting your IUS if you feel any pain or discomfort. You can ask them to stop at any time.

You can have a friend, family member or other member of staff in the room with you during the fitting if you want.

After an IUS is fitted

You might have some period-like pain for a few days after having an IUS fitted. Painkillers such as paracetamol and ibuprofen can help with any pain. You might also have some light bleeding (spotting).

Checking an IUS is still in place

An IUS has 2 thin, soft threads that hang down a little way from your womb into the top of your vagina.

The doctor or nurse who fits your IUS will tell you how to feel these threads to check it's still in place.

Check your IUS is in place a few times in the first month and then regularly, such as after each period.

If you cannot feel your IUS threads

If you cannot feel the threads your IUS might not be in place. Get help from a sexual health clinic, 111 or your GP straight away.

If you cannot feel the threads when you check for them you might not be protected against pregnancy, and you may need emergency contraception. Use another form of contraception until a doctor or nurse has checked your IUS.

The IUS can make some types of emergency contraception less effective, so speak to a pharmacist, sexual health clinic, GP or call 111 for advice.

Having an IUS removed

A trained doctor or nurse can remove your IUS at any time.

An IUS is effective for 3 to 8 years, depending on the type.

If you're using an IUS as part of hormone replacement therapy (HRT) for menopause, it needs to be replaced every 5 years.

It's possible to get pregnant as soon as your IUS has been taken out.

If you do not want to get pregnant, use another type of contraception, such as condoms, starting 7 days before you have it removed.

Side effects

How well does an IUS work?

An IUS is over 99% effective at preventing pregnancy.

This means that less than 1 in 100 women using an IUS as their method of contraception get pregnant each year.

Side effects of an IUS

Side effects of an IUS (intrauterine system), also called a hormonal coil, are most common for a few months after having it fitted. Many IUS users do not get any side effects.

Possible side effects include:

• period-like pain and bleeding (spotting) after having an IUS fitted
• small fluid-filled sacs (cysts) on your ovaries – these are usually harmless and disappear without treatment
• a small chance of getting thrush that keeps coming back – talk to your GP if this happens

Some people report headaches, acne, sore breasts, and mood changes. There is not enough evidence to say if an IUS causes these.

If you get any of these symptoms, they should go away within a few months. If side effects are a problem for you, speak to a doctor or nurse.

Your partner should not be able to feel your IUS threads during sex. If they can, see a doctor or nurse to have the threads checked.

How an IUS affects periods

An IUS can make periods shorter or lighter, or stop them altogether.

For 3 to 6 months after having an IUS fitted, your periods might become longer, irregular or more frequent. You may also have some light bleeding between your periods. This should improve within a few months.

If irregular or heavy bleeding continues for longer than 6 months, see your doctor or nurse for a check-up.

Some types of IUS are effective treatments for heavy periods.

Side effects of an IUS as hormone replacement therapy (HRT)

An IUS is sometimes used as part of hormone replacement therapy (HRT) for symptoms of menopause. It has fewer side effects than other kinds of progestogen used for HRT, and can be a good option if you have heavy bleeding when taking HRT.

Find out about choosing a method of contraception, including side effects and risks of different methods.

Risks of an IUS

An IUS is very safe, but there are some rare risks, including:

• pelvic infections, usually within 3 weeks of having an IUS fitted
• your IUS moving or coming out, usually within 3 months of having it fitted
• damage to the womb
• ectopic pregnancy if your IUS fails

Ask for an urgent GP appointment or get help from NHS 111 Wales if:

You have an IUS and:

• you have pain in your lower tummy (abdomen) and painkillers do not help
• you get sudden pain in your lower tummy that gets worse or does not go away
• you have a high temperature
• you have unusual or smelly discharge
• you have very heavy vaginal bleeding
• you think you might be pregnant
• you cannot feel the threads of your IUS, or they feel different

You can call 111 or get help from 111 Wales online.

If you cannot feel your IUS threads

If you cannot feel the threads when you check for them you might not be protected against pregnancy, and you may need emergency contraception. The IUS can make some types of emergency contraception less effective, so speak to a pharmacist, sexual health clinic, GP or call 111 for advice.

Use another form of contraception until a doctor or nurse has checked your IUS.