Why are we talking about contraception at all and especially ‘the coil’?

Contraception is not a ‘normal’ topic of conversation for me. I could not say with confidence which method my closest friends have opted for over the years.

But when it does come up I am often met with surprise when people discover I have the hormonal coil (specifically the Mirena IUD); followed by hesitant questions, much interest and probing. Within Facebook fitness groups it surprised me the frequency at which the topic arises from women seeking personal stories to add colour to their search of what might be best for them.

While no two women will have identical experiences with the same prescribed medication and I am not claiming to be advising what is correct for anyone else, this is mine which I hope goes some way to reduce the stigma and opacity around female contraception.

Before the hormonal coil (IUD / IUS) what birth control had you used?

Like, I suspect, the majority of women in the last few decades I took the standard route of condoms and / or combined contraceptive pill.

With the combined pill, the brands I remember being prescribed are: Celine, Yasmin. Not a typo, the last oral contraceptive pill I took was indeed of my own first name.

Why did you switch from the pill to the coil?

Frankly, I wanted birth control to be ‘easier’. Short of making it someone else’s responsibility (which I’m not sure how comfortable I would be in any case) I was done with having to get repeat prescriptions, check ups, remembering the daily burden, calculating the impact of changing timezones.

The promise of five to ten years of cover as opposed to a twenty-four hour window was hugely appealing; while the pill is over 99% effective if used correctly, the ‘if used correctly’ remained an ever present concern for me. Since the scenarios of correct and incorrect were reduced by the coil in my mind this alternative birth control offered an even lower probability for an unplanned pregnancy.

Plus I had a sense that the combined pill never quite agreed with me, it had never been awful but it was definitely doing something to my emotions and sense of general wellbeing. I wanted to explore my options available that had been mentioned in passing but had never really felt tangible. (I do not count a pamphlet handed over the first time I went to the doctor to discuss contraception choice at the age of sixteen years sufficient.)

What about the copper coil? What made you choose the hormonal coil instead?

The possibility of no periods with the hormonal coil in situ was hugely appealing. At the time I was living in between France and England, not wanting to have the monthly concern about tampons on the beach or less frequent but anxiety inducing calculation of whether my next trip back to the UK would allow enough time to get a renewed prescription.

How did you find getting the coil inserted? (And removed?)

Right now, I am on my second hormonal coil - which is evidence in itself that I am happy with it!

In truth, it was not pain free or the most fun experience but for me it was definitely worth it. Strangely the first fitting was easier; perhaps because I didn’t know what to expect so there was no anticipation of it being painful or build up of anxiety. Removing the coil was a tad tricky as the doctor discovered the strings had been cut so short they could barely be see during the examination let alone reached, this also meant that for the majority of those 5 years I had no way of checking to see if it was still ‘in place’. I did end up having to go to a specialist the second time, which was fine, possibly better, but something to keep in mind so you don’t leave it to the last minute as this did mean it took a fair bit longer than anticipated because of the additional appointments to confirm where the coil was and that it needed to be removed by a more senior consultant with additional training / equipment available.

For some unknown reason, I really didn’t want the localised anaesthetic. If it is offered to you and you are in more than just ‘discomfort’, don’t be a hero take it! Because I hadn’t needed it for the fitting of the first coil, I convinced myself that the injection would hurt more than the procedure itself and kept stubbornly refusing. Thankfully the doctor and nurse were tremendous at advocating for my needs when I wasn’t making the best decisions for myself, this went as far as suggesting additional check ups when I said the placement didn’t feel quite right and agreeing to cut the strings back to be super short again after enough time had passed that the coil was unlikely to be rejected. This means that while I can’t check that the coil is still there, I definitely can’t ever feel it inside me which was my preference given.

Fun fact: The particular doctor (male and middle aged which shouldn’t matter but I do want to set the scene) who put my second coil in was LOVELY, he also suggests that any male partner joins the appointment if you’re comfortable with that! His explanation being that it is only fair they know firsthand what women experience and the birth control they are benefitting from! I didn’t do this, I decided it would be too stressful for me, but I kind of wish I had since my boyfriend was in the waiting room so may as well have been there for the full experience. I truly hope that anyone reading this who opts for the coil gets a doctor with as much empathy and skill.

Did you do anything before the appointment ‘prepare’ for having the coil fitted?

A few people recommended taking over the counter painkillers such as ibuprofen or paracetamol 20 to 30 minutes before my appointment to get the coil put in, which I did remember the first time around but not the second when it came to the removal and a new Mirena IUD. Did this make a difference? Perhaps. But I would hazard a guess that the local anaesthetic did a whole lot more!

I do wish, however, that someone had mentioned to take along a sanitary towel, panty liner, pad of my choosing. A bit of spotting afterwards is normal and the hospital / clinic will of course have these to offer you, but they tend to be the very thick, not particularly pleasant or discrete kind. Not to sound ungrateful at free female care products which were perfectly appropriate for the job required, but after what is admittedly a fairly invasive procedure I just wanted to be comfortable and this is something I could have planned for! (If you own period underwear I would 100% recommend wearing them.)

The best piece of advice I had was from the various doctors and nurses looking after me in the various appointments: Try to relax and breathe. Telling you to relax might be infuriating, but honestly it helps if you can find a way. The nurses chatted to me, asked me if I wanted to know what was going on or to be distracted, offered to hold my hand if I was worried and the care provided made me so thankful towards the free NHS services being provided. Practically, if you have any experience with breathing techniques be that yoga, pilates, meditation, whatever use this to your advantage to trick your body into calming down!

Finally, a very tangible tip is to go to the toilet just before the appointment. The doctor fabulous doctor I mentioned earlier told me that a full bladder just makes everything far more uncomfortable in the procedure to fit a coil, so make the time while you’re in the waiting room to nip to the loo.

And the immediate After effects of having a coil fitted, how was that?

I was lucky as any side effects from both having the coil fitted and later removed / replaced were short lived and low maintenance.

I did have some spotting for a few days, nothing dramatic and less than my regular menstrual flow. My periods in the following few months were lighter to non-existent until they stopped altogether. That said, because I had had 5 years of no periods and so no cramps, it was a shock to have the cramping when it came to having a new coil inserted and I was not so thrilled about the memorable dull ache in the base of my spine. The pain from the cramps lasted a day or two after having the coil inserted and was never so bad that I was prevented from doing anything I wanted; I did take paracetamol a handful of times and I did ask my partner to come with me to the appointment as a precaution.

What side effects have you experienced from the hormonal coil? (Good and bad)

No periods! Again, I’ve been lucky, as far as I’m aware there haven’t been any others - yet. Fingers crossed it stays that way. The only real downside for me is that because I don’t know when my period is, my (mild) PMS can throw me, so I do have to keep a bit of a note of my hormones month to month just to know where my head and body is at.

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