11 Women On What Getting The Coil Is Really Like

Much like everyone’s “first time” story, women’s experiences of getting the contraceptive coil — otherwise known as an "IUD" (intrauterine device) — are often completely unique. Some insertions feel like just another annual exam. For other women, it’s the worst pain they’ve ever felt.

According to Planned Parenthood, the non-profit reproductive health service, the number of patients using intrauterine devices in the U.S. has increased 91% since 2009. “It’s so effective and convenient,” Vanessa Cullins, MD, vice president of external medical affairs, says. “We quote less than a 1% failure rate for the IUD, whereas we usually quote a 5-7% failure rate for birth control pills.”

In the UK, IUDs are popular, but have seen a decline in use over recent years in favour of the UIS (intrauterine systems), a.k.a. the "Mirena", which is reportedly used by about 5% of women visiting sexual health services. Both IUDs and IUSs are particularly popular among women over 45.

There are different types of IUDs on the market. The copper IUD, or ParaGard IUD, is the only form of temporary birth control that doesn’t use hormones, and it lasts up to 12 years. “The copper itself causes some of the inflammatory spermicidal response that prevents the sperm from being able to fertilise the egg,” Dr. Cullins says, and the lack of hormones means you won’t have to worry about mood swings, weight gain, or other hormonal side effects. The downside? “It will often result in periods that are a little heavier and may have a little more crampiness.” The FDA has also approved Miudella, another copper coil, that uses less copper and is more flexible.

Meanwhile, hormonal IUSs release low doses of progestin — much lower than what might be in the birth control pill — and no oestrogen at all. The Mirena lasts for five years, with doses that can lighten or stop your periods altogether. Skyla and Liletta are both smaller versions that last for three years. “These last two may be better tolerated by a young woman who has never been pregnant, but Mirena and ParaGard can also be options for women who haven’t been pregnant,” Dr. Cullins says.

So, how do you choose the right IUD for you? “You have to think about how long you would want to use it, whether or not you are having problems with heavy bleeding during your period, whether or not you’ll be okay with not having a period over time,” Dr. Cullins says. But, it’s also important to talk to your provider and see what he or she has experience with. “The insertion technique is a little different for each of these options, so they need to be trained or experienced with the one that you want,” Dr. Cullins adds.

You might also be worried about the potential pain. Dr Unsworth, gynaecologist for INTIMINA, says it varies person to person as to how much pain will be felt during the procedure. "In order to fit an IUD, we have to stabilise the cervix (using a device to hold it still), and this can trigger pain in some women, and even trigger episodes of significant light-headedness and pulse changes which we refer to as cervical shock," she says. "We then have to measure the length of the womb which involves inserting a device, known as a sound, through the cervix, up to the top of the womb. If the cervix is very tight, which can be more of a problem in women who have not had a vaginal birth, this can also trigger pain. Inserting the sound into the uterus can also trigger contractions of the muscle wall of the uterus which can also be painful. Finally, we then insert the actual IUD. Traditionally these are a standard T shape, made of plastic. They are held folded in an insertion device, but for most copper IUDs they do require the clinician to load them into the correct position just at the time of fitting, and it can be fiddly! The physical insertion of the IUD can trigger similar pains to the sound."

The new copper coil, Miudella, is smaller, which might make it less painful to insert, but because of that smaller size it only last for three years (instead of the five+ other options offer). Unsworth says this is one thing to consider with newer IUDs.

Once the IUD has been fitted, most women find these pains do settle quickly, but for some the presence of the IUD in the womb can continue to trigger muscle contraction pains, Unsworth adds. Copper coils can make periods heavier and more painful, due to an inflammatory effect it causes, Unsworth says. "The new device has less than half the usual amount of copper than the traditional copper IUDs currently available. This should mean that the inflammatory effect is lower, hopefully leading to less pain and less impact on the heaviness of periods. The new device is also made of a newer flexible material which it has been suggested makes the fitting easier. It also comes in a pre-loaded device, which should also contribute to easier fitting for the clinician. Finally, the diameter of the inserter tube is also narrower — again this should improve fitting making it less painful."

Ahead, 11 women divulge what it was like to get it inserted — and whether the IUD worked for them.