Dr Hannah Bintcliffe runs monthly clinics to fit contraceptive coils and can fit implants at any time with a double appointment.
Coil appointments are 30 minutes long with 2 clinicians present for the procedure.
If you no longer require the appointment, we ask you to let us know as soon as possible and preferably at least 24 hours before your appointment so we can offer this slot to another patient.
Contraceptive implant (Nexplanon)
Advice before having your implant fitted:
· It is important that there is no chance that you could be pregnant when we fit your implant. We ask that you use another method of contraception reliably and consistently until your implant is fitted. Withdrawal is not advised as a method of contraception.
· Please bring a urine sample with you as we may need to do a pregnancy test when you attend your appointment.
· The procedure is done under local anaesthetic – the area on your upper arm will be numbed.
· Please make sure that you have something to eat before your appointment
What are the potential risks and side effects?
· Potential side effects: the implant often changes your bleeding pattern including irregular, prolonged or absent bleeding. It can also cause hormonal side effects such as headaches, breast tenderness, mood changes and can worsen acne.
· The implant is one of the most effective forms of contraception but has a failure rate of <1 in 1000 over 3 years.
· Other risks include bleeding, bruising and pain where it is inserted. Infection and/or scar at the insertion site. Migration of the implant. Difficulty removing the implant.
After the procedure:
· The implant takes 7 days to become effective for contraception so you must use an alternative form of contraception in addition or abstain during this time.
· Keep the dressing on for 24–48 hours
· Avoid heavy lifting or strenuous activity with that arm for 24 hours
· Avoid getting that arm wet for 3 days after
· Bruising, tenderness, or slight swelling at the site is normal
· Paracetamol or ibuprofen can help with any discomfort
· A small scar may remain at the insertion and removal site
Contact your GP if you notice:
· Severe or increasing pain
· Redness, swelling or pus at the insertion site
· You can’t feel the implant- You should be able to feel the implant under your skin (a thin, flexible rod)
· Unusual or heavy bleeding
Hormonal and copper coils
Advice before having your coil fitted:
· Please make sure that you have something to eat before your appointment
· The fitting process may be uncomfortable or painful, and you may wish to take a painkiller an hour or so before the procedure. We suggest either Ibuprofen and or Paracetamol (if you are not allergic to these medicines)
· It is important that there is no chance that you could be pregnant when we fit your coil. We ask that you use another method of contraception reliably and consistently until your coils is fitted. Withdrawal is not advised as a method of contraception.
· If you are having a coil exchanged for a new one, you should not have sex for 7 days before the appointment.
· Please bring a urine sample with you as we may need to do a pregnancy test when you attend the clinic
· We can fit your coil at any point during your menstrual cycle. We will still be able to fit the coil even if you are bleeding; please attend your appointment as usual.
· You are likely to bleed after the fitting, so we advise that you bring a sanitary pad with you
What risks are there to having a coil fitted?
Having a coil fitted is a very safe and simple procedure. But, with any medical intervention, there are always some risks which you must be aware of before proceeding with your coil fit.
· Risk of infection – there is a small risk of introducing an infection into the womb. This usually occurs if you already have an infection. If you are at risk of this, we can take a swab to check. The coil is fitted using sterile, disposable equipment to minimise this risk. This usually presents as discharge, pain or fever in the first few weeks after a coil fit. It can be treated with antibiotics but sometimes requires the coil to be removed as well.
· Risk of expulsion – 1 in 20 people expel the coil. This normally happens in the first 6 weeks and normally with a period.
· Contraceptive failure – no contraception is 100% successful.
– With the Mirena coil 2/1000 women will get pregnant during the first year of use.
– For Kyleena and Jaydess coils 3/1000 women will get pregnant during the first year.
– For the copper coil with typical use 8/1000 women will get pregnant during the first year.
· Ectopic pregnancy. Overall, the risk of an ectopic pregnancy is lower than in someone who is not using contraception but for those who do get pregnant with a coil it is more likely to be ectopic (outside of the womb).
· Uterine (womb) perforation – in about 2 in 1000 coil fits (increased rate in breastfeeding), the coil can go through the wall of your womb (perforation). As the coil then isn’t in the womb it won’t be effective and it will have to be retrieved with keyhole surgery in hospital.
· Some women feel faint during the coil fitting (the medical term for this is cervical shock). This usually resolves with pausing the procedure but sometimes requires an injection to treat.
· Lost threads- in 18% of cases we can’t find the coil threads. Often, we can still remove the coil in the GP surgery but sometimes we must ask the gynae team at the hospital to retrieve it.
What side effects do coils have?
Hormonal coils can change your bleeding pattern to irregular, prolonged and/or absent bleeding. They can also cause hormonal side effects such as acne, breast tenderness, headache and mood changes.
Copper coils can make your periods heavier and more painful.
After the procedure:
· You may experience cramping or light bleeding for a few hours to a few days.
· You can usually return to normal activities the same day.
· Avoid using tampons for first 24–48 hours and don’t use a mooncup as these can pull out the coil.
· Hormonal coils such as the mirena take 7 days to become effective for contraception after insertion so either continue using an alternative contraception or abstain for this time. The copper coil is immediately effective.
· Check for any signs of infection: strong-smelling discharge, fever, severe pain – contact your GP if you experience these.
Checking for coil threads:
· We will advise you to feel for your coil threads 6 weeks after fitting. Don’t pull on the threads.
· If you do not feel able to do this yourself or are unable to feel the threads, you can book a 15-minute nurse appointment to have them checked.
· If you have any concerns such as pain, unusual discharge, fever or bleeding you are concerned about, see your GP.