Sexual Health (young people)

The IUS (hormonal coil)

There are four methods of long-acting reversible contraception (LARC) to choose from; contraceptive injection, the contraceptive implant, the intrauterine device (IUD or non hormonal coil) and the intrauterine system (IUS or hormonal coil). This summary is about IUS (hormonal) coil.

The benefit of LARCs are that they are “fit and forget” methods so once fitted or given, women are protected from getting pregnant until they need to replace them or choose to have them removed.

An Intrauterine system (IUS) is a small, plastic device very similar to an IUD, which also sits in the womb. It releases a hormone called progesterone.

Intrauterine system, IUS, coil

There are two brands used in the UK – Mirena and Jaydess. The most popular is the Mirena and is often referred to by its brand name. As a method of contraception the IUS is more than 99% effective. Less than one in every 100 women who use Mirena will get pregnant in five years, and less than one in 100 who use Jaydess will get pregnant in three years (NHS Choices 2015).

A Mirena lasts for 5 years, and a Jaydess (which is a bit smaller and releases a smaller amount of hormone) lasts for 3 years. Unlike the IUD, a hormonal IUS cannot be used for emergency contraception.

Stefanie would like to hear personal experiences of women who are using the coil.

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Age at interview: 24

Sex: Female

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I was advised by someone I know to try the coil but I’m. I haven’t been told a lot about it and even when I have it tends to be from people who know it from a medical journal and not from personal experience. I would like to meet more people who could give me genuine, firsthand experience of what it is like because it sounds slightly horrifying but it sounds also like the most natural form of contraception without pumping your body full of chemicals. So I really want to weigh up other people’s opinions about it and I don’t tend to. It’s not just something you can just ask everyone you know while over the water cooler.

So now you are thinking about the coil but you would like more information about it.

But I think no amount of reading text or flyers is going to ease my opinion on it. I really would like to see maybe an interview like this with people who can explain what it was like. The procedure itself sounds a little bit terrifying, well not terrifying but uncomfortable. And then what is it like once it’s there? How long can you have it for? Those kind of things and how long and yeah what their body was like afterwards. Did they go, have normal periods? I think if I could see interviews like that from people it would be very useful.

Or for a doctor answering those questions?

I don’t know. I think because of the experiences I’ve had of doctors I do take a lot of it with a pinch of salt. I’m not saying that they are always wrong, of course they are not, but it’s not quite the same as meeting people who have had the real experience of it. And of course their experience could be entirely different from what yours would be but I’d feel more comfortable if I could talk to people who have got it because a lot of doctors may not have even tried it. So they couldn’t give a firsthand experience of what it’s like.

An IUS does not offer any protection against sexually transmitted infections. If there is any possibility of infection, condoms should be used as well.

Why do people choose to have an intrauterine system fitted? People told us that they found it hard to remember to take the pill every day or needed to stop using the pill because of medical reasons such as high blood pressure or medications for other conditions like epilepsy or HIV (see more on epilepsy and contraception).

The women we interviewed got advice and information about hormonal and non-hormonal coils - from their doctors, or from sexual health clinics. Leaflets gave them the pros and cons of each method and helped them know what to expect after being fitted with an IUS (possible bleeding and period-like pain for a few days). None of the women we interviewed had used a IUS (only IUDs) – if you would like to tell us about your experiences of IUS please contact info@hexi.ox.ac.uk for more information.

People often think that only women who have been pregnant can use an IUD or IUS. This is not true, IUD and IUS are safe and effective options for nearly all women, regardless of whether they've had children.

Explains that she has been discussing with doctors the possibility of having a coil fitted and that she didn't know you could have one before having children. (Actor)

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Age at interview: 25

Sex: Female

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(The accompanying video and audio clips are played by an actor)

I know with the IUD, I've been thinking about getting an IUD because in the past the doctor at the Family Planning clinic said that they sometimes use that now in women that haven't had children. It's becoming more common.

I know there's a risk with that, there's a small risk when they're inserting it, you can get infections and damage to the womb but I think that's quite a small risk. But that's something to think about

Have you talked to your doctor?

About getting an IUD? We talked in general but they sort of said I have a think about it and they've got special sessions there, so I haven't decided. I've got a friend that's got one and I'm going to talk to her about it before I decide.

Do you have any reason to believe that there may be a problem if you use it?

Well like I prefer not to be using condoms for the sake of sexual pleasure and also because it can be unreliable. I'd rather have a method that, you know, I knew was reliable but I don't particularly want to use a contraceptive pill. Because of my high blood pressure in our family anyway and so there's something like, when you get older as well it's not so advisable. So the doctor thought that that would be a good method for me.

I mean I didn't know until, I thought, until I'd discussed it with the doctor, I didn't think that you could have an IUD unless you'd had children, for example. And they said oh no, you can, more and more people do, that kind of thing, so yeah, there could be more knowledge.

Some of the women we talked to were concerned about using an IUS. Most women using the IUS have less bleeding each month because of the hormone secreted by the IUS, and irregular or no bleeding at all is also possible with the IUS method.

Some women are not able to use an IUS for medical reasons. Natasha was told that her womb is an odd shape. This means that there are limits to what contracpetion she can use and her ability to get pregnant and have children is affected too.

She felt that the gynaecologist treated her as an oddity when the ultrasound showed that her womb is shaped like a heart. She felt very lonely at the time but felt nurses were nicer than doctors.

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Age at interview: 25

Sex: Female

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What is the name of the condition?

Oh I can’t remember. It has a really fancy medical name, really fancy name that I can’t remember. Even my doctor couldn’t remember. She was like, ‘Yeah your womb just looks like this. She would literally just do that, like that’s ok. And I had ultrasounds and everything because, because even after I got the implant out and, my periods started resuming the flow was a lot heavier than I’d expected. I’ve always had quite heavy blood flow and I just chalked it up to being normal and probably being a bit brown because that’s a standard thing. But then I thought it was a bit weird so I thought, ‘Oh ok, I’ll go to a doctor, see what happens’ and the doctor got that look on their face, ‘That’s about, no that’s not normal.’

So they sent me. They sent me in for an ultrasound which was really strange. I was like, ‘I’m not pregnant. Why am I having an ultrasound?’ But they, obviously they did that and they told me that, that’s how. I found out when I was 20 that I could potentially not have children or if I had more than one child I could die which isn’t something anyone wants to hear, you know.

No not when you are 20.

Right so it was a pretty dark time and I can’t, I don’t really talk to my parents about that kind of thing because it’s. I think it’s a culture thing like you don’t really talk to your parents about your sex life or the fact that, you know, your reproductive organs aren’t exactly at reproductive strength. And so it was pretty hard and obviously a lot of my friends don’t really understand and stuff.

And my, my gynaecologist [laugh] because I got referred to a gynaecologist she just treated me as some kind of medical oddity. She said, ‘Oh can I get the students to look at you. We’ve not had one of these before’. I was like, ‘Well given its 0.03% not surprised’. But I didn’t really feel comfortable with that so I said, ‘No’ which you can do. You can say ‘no’ to having them have the doctor watch you, prod you around like you are some kind of specimen which obviously I am but maybe do it after I am dead so I don’t really know that you are doing it to me and stuff. It’s…

Ok so you didn’t want the students there?

No just because I had only just, I’d only just heard about it and I was coming to terms with it and it felt like a full-on violation that something that I’ve only just realised and now you are getting other people to look at me

All, I’ll be honest with you the nurses were a lot nicer to me than the doctors I think.

The nurses were a lot more gentle. They were a lot more understanding, just nicer actually. I know that’s part of the job description. My mum is a nurse but the doctors were very impersonal, very, very impersonal and I was thinking, ‘You just told me a massive piece of news that could potentially change, you know, but you don’t really seem to care.

Last reviewed January 2016
Last updated January 2016