We would start by recommending a follow up call to discuss your concern with a clinician.

STI testing may be beneficial if you have recently changed to a new partner or have multiple partners as underlying infections can cause abdominal pain in women.

The position of the coil may be checked to see if it is still in place or if you are experiencing expulsion. Expulsion occurs when your uterus contracts and pushes the coil out. The risk of expulsion is 1:20 and is more likely to happen within the first 3-6 months of having a coil fitted. Your coil will need to be removed if you are experiencing expulsion.

A course of antibiotics may be offered depending on your diagnosis.

Pregnancy test may be advised to ensure you are not pregnant.

This is indicative of an infection, please contact us (or your local GP) for a coil check. You will likely be offered a course of antibiotics to resolve this.

When you are fitted with a copper coil (IUD) It is normal for your periods to be painful or heavier than usual. This should become more manageable over time, usually around 6 months after your fitting.

However, If your periods become extremely painful and heavy, or have not settled to a ‘new normal’ after 6 months, you will need to contact a clinician to discuss your options. You can switch to a hormonal coil (IUS) which will have the opposite effect and make your periods lighter, less painful, and may even stop them altogether.

When you are fitted with a hormonal coil (IUS), it is also normal for your periods to be heavier within the first 3-6 months. You may also experience lighter periods or spotting between periods or they may stop altogether. Typically, after 3 months your blood loss will be reduced by 90% making your periods more manageable. However, all women are different and your periods can take many months to settle depending on how your body is reacting to the hormones. If you are experiencing painful and heavy periods that will not settle, you will need to contact a clinician to discuss your options.

If you cannot feel your coil threads, please contact us (or your local GP) for a coil check. During your coil check we will be able to see whether your threads are visible. If your threads are not visible you will require an ultrasound scan to check the position of your device within the uterus. Both the copper and hormonal coil can be seen during an ultrasound scan but if they are not visible then an x-ray will determine whether it is in the abdomen. It will be classed as expelled if there is no sign of the device and you will need a new form of contraception.

You should not rely on your coil for contraception If you cannot feel your coil threads. You should either abstain (do not have sex) or use a condom until your coil is located to be in the correct position.

If you have recently been fitted with a coil and your partner can feel your threads during sex you may need to wait a few weeks for your threads to soften. Once softened, your threads will be less noticeable during sex. If your coil threads still feel too long (or your partner can feel them during sex) or feel anything hard like the end of a matchstick, please contact us (or your local GP) for a coil check. It may be that your threads need trimming or your device is expelling.

If there has been a dramatic change in length, the coil may have moved lower in the uterus. The clinician may advise an USS to check the position of the device.

There are certain instances that may require a professional to check your coil. You can view these concerns and approaches here.

As a rule of thumb, you should book yourself in for a coil check if you are concerned that something is not right, or are in severe pain that prevents you from doing your normal activities.

• A clinician is checking and can rule out potential issues such as infection, pelvic inflammatory disease (PID), pregnancy, and expulsion. Displacement will require an ultrasound scan.
• Treatment may be available in the same appointment, if suitable.
• The coil can be removed in the same appointment if it is safe to do so.
• The bimanual exam will check your internal pelvic organs.
• Pain and discomfort can show up and dissipate randomly, whilst the patient may think this is routine, it can be an underlying infection which would otherwise go unreported without a coil check.
• Asymptomatic problems may be found (i.e. PID).
• Can reinforce good health practices such as regular screening for other health conditions.

• Misplaced coil threads.
• Any inflammation or signs or infection.
• Pregnancy
• Coil expulsion (the coil is being pushed out by the uterus).
• Other asymptomatic problems that may not be related to the reason you booked in for a coil check.

If we have diagnosed a condition which requires medication and we can offer it in the clinic, we will do so.

However, in some cases you may be better suited to be seen in a hospital setting and we will offer you a referral letter to take to your GP.

You can safely have a coil check on your period (as long as you are comfortable).

When you check your threads at home, you are checking to see if you can still feel them. This lets you know whether your coil is still in place or has been expelled or is expelling.

During a coil check, a speculum is inserted into the vagina so that the cervix is visible. This allows the professional to visibly see the position of your coil threads, instead of just feeling them.

If you are experiencing any pain, you will also receive a vaginal examination and a bimanual examination which is done to check the internal pelvic organs for signs of infection or inflammation.

If the device is being expelled and can be seen in the cervix or the vagina, it will be safely removed.

If, during an ultrasound scan, your coil is found to be misplaced, it will not be effective as a form of contraception and will need to be replaced. This will either be discussed with you at the time of the scan or your results will be sent to your clinician.

It is normal to be concerned, however there are treatment options that can be provided in the same appointment. If you need to be referred to a hospital setting, we will provide you with a medical letter.

In all cases we will put your wishes and best interests first, so if you wish for the coil to be removed, this can be done in the same appointment as long as it is safe to do so.

You should try to remember, in as much detail, your reasons for requesting a coil check. Any significant changes that you tell our clinicians will be valuable in reaching a thorough understanding of your situation and a suitable outcome.

Most patients do not need any time off work after their coil check and can carry on their day as normal.

Yes. You can bring your partner, friend or family member to your appointment.

However, if you feel that you would rather not bring someone to the appointment, rest assured that our staff are here to support you and make you comfortable in any way possible. Clarewell Clinics is a safe space.

You do not need to make any special travel arrangements for after your appointment. However, if you feel that you may wish for someone to drive or accompany you home, then you will need to make arrangements accordingly.

Yes, absolutely you can. Please let us know at the time of your booking (or upon your arrival) so that we are ready to accommodate your wishes.

Yes, if it is safe to do so at the time, we can remove your coil in the same appointment.If there has been any sexual activity in the 7 days prior to removal and you do not wish to get pregnant, you will be advised to wait until the risk of pregnancy has gone.

Absolutely. Please request this at the time of booking so that we may book you an extended appointment.

You can read about our STI tests here.

We do provide sanitary products, but you are more than welcome to bring your own.

You can contact us for a follow up call or a consultation if required.

You are able to book in with us for a coil removal procedure. You can find more information on this here.

You will have the opportunity within the consultation to discuss any other options that are available to you. Our clinicians are more than happy to provide you with as much information as you need in order to make the best decision for your body.

As long as you are comfortable and you do not show any signs of an infection, misplaced coil, you can have sex immediately after your coil check.