Copper Coil (IUD)

The copper coil, also known as an IUD (intrauterine contraceptive device), is a small, T-shaped, plastic device that is inserted into the uterus as a form of contraception.

The IUD releases copper ions into the uterus, which is toxic to sperm and eggs. The copper interferes with the sperm’s ability to survive and travel through the cervix into the womb, which prevents the fertilisation of an egg.

The IUD also alters the cervical mucus, making it difficult for the sperm to penetrate and reach into the uterus. In the case that the sperm fertilises the egg, the IUD can prevent the egg from implanting itself in the uterus, therefore preventing pregnancy from occuring.

A copper coil can be used to prevent a pregnancy after contraception has failed, or unprotected sex has occured.

As a rule of thumb, it can be fitted within 5 days after unprotected sex, or up to 5 days after estimated ovulation.

The copper coil is a ‘T’ shaped device which is made from plastic and copper. It has two thin and light threads at the bottom that hang approximately 2 inches down from your uterus, out of your cervix, and into your vagina. Your clinician will cut them to the right length for your body.

Your coil should not be visible to the eye, but you should be able to feel the threads.

We recommend that you check your threads after every period to ensure that you can still feel them and that your coil has not moved. You can find out how to check your threads here.

Here at Clarewell Clinics, we offer two types of the copper coil known as T-Safe which has a 10 year licence, and Nova T which has a 5 year licence.

You will be able to discuss with your clinician in the consultation which coil will be suitable for you.

At the end of the licence period, the coil will need to be removed by a clinician or your health care provider. You will then be able to replace your coil or choose a different form of contraception.

There are several types of copper coils available, which vary in size, copper content, and licensed duration of use to suit different uterine lengths. For example:

• T-Safe 380A QL®: This has 380mm² of copper, is suitable for a uterine length of 6.5cm-9cm, and is licensed for 10 years of use.
• Nova T 380®: This also has 380mm² of copper, is for a uterine length of 6.5cm-9cm, but is licensed for 5 years.
• UT 380 Short: Designed for a shorter uterine length of 5cm-7cm, this coil has 380mm² of copper and is licensed for 5 years.

All these types are more than 99% effective.

The IUD is a method of long-acting reversible contraception (LARC). LARCs are extremely effective forms of contraception as there is no room for user error, provided that the IUD has been fitted properly.

When inserted and placed correctly, the copper coil is over 99% effective and begins to work as soon as it is fitted. This means that fewer than 1 in 100 IUD users will become pregnant within 1 year. When the IUD is used for 5 years, fewer than 2 in 100 IUD users will become pregnant within 5 years.

Considering that 80-90 out of 100 women who are not using contraception will get pregnant within 1 year, the effectiveness of the IUD is remarkable.

Over a period of time, the copper around the coil dissolves, and the coil does become less effective as less copper is available. Hence, the coil will need to be replaced at the end of the specified timeframe.

It is highly unlikely for the copper coil to fail (see the above question on effectiveness).

Failure of a copper coil usually comes from either displacement (movement of the coil) or expulsion (rejection of the coil). If you think either of these are happening to you, please book in to see one of our clinicians.

Once your copper coil has expired it will be classed as ‘out of licence’ and needs to be removed or replaced, which is entirely your choice. You are less likely to be protected from pregnancy with an expired IUD than with a licensed IUD.

Although there are some side effects to the copper coil (which we will explore in the questions below), there are no hormonal side effects of using the copper coil, such as acne, breast tenderness, weight gain, and mood changes.

Menstrual bleeding may change after a copper coil is fitted. This includes cramps and bleeding between periods. This usually settles after 3-6 months. Once this side effect has subsided, many women can predict what their new normal will be for their periods.

Although the copper coil is more than 99% effective at preventing pregnancies while in use, it has no effect on your future fertility.

Your fertility will return immediately after removal, which means you will be able to conceive when you next ovulate and within a few weeks, your menstrual cycle will return to normal.

There is a risk of pregnancy if there has been any sex in the 5 days before the coil is removed.

Using a copper coil may result in increased vaginal discharge. As a result of having a device in their uterus, some women notice a slight change in odour. If an STI test has been performed to rule out infection, the change in discharge is not usually a cause for concern.

The copper coil should not cause itching, redness, or other irritation. All of these are symptoms of infection that should be assessed by a clinician or your doctor as soon as possible.

According to a study recently published in Obstetrics & Gynaecology, women who use copper intrauterine devices (IUDs) as a form of birth control may be at lower risk for high-grade cervical cancer compared with those who use a hormone-releasing intrauterine system (IUS).

Although it is rare, your copper coil can move.

Movement is most common in the first few months after having the coil fitted, which is why it is important to check the strings of your coil more frequently in the first few months.

If you cannot feel your strings, or if your strings feel longer, please arrange an appointment to speak with one of our clinicians.

This is more likely to happen if:

• You have strong cramps during your period (this is because the uterus is contracting).
• You experience heavy bleeding with your period.
• Your IUD has not been inserted correctly.

Signs that your copper coil may have moved are:

• You may not be able to feel the threads (although this can also be normal depending on if the threads have softened and wrapped around the entrance of the cervix).
• You can feel the plastic of the coil.
• Cramping that is not cycle-related.
• You are experiencing bleeding in between periods, and unusual vaginal discharge.

If you suspect that your copper coil has moved, contact us and we will be able to help.

It is highly unlikely for your coil to physically break, but there is a possibility that it may either move, or expel itself – which will cause it not to work.

If you think either of these are happening to you, please book in to see one of our clinicians.

They are more than 99% effective in preventing pregnancy

Sex is not interrupted and you do not have to think about using contraception every day as the coil is there when you need it.

As there are no hormones in the copper coil, you will not experience hormonal side effects such as acne, breast tenderness, weight gain, and mood changes.

Serious complications from IUDs are rare. However, some women do have problems. These problems usually happen during or soon after insertion:

• Approximately 1 in 20 women, the IUD may be pushed out of the uterus (expulsion), or move (displacement). The risk is higher in teenagers, women with heavy menstrual bleeding, and women who have an IUD inserted immediately after childbirth. If the IUD comes out, it is no longer effective. You may be able to have a new IUD placed.
• The IUD can perforate the wall of the uterus during placement. This is rare and occurs in only about 1 out of every 1000 placements. If this does happen, the IUD will need to be removed (and in some cases by having surgery). If your clinician fitting the IUD is experienced, the risk of perforation is very low. However, In women who are breastfeeding, the risk is 6 times higher.
• Pelvic inflammatory disease (PID) after IUD insertion happens very rarely. Using an IUD does not by itself increase the risk of PID. Women with an undiagnosed STI at the time of IUD insertion are more likely to develop PID than women without an STI. We recommend screening for chlamydia and gonorrhoea before or during your IUD fitting where possible.
• Rarely, pregnancy may occur while a woman is using an IUD. If pregnancy occurs, and you wish to continue the pregnancy, the IUD should be removed. If the IUD remains in place during pregnancy, there are increased risks of miscarriage and infection.
• In the rare case that a pregnancy occurs with the IUD in place, there is a higher chance that it will be an ectopic pregnancy. This is a serious condition that needs medical attention right away.

• Copper coils are more than 99% effective in preventing pregnancy.
• They are effective for 5 to 10 years (depending on the coil you have fitted). Therefore, you are able to plan ahead.
• It can be reversed if you change your mind or your circumstances change. Your fertility will return back to normal straight away.
• There is no user error, you do not have to remember to take a pill or get an injection for a copper coil to work.
• There are no hormonal side effects.
• It does not affect your fertility, and fertility will return immediately once the copper coil is removed.
• They are safe to use when breastfeeding.
• They are not affected by any medication.
• They can be fitted 48 hours after natural delivery or 4 weeks after a caesarean section.

• Your periods may become heavier, longer, or more painful, though this may improve after a few months.
• There's a small risk of getting an infection after it's been fitted.
• There's a small risk that your body may push out the IUD or it may move.
• If you get pregnant while you have an IUD, there's a small increased risk of an ectopic pregnancy.