Mirena Coil Fitting (Hormonal)

A Mirena/Hormonal coil can be fitted at any time during your menstrual cycle, as long as there is no chance of pregnancy.

If you are using a method of contraception, please continue with your pills, patches, injection or implant, including on the day of your procedure. This may include reliable condom use.

Your clinician will inform you how long you will need to continue with your other method of contraception after the device is fitted.

If you are not currently using a method of contraception, it is advised to abstain from any sexual contact from the first day of your period. If you are attending for a Mirena/Hormonal coil refitting, we recommend abstaining for 7 days prior to your appointment.

Yes. It is entirely your choice.

Some patients prefer to wait until they have finished bleeding so that they may distinguish between their period bleed and post-procedure bleed (which is perfectly normal). The same occurs with patients who like to distinguish between period pains and post-procedure pains.

Furthermore, some clinicians argue it is more comfortable for the patient to fit the coil when they are having their period (due to factors including natural lubrication and the cervical canal being open to let menstrual blood out).

There’s a very small chance of getting a pelvic infection in the first few weeks after the coil has been inserted. You may be advised to have a check for any existing infections before the coil is fitted.

Please seek medical advice or visit your local GUM clinic urgently if you’ve had a coil fitted and you:

• have pain or tenderness in your lower abdomen
• have a high temperature
• have abnormal or smelly discharge

There’s a small chance that the coil can be rejected (expelled) by the womb or it can move (displacement). If this happens, it’s usually soon after it’s been fitted. We will discuss how to check that your coil is still inside the uterus, by checking your threads and noticing if there are any changes to include them being longer or totally absent.

If you were to become pregnant while fitted with a coil, there is a very small risk that the pregnancy will be ectopic. This is when the fertilised egg is implanted outside of the womb, usually in the fallopian tubes. However the overall risk of an ectopic pregnancy is lower in patients using a coil than in patients using no contraception at all.

About 1 in 100 patients experience lost threads. If you are unable to feel your threads, or you are worried your coil has fallen out, it is important to avoid having penetrative vaginal sex or use alternative contraception, such as condoms. In this instance, please contact us as soon as possible and we will advise you.

We recommend a Chlamydia & Gonorrhoea PCR test
It is important that there is no underlying infection at the time of your coil fitting. This is to prevent any infection (if present) from travelling further up the uterus during the fitting and to avoid long term complications such as Pelvic Inflammatory Disease.

You may also wish to take a painkiller an hour before attending your appointment and have something to eat or drink.

Bring someone to drive you home
Some patients may feel a little faint after the fitting and may feel more comfortable to have someone drive them home.

Most patients do not need any time off work after the procedure. However, it is advised to rest afterwards and avoid any heavy activity.

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 feel 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/accompany you home, then you will need to make arrangements accordingly.

The fitting process will begin with your clinician examining you internally by placing 2 fingers into the vagina and a hand on your abdomen. This can be briefly a little uncomfortable but it doesn’t take long. A speculum is then inserted into the vagina so the neck of the womb (Cervix) can be seen. A small clip is placed onto the cervix to keep it still while a small straw-like tube is inserted into the cervix to measure the length of the womb. This can cause a fleeting period-like cramping pain.

The device is held in a tube which is inserted into the uterus, from which the coil is then released. Once the coil is in place, the threads to the device are trimmed, leaving usually about 2cm of threads outside the cervix. The clip and speculum are then removed and that concludes the fitting process. At this stage we encourage you to take some time to rest before getting dressed again.

Whilst it can be uncomfortable to have a coil fitted, we try to do our best to make it as painless as possible.

We also use different methods of analgesia to make the process more comfortable. You can choose from local anaesthetic spray, local anaesthetic gel or entonox (gas and air). All of this will be discussed with you before we proceed with the procedure.

This includes offering you highly experienced clinicians in the field of Sexual & Reproductive Health and a combination of local anaesthesia.

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.

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

For more information about our STI tests, please visit this page: https://www.clarewellclinics.co.uk/sexual-health-clinic/.

Although every effort will be given to fit your Mirena/Hormonal coil, it may not always be possible if there are unforeseen complications such as the neck of the womb not opening enough to accomodate the measuring sound or coil applicator. If that is the case, your clinician will advise you on next steps.

No, we have pads at the clinic and will supply you with one after your procedure.

Some patients may feel dizzy, faint, or light headed immediately after the procedure. It is advised to stay lying down until these symptoms have passed.

If you feel unwell and have pain in your lower abdomen, with a high temperature or a smelly discharge from your vagina, this may be a sign of infection, so please don’t hesitate to contact us, or your local healthcare provider.

You may experience period-like pains and it is not uncommon to bleed for a couple of days afterwards. Painkillers such as paracetamol and a hot water bottle usually help to alleviate this.

If you are particularly prone to faint after a medical procedure/in a clinical setting, please let us know when booking your appointment.

Rarely patients can develop an infection after having their coil removed. If you are experiencing unusual pain, strong smelling discharge, have a fever or are experiencing any other symptoms indicative of an infection, please seek medical advice or visit your local GUM clinic.

A follow up appointment is not usually required. If you have any questions after your procedure, you can contact our receptionists and they will arrange a follow up call for you.

In the event that you would like a follow up appointment, we can book this in for you (please note that we do charge for a follow up appointment).

As long as you are comfortable, you can have sex immediately after your Mirena/Hormonal coil fitting. Although we do recommend waiting a few days for the strings to soften before receiving penetrative vaginal sex (as the strings may be uncomfortable for your partner at first).

It is very unlikely that you will become pregnant when using an Mirena/Hormonal coil. If you do get pregnant, there is an increased risk of an ectopic pregnancy that develops outside the uterus, usually in the fallopian tube.

If you have a period that is unusually light, miss a period, suspect you may be pregnant and/or have sudden or unusual pain in your lower abdomen, please get in touch, and seek medical advice immediately.

Yes. It is safe to use tampons and menstrual cups after having a Mirena/Hormonal coil fitted.

During your first period after the Mirena/Hormonal coil fitting, using tampons is fine during heavier days of bleeding, but please be careful when the bleeding begins to subside, as the new threads can catch on a dry tampon.

Please be careful not to remove the thread when removing tampons and menstrual cups.

A Mirena/Hormonal coil can be placed at any point during your menstrual cycle, provided you are not pregnant. The Mirena/Hormonal coil becomes effective after seven days as soon as it is fitted, which is why you may need to continue on your current method of contraception or abstain from sex.

Using condoms is advised to reduce the risk of infection and early expulsion of the coil in the first few weeks from fitting.

Your periods can become lighter, shorter and less painful – they may stop completely after the first year of having the Mirena/Hormonal coil fitted.

During your fitting, your clinician will show you how to check that the threads are in place. It’s best to repeat this a few times after the procedure and then every few months or so afterwards.

If you think that your Mirena coil has moved, you can feel something hard like the end of a matchstick or you can’t feel the strings, we would advise that you use another form of contraception and don’t hesitate to get in touch with us so that we can check your Mirena/Hormonal coil.

Generally, the strings should not bother you, but in rare cases your partner may be able to feel them during penetrative vaginal sex. If this causes a problem, please do get in touch, as our clinicians may be able to trim the strings shorter for you.