Contraceptive coil (IUD) Fitting / replacement

You have requested to go on our list for a coil to be fitted/changed ; before we can put you on our list can you please read and complete the enclosed questionnaire and return to the surgery for the attention of Debbie Urry.

The questionnaire is self-explanatory and if needed please make an appointment with of our doctors /nurses

An appointment for IUD insertion is 30 minutes with both a nurse and a doctor which is the equivalent to 6 normal appointments, so patients who do not attend their appointments without warning are preventing another lady from receiving contraception or 6 patients who are unwell being cared for.

You will not go on the list until the questionnaire has been completed.

There are very few people for whom intra uterine contraception is not suitable but prior to fitting some do need further investigations. To try to save you time by avoiding unnecessary appointments we are using this questionnaire.

If you wish to discuss your contraceptive choices further please make an appointment with one of our doctors who specialises in contraception and sexual health : Dr M Lovis, Dr K Long and Dr K Chan.

Pre Intra Uterine Contraception (IUC) Questionnaire

Pre Intra Uterine Contraception (IUC) Questionnaire

Which coil are you looking for: *
What is the appointment for? *
Please specify which method of contraception you are currently using:

The withdrawal method is not reliable form of contraception as high numbers of sperm are usually present in pre-ejaculate fluid.

Please be advised: if your mirena is over 5 years old: your nexplanon is over 3 years old or you are more than 14 weeks since our last syana press / depo injection then you need to be using alternative contraception, unless it was fitted over the age of 45 or you have a copper coil lasting 10 years that was fitted after the age of 40 as these can remain in until menopause (or 55) unless needed for HRT. The mirena must be changed every 5 years for HRT purposes.

If you have had sex without a reliable form of contraception in the 3 weeks prior to fitting our iud then the doctor will not be able to fit the IUD unless you are on your period because there could be an undiagnosed pregnancy. This includes missed pills in that period if emergency contraception would have been required.

If you have had sex without reliable contraception since your last period but more than 3 weeks ago then you must perform a pregnancy test on the day of the fitting and bring a negative test to the clinic.

Do you have any bleeding in between periods?
Do you bleed after sex?
Have your periods recently changed to become heavier than usual, passing clots or flooding through towels/tampons?
Are you known to have a large/multiple fibroids or a uterus that is not the usual shape (e.g. septate uterus)

If you have answered yes, please book an appointment with a doctor to discuss this, unless you have already done so and had investigations.

We cannot insert IUC in ladies who have unexplained vaginal bleeding as it could mask serious causes that need treatment.

Do you have or have you finished treatment for Breast/Ovarian/Cervical/Uterine Cancer?
Are you breast feeding?
Have you had a C section in the last 6 months?

We can insert the IUC from 4 weeks delivery. There is a 2/1000 risk of perforation of the uterus when we insert the IUC. Those who are breast feeding or have given birth, especially via C section in the last 6 months are at higher risk of perforation because the uterus is much softer. This risk does not stop us inserting the IUC. Some women choose to wait for 6 months but for some, other contraceptive options do not suit and the IUC remains the best choice at this time.

There is a small risk that when we insert the IUC, if you have an infection in the vagina it is pushed up into the uterus. To further reduce that risk we test any lady who doesn’t have symptoms but might be at risk of a sexually transmitted infection (STI) for Chlamydia and gonorrhoea. The British Society of Sexual Health has produced guidelines to help identify those who may be at higher risk of STI. This is not a judgement of lifestyle but a means to help protect you from the consequences of infection.

Apart from the risk of introducing infection when it is fitted, once in, your risks of pelvic infection with an IUC are no greater than if you didn’t have one.

Please tick if any of the following apply to you:

If you answer yes to any of these questions please book an appointment with the nurse for a sexual health screen. This will include a vaginal swab for gonorrhoea and chlamydia. We can also offer routine testing for HIV and syphilis which is advised as part of the routine sexual health check. You are welcome to attend for an STI screen without meeting the above criteria at any time. Just make an appointment with our nurses or attend the sexual health clinic https://www.healthysurrey.org.uk/sexual-health/sexual-health-advice-and-clinics .

For your information, all results of sexual health screening are removed for insurance reports and your results are confidential. If positive you will be encouraged to share the information with sexual partners so they can be tested.

If you have any symptoms of pelvic/vaginal infection (new/smelly/coloured discharge: pelvic pain; bleeding after sex or between periods) then please book for swabs with the nurse. In addition to the above tests you will have an extra swab to look for bacterial and thrush infections. Common infections found in women include thrush and bacterial vaginosis. These are not sexually transmitted infections and are due to a change in the normal numbers of friendly bacteria/organisms that live in your vagina. Sometimes we find bacteria called “Group B Streptococcus”. This is not sexually transmitted and is a bacteria that some women carry. It is only significant during labour does not normally cause problems. It tends to recur so is not treated.

If any of the above questions have raised concerns for you then please do book for a chat with one of our GPs who specialise in sexual health to discuss. Some people might be worried about having an IUC inserted after reading the risks in black and white above. It is important to remember that the risks are very uncommon and the benefits of contraception that can be fitted and then forgotten about for 5-10 years are many. For many women, avoiding the reliance on higher dose hormone contraception or the benefits for control of periods with the mirena far outweigh any risks. The above questions are simply a way of ensuring that when we fit the IUC we ensure that we do so in a way that is safest for you and happy in the knowledge that it is the best option for you.