Copper IUD vs Hormonal IUS — What Is the Difference?
Copper IUD
- No hormones — copper ions are toxic to sperm
- Lasts 5–10 years depending on device
- Periods may be heavier or more painful
- Can also be used as emergency contraception (within 5 days)
- Suitable for those who cannot use hormonal contraception
- Fertility returns immediately on removal
Hormonal IUS
- Releases low-dose progestogen locally
- Lasts 3–8 years depending on device
- Periods typically become lighter or absent
- Highly effective treatment for heavy periods
- Often used therapeutically alongside contraception
- Fertility returns quickly on removal
Both types have a failure rate of less than 1% per year — significantly more effective than the combined pill when used perfectly, and far more effective in typical use.
Can You Have a Coil Fitted If You Haven't Had Children?
Yes. The idea that coils are only suitable for women who have already had children is a persistent and unhelpful misconception. Smaller devices are available for women with a smaller uterus, including those who have never been pregnant. The procedure may be slightly more uncomfortable for nulliparous women, and there is a marginally higher rate of expulsion, but the coil is an appropriate option. A knowledgeable clinician and a careful fitting technique make a significant difference to the experience.
What Does the Fitting Procedure Involve?
Your appointment will typically last around 30 minutes. This allows time for:
- A full gynaecological and sexual health history, to confirm suitability and discuss any contraindications
- Discussion of device options and your individual preferences
- A bimanual examination to assess the size and position of the uterus
- Insertion using a speculum, which allows visualisation of the cervix — similar to a smear test
- The fitting itself, which typically takes 5–10 minutes
- Aftercare advice and a follow-up plan
After the Coil Is Fitted
Cramping similar to period pain is common for a few hours to a few days after fitting. Light spotting may occur for several weeks. The threads of the coil (thin plastic strings that sit in the vagina) should be checked periodically — your clinician will show you how to do this. A follow-up appointment 4–6 weeks after fitting is recommended to confirm correct position.