3 Things We’ve All Got Wrong about The Coil (including your Doctor)

3 Things We've All Got Wrong about The Coil (including your Doctor)

Contraceptive Coil image
Warning: Contains explicit content ♦ & is not to be used as medical advice ♥ Disclaimer here

The contraceptive hormonal (IUS) coil is a small t-shaped object that is inserted up your vagina, through your cervix and into your womb. It releases synthetic progestogen and you can keep it in for 3 - 5 years.

 After discussing it with my doctor I decided that this would be the best form of contraception for me. I was wary of messing with my hormones but I decided that the Mirena coil was the least disruptive.

- Sarah J, coil user

The hormonal coil is one of the newer options of hormonal contraception and has been hailed as a fantastic alternative that gives you fewer side effects, is very effective and doesn't require any effort once it's in; a 'get-it-and-forget-it' option. But is it all it's cracked up to be...

What are women not being told?

All patients should be aware that the NHS gives monetary incentives to doctors to promote the coil; it is a cheap way of dealing with women's fertility issues and not only that but surgeries are given extra money for every woman they manage to fit with LARC's (long-acting-reversible-contraceptives such as the coil). The NHS is currently facing huge financial strain and prescribers are under great pressure to do whatever they can to help their particular institution. However, this may lead to women feeling coerced into getting a coil or dissuaded from having it removed. It also means the benefits of the coil are being loudly promoted whilst the risks or drawbacks may be underplayed.

Many women who are not keen on using hormonal contraception are advised to try this coil anyway because it's a ‘lower impact’ hormonal method. Unfortunately, this is quite misleading. The coil is assumed to be less disruptive than other hormonal options, such as the pill or the implant, but this assumption may be based on 3 serious mistakes

Mistake #1:

The coil is in your womb and only has an effect around this area. This means the synthetic hormone only acts 'locally' and doesn't spread around your whole body.

Correction:

Some of the synthetic hormone from the coil does stay in your uterine cavity and act locally (causing your womb lining to thin and making conditions poisonous for sperm). This local effect is thought to be the main way that it works, but it is not the full story. The coil’s synthetic hormone gets into your bloodstream through your womb walls and travels to your brain. Progesterone receptors are found all over your brain and a synthetic version of progesterone is the hormone that is used in the coil; relatively little is known about it's effect in the brains of women, during and following their reproductive years.

We may not know all the effects the coil's hormone has on the brain, but we do know that it triggers an interruption of your monthly cycle which may cause you to stop ovulating and will completely stop your periods (READ THIS POST & get to know why your bleeds on hormonal contraception are nothing like periods). This interruption to your monthly cycle has a profound impact on everything ranging from mental health to hair growth, sex drive, nutrition levels, bone density, concentration and so much more.

The coil's hormone travels around your whole body and has a major effect on your whole hormonal system.

 The idea that Mirena works entirely as a local source of progestogen should be revised, and the recent concerns about Mirena should be made clear to women regardless of the marketing pressures

- Dr Ayman Ewies, a Consultant Gynaecologist at Sandwell and West Birmingham Hospitals

Phallic cactus
How much pain are we willing to endure just to get a good dick-in'

Mistake #3:

The coil being ‘lower dose’ and 'locally acting' means it won't cause many side effects.

Correction:

As we've now discussed, the coil is not necessarily low dose and it spreads its hormone throughout your whole body as well as acting locally around your womb. We also must remember that these are still fairly new to the market and so there's been far less data collected on the coil's side effects in comparison to, for example, the pill. This may lead us to conclude that the coils are better whereas in actual fact it is simply that they are newer and not as well understood (find out why your side effects may be being ignored). Furthermore, there is mounting evidence that suggests the design of coils needs to be revised because they do not suit all sizes and shapes of womb. Young women in particular are at risk of suffering harm from the coil because of their smaller uterine cavities.

 Do we know the long-term effects of Mirena and Jaydess?

No, we don't. Mirena has only been around since about the beginning of this century, and Jaydess has only just been introduced. So to be frank, doctors have no idea what the effects of the hormone might be after another 20 years or so.


-
IUS, Netdoctor

What makes the coil all the more difficult to accurately assess is that its effects may change over time. In a 1-year study approximately 45% of menstrual cycles were ovulatory and in another study after 4 years 75% of cycles were ovulatory. If side effects are variable it makes it very difficult for you to tell whether the coil is to blame or whether it’s something else in your life. For instance, if you are in a relationship, losing your sex drive over time could have a serious impact on your confidence as a couple.

 I can not get over how my sex drive has changed since getting the coil out... So scary how it has the potential to break up relationships.

So these 3 common misconceptions about the coil, combined with the lack of data and the NHS monetary incentives, may mean it's far more popular than it really deserves to be.

A genuine advantage to the coil however is that it's average rate of preventing pregnancy is very high, because unlike contraceptives such as the pill or condom that you have to actually 'remember' to use, you can't really f*ck up your use of the coil! However, you are potentially taking a greater risk. Getting the coil put in is usually safe, but make no mistake it's not guaranteed to go perfectly and if it does go wrong you may end up needing serious invasive surgery. Assuming all goes to plan you might at least have to spend a bit of time in bed with agonising cramps (see your doctor if you have any concerns about your symptoms after insertion because it could be a sign of a more serious problem). A contraceptive that necessitates a hard object being pushed up through our cervix seems a slightly barbaric method considering its 2018 and the technology we have in other areas of medicine is so advanced. People can get bionic eyes these days FFS!

This is also the one significant issue with the coil that is totally disregarded; that having something inserted up through your cervix goes against all natural instinct and is a mild form of trauma to your body. Ask a man if he would consent to a tiny device being poked up through his urethra and just watch him wince at the mere thought of it. There have been no serious studies done to assess any lasting emotional or physical consequences of a coil insertion.

Are there women who are happy with this coil? Yes. Would I want a future daughter of mine to have to use it? Absolutely not.