Monday 23 October 2017

Using the right treatment for you

Dr Nina Byrnes
Dr Nina Byrnes

Our GP explains the different types of coil contraception available.

Question: I need a reliable contraceptive. My doctor suggested the coil. I've heard there are different types. What is the difference between them?

Dr Nina replies: You are right. There are three different types of coil contraceptive available in Ireland. All of them provide very effective contraceptive cover but there are slight differences between them. The easiest way to separate them is to divide them into those with hormones and those without.

If you would like to avoid hormones completely the copper coil may suit you. This can be inserted for up to 10 years and is 98-99pc effective. It works by stopping sperm from surviving in the cervix, womb or fallopian tube thus preventing the fertilisation of an egg. It may also stop a fertilised egg implanting in the womb.

The advantage of copper coils is their reliability and the lack of hormones. As there are no hormones your periods will continue as usual although they may become more heavy, prolonged or painful, especially in the first few months.

There are two hormone-coated coils available. They both contain the hormone progesterone but do not contain any oestrogen. Both coils release a small amount of hormone continuously for up to three or five years. This acts mainly in the womb preventing the lining building up. This prevents an egg implanting and thus prevents pregnancy. The hormone coils also thicken a woman's natural discharge making it hard for sperm to reach an egg. A small amount of hormone is released into the system and in some women this stops ovulation.

The hormone-coated coils are very effective at reducing menstrual flow so are particularly helpful in those who have heavy or painful periods. In 10-20pc of women periods may stop altogether, but they will return once the coil is removed. Irregular menstrual bleeding may be a disadvantage for some women as it may be difficult to predict and can be prolonged. This is most common in the first six months after insertion and usually settles down.

The three-year coil releases lower amounts of hormone than the five-year one but otherwise they are very similar. Hormonal side effects may include breast tenderness, skin, weight and mood changes - but these are quite rare.

Fertility returns once a coil is removed so although these are most popular with those who have completed their families, they can be used in others also.

Insertion is straightforward and takes about 10-15 minutes. There are some potential complications including infection, trauma to the cervix or womb or more rarely perforation of the cervix or womb. All coils carry a higher risk of ectopic pregnancy and none protect against sexually transmitted infections.

If you are considering a coil visit your GP who can advise you on the benefits, risks and side effects of all methods and help you decide which one is best for you. You will require an examination and swabs to ensure there is no infection present prior to inserting the coil. The coil is then usually inserted during your menstrual period. This allows the doctor to be sure you are not pregnant and also makes insertion easier as the neck of the womb opens slightly at this time.

Contraceptive cover is immediate.

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