Private coil removal in London: IUD and IUS

What is coil removal?

Coil removal is a quick procedure where a Consultant Gynaecologist gently pulls on the threads of your intrauterine device (IUD or IUS) to slide it out of the womb. For most women, the removal itself takes under a minute. It is simpler and less uncomfortable than having a coil fitted.

Both copper coils (IUD) and hormonal coils such as Mirena and Kyleena (IUS) are removed the same way.

When does a coil need removing?

There are several reasons you might need your coil taken out.

• It has expired. The copper coil lasts 5-10 years and the Mirena and Kyleena last up to 5 years. Once a coil reaches the end of its licensed lifespan, it should be replaced. We can remove the old coil and fit a new one in the same appointment.
• You want to get pregnant. Fertility typically returns within the first menstrual cycle after removal. If you are planning a pregnancy, a pre-pregnancy check at the same time as removal can help you prepare. This includes blood tests, a smear if you are due, and a review of any medications or supplements.
• You are experiencing side effects. Persistent heavy bleeding with a copper coil, ongoing spotting with a hormonal coil, pain, mood changes, or recurrent infections can all be reasons to have the device removed. Your Consultant will discuss whether switching to a different type of coil might resolve the issue, or whether an alternative contraceptive method is more appropriate.
• You no longer need contraception. Women who have gone through the menopause, or who no longer need contraception for other reasons, should have any remaining coil removed. A Mirena that was fitted as part of HRT should be reviewed with your doctor before removal.
• The coil has moved. If you can feel the hard plastic of the coil in your cervix or vagina, or if a check-up ultrasound shows the coil has shifted out of position, it needs to come out.

What happens during coil removal

The procedure is straightforward and quick.

You will lie on the examination couch with your legs in supports, the same position as a smear test. The Consultant inserts a speculum, locates the coil threads, and uses forceps to grip them gently. A slow, steady pull slides the coil out through the cervix. The coil arms fold upwards as it passes through, which is why removal is generally easier than fitting.

Most women feel a brief cramp as the coil passes through the cervix. This lasts a few seconds. Some women feel nothing at all.

The whole process, from speculum in to coil out, takes about a minute.

If you want a new coil fitted immediately afterwards, the Consultant will do this in the same appointment. Having the new coil placed straight after removal means you stay protected without a gap in contraception.

What if the threads cannot be found?

Occasionally the coil threads curl up inside the cervical canal or are trimmed too short at the original fitting. This happens in a small number of cases and does not mean anything is wrong.

If the Consultant cannot see the threads, the first step is an ultrasound scan to confirm the coil is still in the womb and check its position. In most cases, the Consultant can then retrieve the coil using a narrow instrument such as a thread retriever or IUD hook. This is done in the clinic and rarely requires anaesthesia.

In rare cases where the coil has embedded in the uterine wall, a hysteroscopy under anaesthesia may be needed. Mr Naoum has admitting rights at London's leading private hospitals and can arrange this promptly if required. He will explain the situation and the options before anything is done.

After removal

You can go back to normal activities straight away. Some women have light spotting or mild cramping for a day or two.

If you had a hormonal coil (Mirena or Kyleena), your periods will return. This usually takes 4-6 weeks, though some women get a period within days of removal. Your cycle may be irregular for the first 2-3 months while your hormones readjust.

If you had a copper coil, your periods should return to their pre-coil pattern fairly quickly. If your periods were heavy with the copper coil, they will likely become lighter.

If you are not having a new coil fitted and do not want to become pregnant, use an alternative form of contraception from 7 days before removal. Sperm can survive in the reproductive tract for up to 7 days, so unprotected sex in the week before removal could result in pregnancy.

Fertility after coil removal

Fertility returns quickly. With both the copper coil and hormonal coil, most women can conceive within the first few menstrual cycles after removal. There is no evidence that long-term coil use delays the return of fertility.

If you are planning a pregnancy, your Consultant can discuss timing and offer a pre-pregnancy check in the same visit.

Frequently asked questions