Intrauterine System (IUS)

NUPAS > Abortion Care > Contraception > Intrauterine System (IUS)

Long-acting contraception with low hormone level

The Intrauterine System (IUS) is a type of long-acting reversible contraception (LARC). The IUS is sometimes called the hormonal coil. It is a small, plastic, T-shaped device that contains a hormone called levonorgestrel (a type of progestogen). It is inserted into the womb (uterus) through the vagina and cervix. The IUS has the lowest hormone level of all the types of hormonal contraception.

Once fitted it works as contraception for 3 - 5 years, depending on the type of IUS.

A trained doctor or nurse will fit the IUS. The procedure can take between 5 and 15 minutes. The fitting of an IUS may cause some discomfort or pain. At NUPAS we can provide painkillers or a local anaesthetic before the fitting.

The IUS will have one or two fine threads at the bottom. When the IUS is in place, these threads hang through the cervix opening and sit at the top of the vagina. This allows you to check that the IUS is still in place. This should be checked monthly.

The IUS can be taken out sooner if you choose. A trained doctor or nurse will remove the IUS. Your fertility returns to normal as soon as the IUS is removed.

How does the IUS work?

The IUS slowly releases the hormone progestogen into the womb (uterus). This thins the lining of the womb to stop a fertilised egg attaching and growing. It also thickens cervical mucus (fluid at the neck of the womb) to stop sperm reaching an egg.

For some people it can stop an egg from being released each month (ovulation). Most people who use the IUS still ovulate (release an egg).

When can I start using an IUS?

An IUS can be fitted by an experienced doctor or nurse straight after an abortion. If you are having a surgical abortion, the IUS can be fitted during the procedure. You'll be protected against pregnancy immediately.

Advantages, Disadvantages and Effectiveness

All contraception has different advantages, disadvantages and effectiveness. It is important to look at this when finding the right contraception for you.

What are the advantages of the injection?

Does not interrupt sex

Works immediately

Works for between 3 - 5 years (depending on the type of IUS)

You don’t have to remember to take it every day

It is not affected by other medication

Can cause periods to be lighter and shorter

Can reduce pain from periods

Contains a very low level of hormone

Can often be used by people who cannot take oestrogen

It is usually easy to remove (by a trained doctor or nurse)

What are the disadvantages of the injection?

Does not protect against sexually transmitted infections (STIs)

The insertion process may cause some discomfort or pain

What are the risks of the IUS?

Possible side effects of the IUS for the first few months after fitting include:

irregular bleeding
headaches
sore breasts
acne
changes in mood
cysts (small sacks filled with fluid) on your ovaries. These are usually harmless and disappear without treatment.

There's a very small chance of getting a pelvic infection when the IUS is put in.

There's a small chance that the IUS can be rejected (pushed out) by the womb (1 in 20 users).

There is a risk that the IUS could come out after a period (1 in 20 users).

There is a small chance that the IUS could move (displacement).

In rare cases, an IUS can make a hole in the womb (perforate) when it’s put in. The risk is extremely low (fewer than 2 in 1000 people) with experienced fitters. If you’re feeling pain or cannot feel the threads of your IUS, you may need surgery to remove it.

If the IUS fails and you become pregnant, there’s a rare risk of ectopic pregnancy. This is when an embryo starts to grow outside of the womb.

How effective is the IUS?

The IUS is over 99% effective. Less than 1 in 100 users will get pregnant in a year.

What makes it less effective?

If the IUS is fitted incorrectly.
If the IUS moves out of place.
If the IUS comes out.

The correct position of the IUS can be checked by feeling for the threads at the top of your vagina.

Protection from STIs

The IUS does not protect you from sexually transmitted infections (STIs). We recommend that you also use condoms to protect against STIs. We offer all our patients condoms to take away with them. Get in touch if you’d like advice on the different contraception options after an abortion.

Contraception options available at NUPAS

At your abortion appointment, we will discuss contraception options with you.

Fertility can come back as soon 5 days after an abortion. This means you could get pregnant again if contraception is not used. There are lots of methods of contraception to choose from so don’t be put off if the first type isn’t quite right for you.

Find out more about contraception options available at NUPAS.