Copper or hormonal coil? Fitting, removal and replacement

Your coil is due out, or you've decided it's time for one, and the booking page offers copper, hormonal, removal, replacement and an arm implant all at once. Which one is actually yours?

Usually it comes down to two questions: do you want hormones or not, and is anything going in, coming out, or both? Every procedure here is done by a consultant gynaecologist, Dr Hikmat Naoum, in a single visit.

If you'd rather skip the reading, coil clinics run on Thursdays and Fridays at 117a Harley Street, and you can book a coil appointment online without a referral. A copper coil fitting is £550 and a hormonal one £650, with a £100 deposit to secure the appointment.

Copper or hormonal coil: what is the difference?

A coil is a small T-shaped device placed in the uterus. The copper coil (IUD) contains no hormones: copper ions make it harder for sperm to reach an egg. The hormonal coil (IUS) releases progestogen locally in the uterus, which thins the lining and thickens cervical mucus.

That local action is the thing to remember, because it means a hormonal coil changes your periods as well as preventing pregnancy. Hormonal coils usually make periods lighter, and Mirena may stop them altogether. Copper may make periods heavier, especially in the first few cycles.

So if you'd like to avoid hormones and your periods are manageable, copper is the usual choice. If heavy or painful periods are part of the reason you're here, Dr Naoum can discuss whether a hormonal coil would suit you. Kyleena uses a lower local hormone dose and is slightly smaller than Mirena, which some people who haven't had children find more comfortable. Neither type is better for everyone.

Dr Naoum recommends a device from your history, your periods and what you want the coil to do, and explains how long it's licensed to stay in. T-Safe and T-Safe Mini are the copper devices we keep in stock, and Mirena and Kyleena are the hormonal ones. If you're thinking about perimenopause care, ask whether a hormonal coil could sit alongside oestrogen as part of HRT.

Fitting, removal or replacement: which should you book?

Whether it's your first coil, you want the current one out, or you're due a new one, you can book directly without a referral.

Because the devices are in stock, the consultation and procedure happen together in about 20 to 30 minutes. Removal itself often takes under a minute once the threads are accessible, while a fitting takes longer because it includes the consultation. A £100 deposit secures any of the four appointments.

If you still want a coil, book the replacement appointment (from £700) rather than removal (£400), so the new one goes in on the same day. If you only want it out and don't want to become pregnant, avoid sex or use condoms for 7 days beforehand, because sperm already present can cause a pregnancy once the coil is out.

An optional six-week check can be arranged after fitting, including ultrasound if needed. Just ask after your procedure. Nexplanon is a small flexible rod placed under the skin of the upper arm, and it's arranged by phone or through a consultation. Our sister clinic offers coil fitting as a separate service.

Who fits the coil, and what happens on the day?

Dr Hikmat Naoum, Consultant Gynaecologist, GMC 3047637, does every IUD and IUS fitting and removal at Medical Express Clinic personally, with a nursing chaperone throughout. The clinic is CQC-registered and has practised at 117a Harley Street since 1984.

No special preparation is needed, and the visit doesn't have to fall during a period. If cramping worries you, ibuprofen or paracetamol an hour before can help. Bring a note of your current medicines, the date of your last period if you know it, and any paperwork about a coil you already have. Dr Naoum will explain any contraception precautions that apply to you.

After a short consultation there's a speculum examination, then the fitting or removal. Instillagel, a lidocaine gel, is applied to the cervix as standard, and ultrasound is used during the procedure when position or a difficult removal needs it. He explains each step, and you can ask him to pause at any point. Most people describe a strong period cramp lasting a short time during insertion.

You can return to your usual activities the same day. Mild cramping or light spotting for a day or two is common, and you'll get after-care instructions before you leave. If you have severe pain, heavy bleeding or a fever afterwards, call the clinic.

Both copper and hormonal coils can be used while breastfeeding, and Dr Naoum fits coils whether or not you've had children. If you've never been pregnant, mention it, because that can change which hormonal device is discussed.

Can a coil be used as emergency contraception?

The copper coil can, and it's the most effective method of emergency contraception in guidance from the College of Sexual and Reproductive Healthcare (CoSRH, formerly FSRH). It can be inserted within five days after the first unprotected sex in a cycle, or within five days of the earliest estimated date of ovulation, whichever is later. It still works after ovulation provided it goes in well before the earliest likely date of implantation, and it then carries on as immediately effective ongoing contraception.

Hormonal coils aren't recommended as emergency contraception in UK guidance.

If that's why you're here, call the clinic promptly. Coil clinics run on Thursdays and Fridays only, and the team can talk through whether you're still within the window. Oral emergency contraception, usually from a pharmacy or a GP, is a separate option, and if you can't be fitted today, get it from a pharmacy now as well. Levonorgestrel doesn't stop a copper coil being fitted later.

When should you see a gynaecologist first?

If you have pelvic pain, abnormal bleeding, a fertility question or an early-pregnancy concern, book consultant gynaecology first, at £250, or £450 with an ultrasound. A coil is contraception, or emergency contraception in the case of copper, and those symptoms deserve their own assessment before anything is fitted.

Our sister Gynae Clinic also runs a dedicated coil removal service. New, severe or rapidly worsening symptoms need same-day GP or emergency care. Our guide on whether to see a GP or a gynaecologist first covers the wider choices.

How does a private coil fitting compare with the NHS?

The device is the same. The difference is who fits it, whether consultation and fitting happen together, and how you book. On the NHS the wait varies, and the person fitting your coil may be a GP, a nurse or a doctor with coil training. Primary care often splits the conversation and the procedure across two visits, and you may be asked to bring a device if the surgery doesn't stock it.

Here, every coil is fitted and removed by a consultant gynaecologist, Dr Naoum, with a nursing chaperone, in one visit, with devices in stock. The NHS remains a reasonable option if you can get a timely appointment through your GP or a sexual health clinic.