How does the IUS work after insertion?

The hormone spiral looks very similar to the copper spiral. However, unlike the copper spiral, the hormone coil contains a supply of hormones in its plastic frame. After insertion, these are released by the coil directly to the lining of the uterus.

The hormone release ensures that the mucus in the cervix “thickens”. The viscous mucus makes it difficult for sperm to reach the uterus. In addition, the hormones have an inhibiting effect on the build-up of the uterine mucosa. In the case of the hormone coil, the released substances only act locally or in the uterus. In contrast to the contraceptive pill, ovulation therefore continues to occur in affected women.

How does the insertion process work?

The insertion of the copper or hormone coil is done by the gynecologist. The best time for this is during menstruation or the last days of the menstrual cycle. This may sound a bit unusual, but it is because the cervix is slightly wider during the period, which makes it easier to insert the IUD into the uterus.

In addition, the risk of pregnancy is most unlikely during an existing menstrual period. After inserting the IUD, the length of the return threads, which are special threads attached to the IUD, is adjusted by the doctor. At the end they should be long enough to reach into the upper part of the vagina.

This allows the woman to feel the threads herself. After placing the copper or hormone coil, an ultrasound is used to check the correct position. 4-6 weeks after the insertion of the coil, a new position check is performed by the gynecologist. Subsequently, appointments are made every six months for a checkup.

What are the advantages and disadvantages of using a spiral?

There are both advantages and disadvantages of inserting or using a copper or hormone coil. With the insertion of the copper coil, it is possible to use hormone-free contraception. The women are not dependent on daily tablet intake and do not have to deal with the subject of contraception for many years.

Usually the coil remains in the uterus for several years. If there is a desire to have a child, pregnancy can occur after the removal of the copper coil in the following cycle. One advantage of the IUS can be its effect on menstruation.This occurs much less or irregularly in many women after insertion.

Due to the local effect of the hormones, the IUS can also be used in women who are not allowed to take birth control pills due to certain risks. A further advantage, like the copper coil, is its long-term effectiveness. The women do not have to try to use contraception for many years.

Furthermore, the hormone coil offers an advantage for women with an intolerance to estrogen preparations, as it only releases progestins. Disadvantages of inserting the copper coil include abdominal and back pain, which usually occurs some time after insertion. Menstrual bleeding can also change under the copper coil: it can last longer, be more pronounced or even be associated with pain.

The opposite phenomenon can occur with the hormone coil. The menstrual period is usually weaker and sometimes it is so weak that it is hardly noticed by the woman. Some women find this unpleasant or disturbing.

In addition, the release of hormones can cause side effects. Although these are less frequent than with the contraceptive pill, they can be noticeable, especially in the first few months. These include headaches, acne, a feeling of tension in the breasts, etc.

Occasionally, the copper or hormone spiral is flushed out with the menstrual period. For this reason, regular check-ups by the gynaecologist and also by the women themselves by palpating the retraction thread in the vagina are necessary. Young women in particular are advised by the doctor to have regular palpation checks, as they are more frequently affected by the flushing than older patients.

In rare cases, the copper or hormone spiral can cause an infection, and attention should be paid to discharge, fever or abdominal discomfort or pain. If the above-mentioned symptoms occur, a visit to a doctor is strongly recommended. The risk of an ectopic pregnancy is also slightly increased if pregnancy occurs under the coil. If, after the insertion of a copper or hormone coil, there is no menstrual bleeding or discomfort in the lower abdomen, a visit to the gynecologist is always recommended.