Intrauterine contraceptive (‘coil’)
Where does the intrauterine device stand?
This device, widely but probably unfairly known as the "coil", is an excellent contraceptive.
Unbeknown to most people is the fact that there are three different types of intrauterine devices. The oldest is the non-medicated device, which is hardly used nowadays. The next is the medicated type (there is a variety of these). This is the most common type in use.
The third, which has been available only in the last decade or so, is the progestogen hormone carrying device.
All types of intrauterine devices have excellent effectiveness, with the progestogen device (Mirena®) being more effective than the combined pill - hitherto, the most effective mode of contraception. In fact, this device is claimed to have a lower failure rate even when compared to female sterilization. Now, that is impressive!
Is the intrauterine device ideal to use in the postnatal period?
Yes. However, two words of caution.
There is a slight increase in the tendency of the device to fall out, if inserted in the period soon after delivery. If this happens and the loss goes unrecognised, there is a risk of pregnancy because the woman will be under the illusion that she is protected.
Secondly, for the plain and the medicated devices, there is evidence that there is a slight increase in the risk of pelvic infection. So, while it is perfectly all right for a woman in a monogamous relationship, it is not ideal for one who is likely to have multiple sexual partners, as the risk of pelvic infection is then quite real.
Are all intrauterine devices otherwise the same?
No. The progestogen-carrying device is certainly the most effective one.
It is actually so effective that, as stated earlier, it rivals sterilization, with the important exception that its effect is readily reversible. The medicated device is also quite effective, rivalling the combined pill in the medium and long-term.
The progestogen-carrying device (Mirena®) has one more important advantage. It almost invariably reduces the amount of menstrual blood loss. Some users stop having periods altogether. All the effects are, however, readily reversible on its removal.
And another thing. The progestogen device is actually believed to reduce the risk of pelvic infection. It has protective properties against this and therefore a woman who has this fitted is at an advantage in this regard.
Any device names?
There has been various brands of the medicated devices over the years. Some famous brands such as Multiload® Cu250 have since been discontinued. There is only slight variation among the various brands and they all work on a similar principle. Licensed medicated devices available in the UK include UT 380 Short®, Load® 375, Flexi-T® 300, Nova-T 380® and Multiload® Cu375.
The numbers appearing on the brand names simply refer to the approximate surface area (in mm) of the device.
One device that is designed radically different from the rest is Gynefix® which is frameless. It consists of a thread with six copper sleeves. It works on the same principle as the rest.