On this page
Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Assessment online: whether the hormonal coil is right for you, what it will do to your periods, and any problem once it is in. A clinic fits and removes it.
- How well it works: over 99% effective: in UK guidance, about 0.2 to 0.3 in 100 users become pregnant in the first year.
- How long it lasts: 3 to 8 years, depending on the type. Some types fitted at 45 or over can stay in until 55.
- Periods: usually lighter, shorter and less painful over time, and they may stop. Irregular bleeding is common in the first months.
- Emergency: sudden, severe pain low in the tummy, fainting, or feeling very unwell with a coil in place means 112, more so if a period is late or a test is positive.
Do not book a video appointment if you have a hormonal coil and sudden, severe pain low in the tummy, you have fainted or feel very unwell, or a pregnancy test is positive and you are in pain: call 112 or go to an emergency department. In the weeks after a fitting, pain that painkillers cannot touch, a high temperature or discharge that smells needs an in-person check without delay.
Can an online doctor help with the hormonal coil?
No, a hormonal coil cannot be fitted online: it is placed in the womb by a trained doctor or nurse, at a sexual health clinic or a doctor’s surgery, and taken out the same way. By video the doctor can weigh up whether it suits you, explain what it will do to your periods and how it is used for heavy periods or with HRT, sort out problems once it is in, and say where to go when an examination is needed.
How an online consultation helps with the hormonal coil
- Is it right for you?: Your periods, your health history and your plans, and how the hormonal coil compares with the copper coil, the implant and the pill.
- Bleeding explained first: What usually happens to your periods in the first months and afterwards, so changes do not come as a surprise.
- Heavy periods and HRT: Whether the hormonal coil can treat heavy periods, or protect the womb lining as part of HRT.
- Problems sorted promptly: Troublesome bleeding, threads you cannot feel, a possible pregnancy, or a coil due for a change.
What the doctor checks in an online hormonal coil consultation
The warning signs come first, then your periods, your health and your plans. The doctor asks about:
- Warning signs: pain low in the tummy that is severe or getting worse, a high temperature, discharge that smells, bleeding far heavier than before, or any chance of pregnancy.
- Your periods: how heavy and painful they are, and any bleeding between periods or after sex, which needs checking first.
- Your health: breast cancer now or in the past, cervical or womb cancer, liver conditions, serious heart disease or stroke, and pelvic or sexually transmitted infections.
- Pregnancy, birth and feeding: when your last period started, any unprotected sex since, a birth in the last weeks, and whether you are breastfeeding.
- Your plans: how long you want contraception for, and whether you use or are thinking about HRT.
- A coil you already have: when it was fitted, which type it is, and the bleeding pattern you have now.
Have the date your last period started ready, and for a coil you already have, the date and type of the fitting. A bleeding diary over the last few months turns a vague review into a precise one.
What is the hormonal coil, and how long does it last?
The hormonal coil, or intrauterine system (IUS), is a small T-shaped plastic device that a trained doctor or nurse places in the womb. It releases a low level of a progestogen hormone, levonorgestrel, and contains no oestrogen. It is over 99% effective, and fertility returns to your usual level as soon as it is removed.
Swipe sideways to compare →
| Type | Contraception for | Also used for | Pregnancies in the first year |
|---|---|---|---|
| Larger hormonal coils | 5 to 8 years, depending on the type; until 55 if fitted at 45 or over | Treating heavy periods; protecting the womb lining as part of HRT | About 0.2 in 100 |
| Smaller hormonal coils, with less hormone | 3 or 5 years, depending on the type | Contraception only: not studied for heavy periods | About 0.3 in 100 |
Used as part of HRT, a larger coil protects the womb lining for 5 years and is then replaced. The doctor checks which type you have, or which suits you, because the time limits differ.
When does the hormonal coil start working?
Straight away if it is fitted in the first 5 days of your cycle, counting the first day of your period as day 1. Fitted at any other time, it needs 7 days, so use condoms or avoid sex for the first week.
What does the hormonal coil do to your periods?
Over time, periods usually become lighter, shorter and less painful, and for some people they stop altogether: in UK guidance, about 1 in 4 users of the larger coils have no periods after 3 years, and about 1 in 8 with the smallest type. In the first months, irregular bleeding and spotting are common; bleeding then tends to become lighter and less frequent the longer the coil is in.
Can the hormonal coil treat heavy periods?
Yes, the larger hormonal coils are licensed to treat heavy periods. In one trial, bleeding fell by up to 90%, and in another study, 92.1% of women no longer had heavy periods after 6 months.
Swipe sideways to compare →
| Time since fitting | What usually happens | Get it checked if |
|---|---|---|
| First few days | Period-like pain and spotting | The pain is severe or does not ease with painkillers |
| First 3 to 6 months | Irregular bleeding or spotting, sometimes on many days | Bleeding is very heavy, follows sex, or comes with pain, a high temperature or discharge |
| After 6 months | Lighter, shorter, less frequent periods, or none | New bleeding starts after a settled pattern |
| Any time | A missed period may simply be the coil | You have pregnancy symptoms or a positive test |
Bleeding that worries you is worth a review rather than putting up with it. The breakthrough bleeding page explains the causes and what helps.
Hormonal coil side effects and risks
Irregular bleeding in the first months is the most common side effect. Some users report acne, tender breasts, headaches or mood changes, mostly in the first few months, although studies have not confirmed that the coil causes them. Harmless ovarian cysts can be more common. Weight gain is a common worry, but studies have not found that the hormonal coil causes it.
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| Risk | How often | When | Signs |
|---|---|---|---|
| Pelvic infection | Under 1 in 100 | The first 3 weeks after the fitting, mostly | Pain low in the tummy, a high temperature, discharge that smells |
| The coil coming out (expulsion) | Around 1 in 20 | Mostly in the first year, and above all in the first 3 months | Threads that are longer or gone, or the coil felt low in the vagina |
| Damage to the womb (perforation) | 1 to 2 in every 1,000 fittings | At the fitting; the risk is higher after a birth and while breastfeeding | Pain that does not settle after the fitting, threads that cannot be felt |
| Pregnancy | About 2 to 3 in 1,000 in the first year | At any time | Pregnancy symptoms, or a positive test |
| Ectopic pregnancy | Rare, and only if the coil fails | If a pregnancy happens with the coil in place | Pain on one side low in the tummy, bleeding, pain at the shoulder tip |
The pros and cons of the hormonal coil
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| Pros | Cons |
|---|---|
| One of the most effective methods, with nothing to remember for years | Fitting is uncomfortable for most and painful for some |
| Periods usually become lighter and less painful | Irregular bleeding is common in the first months |
| Can treat heavy periods and be part of HRT | Some people report acne, tender breasts or mood changes |
| No oestrogen, so it suits many people who cannot take the combined pill | No protection against sexually transmitted infections |
| Fertility returns as soon as it is removed | Fitting and removal need an appointment |
Why do doctors often recommend the hormonal coil?
Because it combines very high effectiveness with years of protection, it usually makes periods lighter, and the larger types can treat heavy periods and protect the womb lining with HRT. It still has to suit you: the doctor goes through your health history and how you would feel about irregular bleeding before recommending it.
Fitting and removing the hormonal coil
The fitting takes about 5 to 10 minutes, but allow at least half an hour for the appointment. It can be done at any point in your cycle if you are not pregnant.
- Before the fitting you may be tested for sexually transmitted infections, and for pregnancy if there is any doubt.
- Most people find the fitting uncomfortable and some find it painful: paracetamol or ibuprofen an hour before helps, and you can ask for a local anaesthetic or other extra pain relief.
- The coil goes in through the cervix with a speculum in place, and you can ask for the fitting to stop at any point.
- Cramps and spotting for a few days afterwards are usual.
- Check that you can feel the 2 threads now and then: a few times in the first month, then once a month, after your period if you still have one.
How is the hormonal coil removed?
Removal is an appointment with a trained doctor or nurse, at any time you choose. Fertility is back at once, so to avoid a pregnancy either use condoms for the 7 days before the removal or have the next coil fitted at the same visit.
If you cannot feel the threads
A coil you cannot feel may have moved, and then it may not be protecting you. Use condoms until it has been checked, and ask about emergency contraception if you have had sex: because a hormonal coil can blunt some emergency pills, the doctor may suggest the copper coil or a different pill.
What might the doctor recommend about the hormonal coil?
What the doctor suggests depends on where you are: deciding on the hormonal coil, living with one, or thinking about HRT. This is the framework the doctors use, in line with UK sexual health guidance:
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| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| You want long-term contraception with lighter periods | A suitability check, then a fitting appointment | Yes, to assess | For the fitting |
| Heavy periods | A check of the cause, and the hormonal coil as a treatment option | Partly | An examination or scan if the cause needs looking into |
| You use or are starting HRT | Checking whether a larger coil can protect the womb lining | Yes, to assess | For the fitting |
| Irregular bleeding since the fitting | Advice on what is expected; if it is a problem, a 3-month course of the combined pill when it is safe for you | Often | If bleeding follows sex, or comes with pain, discharge or a high temperature |
| Threads you cannot feel | Condoms until it is checked, and advice on emergency contraception | Partly | An examination to find the coil, with a scan if needed |
| The coil has reached its time limit, or you want it out | A date for the removal or the next coil, with condoms for the 7 days before | Yes, to plan | At the clinic, for the removal or the change |
| A positive pregnancy test while the coil is in | Assessment without delay, with ectopic pregnancy in mind | No | Urgently; severe pain or fainting means 112 |
Not sure whether the hormonal coil is right for you? A doctor can tell you in one consultation.
See available times →Hormonal coil care and options
What you can do yourself
- Keep a bleeding diary for the first 6 months before deciding the coil does not suit you: bleeding usually settles.
- Cramps after the fitting respond to paracetamol or ibuprofen.
- Make a habit of checking the threads: a few times in the first month, then monthly.
- Write down the type of coil and the fitting date, so the change date is never a guess.
- With a new partner, add condoms: no coil protects against sexually transmitted infections.
Prescription treatment
A prescription is never issued without a consultation. The hormonal coil itself is fitted in person, but around it the doctor may prescribe a method to use until the fitting, such as the progestogen-only pill, a short course of treatment for bleeding that is a problem after other causes have been considered, or emergency contraception if you cannot feel the threads. Should the hormonal coil turn out not to suit you, the alternatives are gone through and one is prescribed when it is safe for you. If the doctor prescribes, use the prescription at a pharmacy near you.
What does not help
Having the coil taken out in the first weeks because of spotting that would probably have settled. Trying to remove or move a coil yourself. Ignoring bleeding after sex, which needs checking whatever contraception you use.
Special situations
Perimenopause and HRT
HRT does not prevent pregnancy. A larger hormonal coil can do both jobs at once: it is the progestogen part of HRT, protecting the womb lining, and it is contraception. Fitted at 45 or over, it can stay in for contraception until 55. The contraception in perimenopause page explains when contraception can stop, and the menopause page covers HRT.
When oestrogen is not suitable
The hormonal coil contains no oestrogen, so it is often an option when the combined pill, patch or ring is not, for example with migraine with aura or a higher risk of blood clots. The doctor checks this against your full history.
After a birth and while breastfeeding
Breastfeeding is no bar to the hormonal coil: it does not affect the baby or the milk. Fitting is possible in the first 48 hours after a birth, but the usual advice is to wait 4 weeks, with another method covering you from day 21.
Living or travelling abroad
Carry a note of the type of coil and the date it was fitted, because the time limits differ between types. If it is due for a change while you are away, a doctor by video can plan cover until it can be replaced.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When the hormonal coil is assessed online, and when you need in-person care
Assessed online: choosing a method, heavy periods and HRT questions, bleeding changes after a fitting, threads you cannot feel, emergency contraception, and planning a removal or a change.
In-person care: the fitting, the removal and the change, examinations, swabs and scans, bleeding after sex, and pain, a high temperature or a pregnancy while the coil is in.
When to get in-person care
Call 112 or go to an emergency department now for:
- sudden, intense pain in the tummy together with feeling faint or passing out
- severe pain low in the tummy with a high temperature and feeling very ill
- severe pain on one side low in the tummy when a pregnancy test is positive or a period is late
Get medical advice the same day for:
- pain low in the tummy that painkillers cannot ease, or that keeps getting worse
- a high temperature or discharge that smells, in the weeks after a fitting
- bleeding far heavier than your periods used to be
- pregnancy symptoms, or a positive test, while the coil is in
- threads that have gone, or feel longer or different, above all if you have had sex since
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about the hormonal coil: say whether you are choosing, living with one or thinking about HRT, how your periods are, and for a coil you have, the type, the fitting date and what has changed.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Noticed a new symptom since having the hormonal coil fitted? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Copper Coil (IUD) can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about the hormonal coil
How long does the hormonal coil last?
A hormonal coil lasts 3 to 8 years, depending on the type. Some types fitted at 45 or over can stay in for contraception until 55. Used as part of HRT, a larger coil is replaced every 5 years.
How does the hormonal coil work?
It is a small T-shaped device placed in the womb that releases a low level of a progestogen hormone, levonorgestrel. It contains no oestrogen and is over 99% effective.
Is the coil hormonal?
There are 2 kinds of coil. The hormonal coil, or IUS, is a small plastic device that releases a low level of the progestogen levonorgestrel into the womb. The copper coil, or IUD, contains no hormones at all and works through copper. Both are over 99% effective, and the hormonal one usually makes periods lighter.
What are the side effects of the hormonal coil?
Irregular bleeding and spotting in the first months are the most common side effects of the hormonal coil. Some people report acne, tender breasts, headaches or mood changes, mostly in the first few months, although studies have not confirmed the coil causes them.
Does the hormonal coil cause weight gain?
The studies have not found that the hormonal coil does. A change in weight after the fitting is still worth raising with a doctor, because other causes can be looked for.
Will the hormonal coil stop my periods?
It might. With the hormonal coil, periods usually become lighter, shorter and less painful over time, and for some people they stop. Irregular bleeding is common in the first months.
What can I do at home about bleeding with the hormonal coil?
Give the hormonal coil time: irregular bleeding and spotting are usual in the first 3 to 6 months and then tend to become lighter and less frequent. Keep a bleeding diary so the pattern is clear, use period pants or liners for spotting, take ibuprofen or another anti-inflammatory painkiller for cramps, and check that you can still feel the threads. Get it checked if bleeding is very heavy, follows sex, or comes with pain, a high temperature or discharge.
What are the downsides of the hormonal coil?
The fitting is uncomfortable for most and painful for some, irregular bleeding is common at first, some people report hormonal side effects, and it does not protect against sexually transmitted infections.
Does the hormonal coil help heavy periods?
Yes, the larger hormonal coils are licensed to treat heavy periods. In one trial, bleeding fell by up to 90%, and in another study 92.1% of women no longer had heavy periods after 6 months.
How is the hormonal coil removed?
A trained doctor or nurse removes the hormonal coil at an appointment, at any time. You can become pregnant straight away, so use condoms for 7 days before removal if you do not want to, or have a new coil fitted at the same visit.
What are the signs that the hormonal coil has moved?
If you cannot feel the threads, they seem longer or shorter, or you can feel the hard end of the hormonal coil at the cervix, it may have moved. Bleeding that starts again after a settled pattern, new cramps or a partner noticing something hard during sex are other clues. Because a moved coil may not protect you, use condoms until it has been checked, ask about emergency contraception if you have had sex, and see a doctor or nurse.
Can I use the hormonal coil with HRT?
Yes. A larger hormonal coil can be the progestogen part of HRT, protecting the womb lining for 5 years, and it is contraception at the same time. HRT on its own does not prevent pregnancy.
Which is better, the hormonal coil or the copper coil?
The hormonal coil is slightly more effective and usually makes periods lighter. The copper coil has no hormones, works straight away and can be used as emergency contraception, but it can make periods heavier.
Can an online doctor fit or prescribe the hormonal coil?
No: a trained doctor or nurse fits it at a clinic. What a video consultation gives you is the assessment, what to expect from your periods, help with any problem once the coil is in, and the right place to go for the fitting.
- What is an IUS (intrauterine system) or hormonal coil?, NHS, National Health Service (UK), reviewed 22 February 2024.
- IUS: who can get it, NHS, National Health Service (UK), reviewed 22 February 2024.
- IUS: getting it fitted or removed, NHS, National Health Service (UK), reviewed 22 February 2024.
- FSRH Clinical Guideline: Intrauterine Contraception, Faculty of Sexual and Reproductive Healthcare (now the College of Sexual and Reproductive Healthcare), March 2023, amended July 2023.
- Hormonal coil (LNG-IUD), Contraception Choices, College of Sexual and Reproductive Healthcare (UK), accessed 15 October 2026.
- What is an IUD (intrauterine device) or copper coil?, NHS, National Health Service (UK), reviewed 15 February 2024.
- Ectopic pregnancy, NHS, National Health Service (UK), reviewed 23 August 2022.
- Problematic bleeding with hormonal contraception, Faculty of Sexual and Reproductive Healthcare (now the College of Sexual and Reproductive Healthcare), Clinical Effectiveness Unit, July 2015.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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