Tartaczna 2
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A hormonal coil, also called an intrauterine system (IUS) or hormonal intrauterine device (IUD), is a long-acting, reversible method of contraception. At Tartaczna 2 Medical Centre in Gdańsk, we help you choose a suitable system and provide fitting, position checks, replacement and removal.
The choice of system depends on factors including the shape of your womb, your bleeding pattern, medical history and plans for pregnancy. Hormonal coils differ in their approved uses and how long they can remain in place.
The system consists of a small T-shaped frame and a reservoir that gradually releases levonorgestrel, a progestogen hormone. Your doctor places it inside the womb. Threads passing through the cervix allow the system to be removed later.
Its contraceptive effect mainly involves:
Levonorgestrel also suppresses the growth of the womb lining, known as the endometrium. This can make periods lighter or shorter, and they may eventually stop. Many women continue to ovulate while using a hormonal coil.
The coil acts mainly within the womb, but the hormone also enters the bloodstream. Side effects affecting other parts of the body are therefore possible. The system does not contain oestrogen.
These amounts refer to the total hormone content of each system, not the amount released each day. A lower hormone content does not automatically make a system more suitable for every patient.
A levonorgestrel-releasing system may be an option for treating heavy menstrual bleeding once its cause has been assessed. Before fitting, your doctor will consider whether further investigations are needed, such as a gynaecological ultrasound scan, an endometrial biopsy or hysteroscopy.
Mirena is effective for 5 years for the treatment of idiopathic heavy menstrual bleeding. According to its Polish Summary of Product Characteristics, continued use may be considered if symptoms have not returned after this time. The system should be removed or replaced if symptoms recur, and no later than 8 years after fitting.
Kyleena may make periods lighter during contraceptive use, but it should not be presented as an alternative to Mirena for treating heavy menstrual bleeding.
Both systems are over 99% effective at preventing pregnancy during the first year of use. Unlike the contraceptive pill, the coil does not require you to remember a daily dose. However, no contraceptive method provides a complete guarantee against pregnancy.
Protection depends on the system remaining correctly positioned and being replaced within the recommended timeframe. If it partly or completely comes out, its contraceptive effect may be reduced or lost.
The coil does not protect against sexually transmitted infections. Condoms reduce the risk of transmission.
Before the procedure, your gynaecologist will take your medical history, examine you, assess the womb and check for contraindications, including pregnancy and active genital tract infection. Any additional tests are arranged individually. Unexplained vaginal bleeding needs to be investigated before the system is fitted.
For your consultation, prepare the date of your last period and details of your current contraception, medicines and previous gynaecological procedures. Tell your doctor if examinations or procedures have been painful in the past so that pain relief can be discussed in advance.
According to the current Polish Summaries of Product Characteristics, both systems can be fitted within the first 7 days after your period starts. When fitted during this time, they provide contraceptive protection immediately. You do not need to wait for the heaviest day of bleeding.
Fitting at another time is also possible if your doctor can reliably exclude pregnancy. In this situation, you should use condoms or avoid sexual intercourse for the following 7 days. Your doctor will explain the specific instructions if you are switching from another contraceptive method.
After childbirth, fitting at an outpatient clinic is usually planned once the womb has returned to an appropriate size, no earlier than 6 weeks after delivery. If this recovery takes longer, fitting may need to be postponed.
The procedure takes place on a gynaecological examination chair. Your doctor inserts a speculum, prepares the cervix, checks the direction and depth of the womb cavity and then inserts the system using an applicator. The threads are trimmed at the end of the procedure.
Fitting itself usually takes a few minutes, but the appointment also includes assessment, preparation and aftercare advice. An ultrasound scan may be used to check the position of the system.
Experiences vary, from mild discomfort to stronger cramps and pain. Before the procedure, discuss pain relief and the option of local anaesthesia with your doctor. Pain should not be dismissed.
After fitting, you may experience period-like cramps, spotting or temporary dizziness. Severe or worsening symptoms require medical assessment.
The video illustrates the procedure. The fitting technique depends on the system selected.
Irregular spotting or bleeding is common during the first 3–6 months. Over time, periods usually become lighter and shorter, and some women stop having periods altogether.
An absence of periods can result from suppression of the womb lining and does not mean that blood is building up inside the womb. However, if you develop symptoms of pregnancy, take a pregnancy test and contact your doctor.
New or heavier bleeding after your bleeding pattern has settled, bleeding after sex or persistent symptoms should be assessed by a gynaecologist.
Contraindications listed in the product information include:
The final assessment takes account of your full medical history and the product information for the chosen system. An abnormal cervical screening result does not by itself establish a diagnosis of cervical dysplasia, but it requires assessment before fitting.
Reported side effects include headaches, acne, breast tenderness, mood changes and functional ovarian cysts, which often resolve on their own. Discuss any troublesome symptoms with your doctor.
Less common complications include infection, movement or expulsion of the system, and perforation of the womb wall. The risk of perforation is higher during breastfeeding and when fitting takes place in the period after childbirth. Your doctor will consider these factors during the assessment.
Seek urgent medical advice if you develop: severe or worsening lower abdominal pain, fever, unusual vaginal discharge, very heavy bleeding or a positive pregnancy test. Pregnancy with a coil in place is rare, but if it occurs, an ectopic pregnancy must be excluded.
A change in weight while using a hormonal coil does not necessarily mean that the coil is the cause. However, it would not be appropriate to promise that no patient will gain weight. If you notice a substantial change, discuss it with your doctor, who can also assess other possible causes.
According to the product information, the first check is due 4–12 weeks after fitting Mirena and 4–6 weeks after fitting Kyleena. Further appointments are usually arranged annually, or sooner if clinically indicated.
If you can no longer feel the threads, their length has clearly changed or you can feel the hard part of the system, do not try to reposition it yourself. Contact your gynaecologist. Use condoms or avoid sexual intercourse until the correct position has been confirmed.
The coil can be removed earlier if you wish to change contraception, plan a pregnancy or have a medical reason for removal. Fertility returns quickly, and pregnancy is possible during the first cycle after removal.
If you are not planning a pregnancy, agree on your contraceptive arrangements before the appointment. Sexual intercourse during the 7 days before removal is also relevant. Your doctor will explain whether additional contraception is needed beforehand and how to maintain protection.
The replacement date depends on the type of system and the reason for using it. Not every hormonal coil needs to be replaced after 5 years.
Visit Tartaczna 2 Medical Centre at 2 Tartaczna Street in Gdańsk city centre. Consultations to help you choose a hormonal coil are available with Dr Marek Korożan, Dr Dominika Kozikowska and Dr Volha Khitrun.
When booking, please specify whether you need an assessment, fitting, replacement or removal. Our reception team will provide the current price and explain whether it includes the system itself, the procedure and any additional investigations.
To book, contact our reception team, call +48 58 719 10 25 or check appointment availability on ZnanyLekarz.
