To be terrified about coil fitting on Wednesday?

[user1483284537]

Long term MN lurker here but first time poster, so um hi

I'm going to start taking medication soon which requires the use of contraception because it causes birth defects. My doctor won't prescribe it to me unless I have a coil fitted so I have an appointment on Wednesday to have it fitted.

Bit embarrassing at my age (22!) but I've never had sex and can't use tampons because I find them too sore.

AIBU to be terrified that this is going to hurt but also be wondering htf it is even going to be fitted in the first place?

Someone please tell me it won't be that bad....

I'd imagine a speculum would be painful if you've never had sex because having a PIV automatically makes it bigger 🙄

OP i wouldn't worry too much, although definitely raise your concerns before hand and see if they are willing to offer an alternative. The reason you can't manage tampons could be something simple, it is unlikely to be because they don't fit, so a small sized speculum should be fine when inserted by a trained professional. Also the reason they are reluctant to offer them to women withou children is not because of the ease of inserting, it's more to do with cost - childless 20 something is more likely to want it removed before the 5/10 year limit so the pill is cheaper both for the actual prescription and appointment wise.

I have had 3 coil fittings and none of them have even been remotely sore.

Then why did the consultant gynae tell me that "they must have had a hell of a job getting it in" Reality?

And having sex doesn't make your vagina larger but presumably it make you more used to having things put up it. The first time you had sex was he able to just wang it in no problem? I can certainly have sex much more easily now than I could when it was a new thing.

Netdoctor says this which is very interesting:

"IUDs are not so easy to insert in young women who haven't had children. However, recently there has been some official pressure on doctors to insert IUDs into younger females – so coil usage in this age group seems to be increasing"

Anyway this doesn't help the OP.

OP - can you try and get a telephone appt before the insertion date and explain to them that you have never had sex / a smear / can't use tampons and are there any other options available if you must have long-term contraception? Because there are ones out there and so they really ought to be offering them to you / trying to see which will suit you best rather than going straight in for a coil.

They said to me it's always more difficult if you haven't had penetrative intercourse - due to the presence of a hymen and naturally increased anxiety. My gynaecologist also said it can be harder to go through a cervix that hasn't already been dilated through childbirth, if that sounds right. I know I'm not using the exact right words.

Please don't let them push you into it if you don't feel you can cope. I wish someone had told me I had the power to say 'no' having allowed doctor to force when I was 16 or so, I wish I had said I wasn't comfortable with what they were doing.

As someone that had a small IUD fitted in my early 20s, before being pregnant, I cannot believe they STILL carry this barbaric practice out.

OP I would insist on going somewhere where you can have a nerve block. Seriously.

IUS is a bigger device so unless you are in to torturing people should really never be fitted in women who have not had dilation of the cervix before.

because having a PIV automatically makes it bigger

No but it does mean you're more used to having things up there.

A lot of women find their first time having sex painful. I know my first time was excruciating. So I don't think it's a stretch to say that a woman who hasn't had sex may well find a piece of plastic jammed up her fanjo painful.

Incidentally I always had trouble using tampons prior to having sex. Now I can use them no problem.

Gosh. And this is why you should never ask for medical advice over the internet...
There is a huge amount of misinformation here which I don't want to start a bunfight about.
OP please hold off for now and have a discussion with your derm and / or GP. I know it's not easy but please tell them concerns and that you have not had sex, especially if you don't plan to anytime soon. It is definitely worth asking about the implant too, unless contraindicated with your new medicine, but your derm should be able to tell you if it is.
Good luck and I hope you get it all sorted.

Hm I came to say it's grim but worth it but actually if you're not having sex then it probably isn't. Is it a copper coil? They are the most effective contraception I think so not really a surprise they're pushing it but I would explain your specific circumstances and see if there's another, more suitable option - or if there is some way to make the procedure more comfortable for you. I'm sure I've read on here of women being able to get sedation or even general anaesthetics for coil insertion. It's definitely worth being open with gp!

Health Care Professionals get a fee for every coil they fit.
I had a terrible few years when every time I visited the Dr -neck problem/knee issue I would be asked about my periods/family planning guidance and the Mirena Coil pushed/promoted.
I'm sure the implant would be a better option releasing I'm guessing (not a happy myself) the same hormones.
I have many friends that claim Mirena has changed their lives for the better but all of them had hideous menstrual issues. I know a few that have had problems and 2 needing hospital intervention.
I would be asking about other options and asking very very specifically the exact list of reasons why it can only be the coil and not other similar/hormonall forms of contraception.

WetNovember,
Where are you getting the information that healthcare professionals get a fee for every coil they fit?? I've never ever heard that and it seems a bit dubious to me.

If you haven't had sex and don't plan to do so in the near future then you don't need the coil fitting.

Nor should you have to agree to take any other contraceptive.

You are fully aware of the issues which could arise should you become pregnant whilst taking the skin medication. Ultimately it should be your decision - not for the doctors to pressure you into it.

This is from an acne forum. The post is about a woman who need to go on Roaccutane but her doctor refuses to prescribe without contraception despite her being celibate.

www.acne.org/messageboard/topic/264876-to-females-going-on-accutane/

This is medieval.

Barbaric of the doctor.

OP please don't agree to this, I wouldn't have a coil and I have given birth twice.

Your position in this whole scene needs to be respected.
You are not having sex, so no need for the coil.
If your GP won't agree then find another doctor.

I wasn't a virgin when I had mine fitted but I hadn't had DC. I had a copper coil fitted and I am always shocked when I read these threads how many women had a bad experience. Mine consisted of one cramp at the moment of insertion which made me wince and that was it. Five seconds of pain maximum. However during labour the midwife asked my husband if I had always had a high pain threshold so I may not be very representative! Hopefully you will also have a good experience :)

Whether or not other posters found the coil easy to fit or not is not the point.

The point is that the doctor has no right to be controlling the OP like this.

The coil sounds great if you need contraception and other methods are causing problems. That's why it is provided as an alternative.

But to insist on it being fitted when the patient (a) doesn't need contraception and (b) hasn't been offered gentler alternatives does seem very wrong. Like others I think you should see the GP again and insist on another method.

I had a mirena coil fitted and had never had a child. It was done by a family planning clinic who do them all the time.
It hurt quite a lot, I almost passed out, and when it needed changing a couple of years back I asked to be referred to a gynecologist, they struggled so much so that they gave up and I had to have it done under spinal anaesthetic.
I wouldn't let my GP put one in...

I agree mind! Was just trying to reassure OP and anyone else reading this thread who is considering the coil that it's not always bad.

GP definitely shouldn't be insisting on the coil. I work with doctors who prescribe a medication that is associated with birth defects. When planning to get pregnant patients are advised to take a safer alternative, however if they refuse the doctor does not refuse to prescribe their normal medication. The birth defect risk is one for the patient to decide on not the doctor.

The birth defect risk is one for the patient to decide on not the doctor.

Exactly.

Can you go to a family planning clinic fir advice. I got mine put in at a clinic and it was good because nobody knows you, there is a wealth of specialist knowledge and if you do need a procedure they are doing them all say every day.

When I requested mine they were initially reluctant as I was told they generally don't suggest them for women who have not had children yet. I got the impression this was to do with ease of insertion more than anything else.

Fwiw this is outdated advice. The coil is now being actively promoted as an excellent option for childless women due to its reliability, lack of hormones and long lasting nature. There is still something of a hangover from thirty to forty years ago when there were more problems with them and so some doctors still subscribe to the idea that they are primarily for women who already have children. I had my first one fitted pre children and loved it.

That said I think the doctor should discuss alternative contraception like the implant if the OP does not wish the coil. They are keen on the contraception even though OP is not currently having sex because 1) this could change any day, 2) people lie to their doctors, a lot, about how much sex they are or are not having, 3) some women are sadly in a position where they are not in control of their bodies/sex lives.

Mirena has hormones. Don't know if this is what's been offered to OP or copper coil.

I am really dubious about women being encouraged to take on this and other forms of contraception that they can't easily stop / remove, when they don't know what the side effects for them are going to be.

I thought putting 16 yo on the pill the whole time was bad but this is worse. When will we get some more options that don't involve such a high level of possible side effects and deeply unpleasant ways of getting them into you and then problems if you want them out? Anyway - that's a side rant

Mirena are real marmite looking at threads on here. Mine gave me side effects and I had it out (was always OK on the pill).

I'm disgusted by this to be honest. The doctor has no right to say you have to have a coil if you're to be prescribed a certain medication. Please go back and make that very clear. Raise merry hell frankly but do not just accept the coil.

I'm not a virgin, but I've never had a pregnancy. I found the fitting of Mirena coil quite painful, but it doesn't take long to fit so it's over quite quickly. It is a harder procedure if you've not had a vaginal birth, but not impossible.

Things I'd consider if I were you, OP:

I actually only lasted six weeks with Mirena coil before I had it removed. I was depresssed and irritable as soon as it was fitted, and bled every day it was in, including a 12-day period with cramps that had me rolling on the floor with pain. The day after it was removed, my irritability and depression lifted. This doesn't happen to everyone though, it's just something to bear in mind. I imagine the bleeding would have righted itself eventually, but I don't think the depression would have.

If you go ahead with it, have it fitted at your family planning clinic rather than your GP. Family planning fit them day in, day out, whereas your GP will only likely fit them occasionally. It should be an easier process at your family planning, especially as you've not had a vaginal birth.

I've no idea if it's true about GPs pushing Mirena coils because of fees or whatever, but they do seem to encourage them. If you need a simple birth control just for the sake of your other medication, if it were me, I'd be researching the pill, the implant or condoms.

It's advisable that you take a decent contraceptive if you're on things like roaccutane. However if you're not sexually active then your contraception is abstinence which is 100% effective. Your GP should not be refusing you unless you have a coil. He should be informing you of the risks and documenting the discussion.

FWIW I'm a family planning doctor and the idea that you have to have had a child for a fit is very outdated. I've fitted them in teenagers who have tolerated it fine and mums of 6 who found it awful.
If you want one anyway then get it but otherwise you can refuse. The procedure does have risks so needs to be done for good reason.
I'd only let a GP fit mine if they did at least 2 a week.