To be scared of coil insertion?

[Loungingbutnotforlong]

Triggered by the recent post on cervical smears, I’m asking for advice on coil insertion. I’ve had one before- put in under GA.

I find smears painful- I need them to use the smallest speculum. does a coil insertion take much longer than a smear?

beyond taking paracetamol, I assume there is nothing to be done. What sort of pain should I expect. How will I know if it’s ‘normal’ pain (I am being wimpy), or whether it’s not going to work for me?

Yabu- woman up
YANBU - it’s v painful

Ask for pain relief (numbing gel/spray) and let them know about smear issues. It’s incredibly quick - seconds, but there’s lots they can do which isn’t always routinely offered, like the pain relief. I’ve had 3 without and was fine (not painful just a weird split second feeling) but don’t have your issues - the pain relief is there for you, The coil is life changing btw.

Mine was very quick. It was painful but only for about a minute. I just did some deep breaths and held the nurse's hand. They are very reassuring and said they would stop at any time. Took paracetamol 30 mins before. Honestly much better than I was expecting.

I think you can have local anesthetic?

I agree that explaining your issues and requesting pain relief will be important for you.

I've never had issues with smears and I found my could insertion quick but painful.

Mine lasts until next year but I will go for a second, it hasn't put me off.

Thank you- I didn’t know about the local pain relief, so I’ll definitely ask for that.
I’m hoping it goes well as my perimenopause periods are horrendous- really impinging on life and keeping me trapped in the house for fear of leaks every few weeks.

Coil stopped my periods at 30, haven’t had any of that nonsense for 16 years. Listen to perimenopausal women now and very, very grateful, it’s my fave invention. Absolute game changer OP if it does the same for you.

Pain relief you can ask for and I also go to the “difficult patient” clinic. There’s a better name for it but they do a longer appointment and the staff are great!

if it helps then the speculum bit is as for a smear
i felt a cramp when they were sounding (measuring the uterus)
another cramp when they put the coil in - like a big period pain but so quick I couldn’t finish saying “ow”!
then they trim the strings and give you time to sit up, get dressed etc
i usually keep the rest of the day free as I cramp after

It’s the complex coil clinic (not difficult patient 😂) - I went to one the other day after a failed attempt to replace my coil previously. I have a retroverted uterus and quite a clamped shut cervix apparently. It was ok. It was pretty uncomfortable for about 2 minutes. Not excruciating- I would rate the pain as 5/10. They put some cooling spray in. They offered me an injection to reduce the pain but I said no. They told me the injection itself stings a bit so I decided to try without. I went straight to work after (not ideal).

Do you have DCs OP? I don't and was advised to have mine done while I was under GA for a gynae issue as apparently it's more painful if your cervix hasn't been stretched by labour. I don't know if this is true or not, just what I was told by my gynae.

Ask for all the pain relief, not just paracetamol.

OP- do you have a retroverted uterus? That can make insertion more painful and tricky- not impossible at all though. If you do, then despite what you think, a long speculum is better for visualising the cervix.

Yes I was about to ask the same. I can very much believe it’s less painful when you’ve had kids. I’ve had two and never get periods pains at all now, pre-kids they were much more painful. Stretched to hell I would say now! 😬

Sorry OP, I have a high pain threshold (3 births with no pain relief at all). But the coil insertion is the worst pain I've ever experienced.
The coil itself worked brilliantly at stopping postmenopausal bleeding, but even so I wouldn't do it again.
Get all the pain relief.

Take paracetamol and ibuprofen 1h before, then call them in advance to say you want them to make a note for the nurse - so that they bring it out. If they don't know in advance they may say rebook or do it without ir - it just makes sure they have it ready and you don't have to stress etc.

When you call reception, ask them to make sure the nurse/doctor prepares it all, and for reception to put a note on your appointment. Say on the phone you want licodaine injected into your cervix (a local anesthetic, but be specific - all Gps will have it as they use it for other minor procedures etc) and also numbing gel/spray as well, and lubricant as well - somtimes with people with vaginismus etc it helps to relax the coil and get the speculum in easily.

You can't get a referral to complex coil insertion clinic without having

1. The GP nurse/doctor etc fail to get the coil in
2. Maybe it falls out previously, prolapse issues etc
3. Another conditon like vaginismus and they offer it to you initially.

The coil clinic, is basically just done in the hospital in a room which a special chair etc, sometimes stronger anesthetic, the often do an ultrasound after to check the position is good as well.

You'll be fine, take deep breaths and stay calm - that will relax the cervix and make it easier, also they'll be a chaperone - they are happy for your to squeeze their hand if you need to.
When is your coil insertion date? Is it the mirena or copper one?

Also I recommend getting a hand warmer, like the small ones you activate with pressing, and after sit on it. Like put it in your trousers or on the chair/bed and sit on it through your trousers. It helps soothe the area for me, maybe wait a bit if you don't want high heat. I hope it goes well and it's not painful for you.

Well, I found it total agony, passed out from the pain. The first time. Second time they gave me local spray anaesthetic, didn't make the blindest bit of difference.

Third time I asked for, and got, GA.

Taking it out I had the local again (needle in my cervix, oh yeah, fucking great) and I screamed. That was at the complex clinic because the strings had got tangled up. I'm done now, 57 and it's all in the past now.

I do wonder why they don't offer sedation. I had that for both a colonoscopy and a endoscopy and it's fine, don't feel anything. But no, we're expected to just put up with it.

Sorry to put you off. I kept being told "it will be fine, it's uncomfortable, might hurt a bit but it's very quick" etc, and one memorable doctor "yes, I've heard it does smart a little". None of that was my experience.

But, I guess it all beat having to bring up kids!

This seems to be one of those things that varies enormously. I was going to have the coil as part of HRT treatment. With me the pain was so bad I left the hospital feeling traumatised and I have a high pain threshold. Never again. I have children but they are adopted so have never given birth.

i left the hospital without having it done as my cervix opening was too small. This was despite taking pesseries beforehand to supposedly help soften and open it up. I didn’t even realise having a GA was an option until speaking to people about it afterwards.

I take the pill for this reason. I find anything like a smear test and vaginal exams very traumatic.

Make sure you're not too warm when you're having it inserted. So, don't wear a thick jumper or anything like that. A friend of mine works at a GP surgery and it is relatively common for people to faint during/after the procedure. There has also been more than one occasion where the woman has vomited and soiled herself , which was horrendous for all concerned. So keep cool and take pain relief!

I fainted during mine, not from pain but from pressure on a nerve, apparently it’s quite common. But it made such a difference to me in perimenopause. You can email the clinic in advance.

Thanks so much everyone for the advice.
@TheLivelyViper I’ll ring today- appointment is Tuesday, so hopefully they can get organised.
I did have a coil 10 years ago, but they put it in via general anaesthetic, after a failed painful attempt. I have given birth as well, so that did not seem to help.
im having the mirena coil- which i had in the past and stopped my periods (after initial 3 months of constant bleeding.) I’m anemic now from such heavy periods, so I am really hoping this works.

The pain is really very short lived, just long enough for me to shout “F%#*+#g hell!” very loudly and apologise to the doctor. Definitely worth it - my horrific peri periods stopped straight away.

That’s the one I forget the name every time and they always laugh and get what I mean!

Make sure to ask your GP for an iron infusion, as if your levels are as low as they sound you'll be eligible. It might be good to have one or two then use oral iron pills as well, whilist the mirena kicks into gear.

Also as the mirena settles, ask for tranexamic acid or northisteron from your GP - a smallish dose, to use occasionally when your bleeding is still heavy as the mirena settles.

They may not have your previous failed attempt on record. Obviously they won't do general just for a coil, they'll be doing another op and then might as well do it at the same time sort of thing. However if you do want the complex coil clinic you would be waiting longer as it is the gynaecology ward, and so a F1/F2, some more trained nurses are needed, and they'll be using them for ultrasounds, and other things, so they often don't do many clinics across the month, so it can be a few months wait often. I'd still go on Tuesday, make sure they have everything and then hopefully it all goes fine.

Have you called them yet?

I hope it goes well for you, the pain relief should definitely help. If you have Co-codamol take 1 or maybe half of 1 (if it is the over the counter dose, maybe 1 as it is a lower dose). It is capped at 8/50mg, whereas prescription ones can be higher. Obviously don't use it regularly nit good if something worse happens and addiction risk etc. You could also use the paracetamol and ibuprofen definitely 1h before, and after if it very painful use 1 Co-codamol, but get the hand warmers I also mentioned ready, as they help.

Do you have pain with your bleeding? Of so ask your GP to prescribe you an NSAID so naproxen, or mefenamic acid or other ones. They help with pain, but crucially always take it with food and omeprazole, and also start taking it before the pain starts, so a few days before your period should start. For tranexamic acid or northisterone, initially for your next period and maybe the 2nd one as well, use it before your period should start as well, but then as the mirena settles, only use it occasionally in a day where bleeding is getting heavy.

Same experience- I found it far more
painful than childbirth, then had horrible cramps and expelled it. Strange how much it varies.

Gel anaesthetic doesn't work for everyone. It's not a quick procedure if your neck of uterus opening is tight, it can be incredibly painful, & yes, the insertion of the coil can be life changing for those with difficult menstrual cycles.

@Loungingbutnotforlong you can ask for insertion to be done as a day case if you find cervical screening painful.

Ask away for an iron transfusion but it’s unlikely she’ll be given one unfortunately, such is the state of the NHS. They’ll make her try iron tablets first no doubt unless she’s extremely lucky. Apparently anaemia is fine for women to endure even though the infusion would help instantly.

I say that as someone who has had severe anaemia and two emergency blood transfusions because I had no iron stores left and they still said I need to take the tablets first. That’s the easiest and cheapest option though of course 🙄