The copper coil, or intrauterine device (IUD), is a small T-shaped device made of plastic and copper that sits inside the womb. It prevents pregnancy for up to 10 years with the device used in Sri Lanka, and it contains no hormones at all.

It is more than 99% effective, and because there is nothing to remember day to day, it works just as well in real life as it does in theory.

How it works

Copper changes the environment inside the womb so that sperm cannot survive or move properly, which stops fertilisation. It also makes it harder for a fertilised egg to implant. It does not affect your natural hormones or your ovulation — your cycle continues as normal.

Why women choose it

  • No hormones — useful if hormonal methods have not suited you, or if you would rather avoid them
  • Very long-lasting — up to 10 years from a single fitting
  • Immediately reversible — fertility returns as soon as it is removed
  • Cost-effective over its lifespan
  • Works immediately from the moment it is fitted
  • Safe while breastfeeding

What fitting is actually like

We would rather be straight with you about this than have you arrive expecting nothing.

Fitting takes only a few minutes and is done in a clinic room without general anaesthesia. A speculum is used, as for a smear test, and the device is passed through the neck of the womb.

Most women find it uncomfortable, and some find it painful. The sensation is usually strong period-like cramping that peaks briefly as the device passes through the cervix. It passes quickly. Some women feel faint immediately afterwards. Taking a simple painkiller an hour beforehand helps, and you should ask about pain relief options if you are anxious — that is a reasonable thing to raise, not a fuss.

Cramping and spotting for a few days afterwards are normal.

How it affects your periods

This is the main trade-off, and worth understanding before you decide.

The copper coil commonly makes periods heavier, longer and more painful, particularly in the first 3 to 6 months. For many women this settles. For some it does not, and it is the usual reason the copper coil is removed.

If your periods are already heavy or painful, this may not be the right method for you — the hormonal coil tends to do the opposite and make periods lighter. It is worth discussing which of the two suits your situation.

The copper coil as emergency contraception

A useful fact many women do not know: a copper coil fitted soon after unprotected sex is the most effective form of emergency contraception available — considerably more effective than emergency pills. It can then simply stay in place as your ongoing method. If you need emergency contraception, ask whether this is an option for you.

Afterwards

Two thin threads pass through the cervix into the top of the vagina. You can feel for them occasionally to check the device is still in place. You will be shown how. If you cannot feel the threads, or you can feel the hard plastic of the device itself, use condoms and get it checked.

See a doctor if you have persistent pain, unusual or smelly discharge, fever, or bleeding after sex.

Who it may not suit

The copper coil may not be suitable if you have an untreated pelvic infection, unexplained vaginal bleeding, certain abnormalities in the shape of the womb, or a copper allergy. Women with very heavy or painful periods are usually better served by another method. Your doctor will discuss your history before fitting.

The bottom line

The copper coil offers up to 10 years of highly effective, hormone-free contraception with nothing to remember. The trade-offs are an uncomfortable fitting and periods that are often heavier and more painful, at least at first. If those are acceptable to you — and particularly if you want to avoid hormones — it is a very good option.

References

  1. National Health Service. Intrauterine device (IUD) [Internet]. NHS; [cited 2026 Jul 22]. Available from: https://www.nhs.uk/conditions/contraception/iud-coil/
  2. National Health Service. Contraception [Internet]. NHS; [cited 2026 Jul 22]. Available from: https://www.nhs.uk/conditions/contraception/
  3. World Health Organization. Medical eligibility criteria for contraceptive use. 5th ed. Geneva: WHO; 2015. Available from: https://www.who.int/publications/i/item/9789241549158