Wondering what to expect when you're saying goodbye to your coil, be it the copper Intrauterine Device (IUD) or the hormonal Intrauterine System (IUS)?

The good news is that it is a quick and straightforward process, and under normal circumstances, the removal shouldn’t take more than a few minutes.

When to remove or replace the coil?

Reasons for waving farewell to your coil might include:

• It's time for a replacement (these trusty devices last between 3-10 years).
• You're eyeing a different contraception method.
• You're experiencing side effects.
• Pregnancy plans are on your horizon.

How does coil removal happen?

The removal of both IUD and IUS follows the same procedure. It involves the use of a speculum to keep the vaginal canal open, allowing your healthcare provider to visualise the cervix and access the IUD strings. The strings are then gently pulled using forceps, with the IUD arms folding up as it's withdrawn through the cervix. 

Compared to the insertion process, many find removal to be quicker and less painful.

A note on precautions before removal

If you're using the Mirena coil and are not planning a pregnancy, you will need to use barrier protection for seven days prior to removal. This precaution prevents potential pregnancy after removal due to sperm's ability to survive for several days within the female reproductive system.

Are there complications?

For most, IUD or IUS removal is a routine and uncomplicated procedure, but rarely, there can be complications – it may be embedded (stuck) in the tissue in your uterus, the strings may have moved and be difficult to locate, or a piece of the device may break off. If a complication does happen, a nurse or doctor will know what to do to safely remove it.

Can you remove your coil at home?

No. You should never try to remove a coil by yourself or by a non-trained health professional. Despite the “remove your IUD at home” TikTok challenge (yes, really), IUD removal should always be left to a qualified healthcare provider. DIY removals can lead to injury and other complications. Leave this procedure to those trained to handle it safely and effectively.

How painful will it be? 

Pain experiences vary widely, and it's okay to feel anxious. To ease discomfort, consider over-the-counter pain medication like paracetamol in the hour beforehand, and discuss the possibility of local anesthesia with your provider. If you encounter pain or if the process becomes overwhelming, communicate with your provider—you have the right to ask them to stop at any time.

What can you expect immediately after removal?

After the coil is out, you may experience some soreness, cramps, or light bleeding. Using pads or menstrual underwear may be helpful here. If you notice persistent pain, heavy bleeding, severe cramps, fever, chills, or unusual discharge, speak to a healthcare provider. 

For those transitioning back to a natural menstrual cycle, it's common to experience premenstrual syndrome (PMS) or a reemergence of symptoms that were previously managed by the hormonal coil such as heavy periods. 

The 'Mirena Crash'

Some individuals report experiencing a cluster of symptoms similar to PMS after the removal of a hormonal IUD, often referred to as the 'Mirena crash.' These can include mood swings, hormonal fluctuations, and discomfort. While these are not universally recognized in medical literature, they are valid experiences. If these symptoms persist or affect your quality of life, speak with your healthcare provider.

How long will it take for hormones to start working regularly? 

Copper Coil Users: Since the copper coil is hormone-free, there will be no hormonal changes post-removal.

Hormonal IUD Users: Hormonal levels and menstrual cycles can take some time—typically up to 3 months—to normalize after IUD removal. This is because the hormonal IUD often thins the uterine lining, which can result in lighter periods or a complete halt. After removal, your body needs to gradually rebuild this lining.

If menstruation hasn't resumed within six months post-removal, speak with your healthcare provider. 

How quickly can you conceive after removal? 

Fertility can rebound quickly after coil removal, so it's important to have a contraception plan in place if you're not looking to conceive. If you desire another coil, insertion can often occur in the same appointment as removal.