An IUD (intrauterine device) is a small, T-shaped device that a doctor or nurse fits into your womb to prevent pregnancy. It doesn't use hormones. Instead, it releases copper, which stops sperm surviving in the womb. That's why you'll also hear it called the copper coil.

It's one of the most effective forms of contraception available on the NHS, working from the moment it's fitted and lasting for 5 or 10 years, depending on the type. It's also over 99% effective, which means fewer than 1 in 100 people using one will get pregnant in a year.¹

Types of IUD

There are a few different copper IUDs available in the UK, and they vary slightly in size and how long they last, usually somewhere between 5 and 10 years. Your doctor or nurse will help you choose the right one for you based on your womb size and how long you want it to last.¹

IUD vs IUS

The IUD and the IUS are often confused, and it's easy to see why. Both are small T-shaped devices fitted into your womb, and both are over 99% effective. The difference comes down to hormones.¹,³

The IUD is copper and hormone-free. It can make periods heavier or more painful, especially in the first few months. The IUS, also called the hormonal coil, releases the hormone progestogen, which thins the womb lining. It often makes periods lighter, shorter and less painful, and for some people, periods stop altogether.

IUD vs the pill

The biggest difference is effort. The pill needs to be taken at roughly the same time every day, and missing doses lowers how well it protects you. The IUD is a "fit and forget" method. Once it's in place, you don't need to think about it again until it's due for removal or replacement.

Both are highly effective when used correctly, but the IUD takes daily routine out of the equation entirely.

Implant vs IUD

The contraceptive implant and the IUD are both long-acting, but they sit in different places and work differently. The implant is a small rod placed under the skin of your upper arm, and it releases progestogen to stop your ovaries releasing an egg each month. It currently protects against pregnancy for 5 years.⁴

The IUD, by contrast, sits inside your womb and works without any hormones at all. If you'd rather avoid hormonal side effects, the IUD may suit you better. If you'd prefer not to have anything fitted internally, the implant could be worth discussing with your GP.

How does an IUD work

Once it's in place, the IUD releases small amounts of copper into your womb. This changes the environment inside the womb in a way that stops sperm from surviving, so it can't reach and fertilise an egg. Copper can also make it harder for a fertilised egg to implant in the womb lining.¹

None of this involves hormones, which is why some people choose the copper IUD specifically to avoid hormonal side effects like mood changes or acne.

How to get an IUD

Contraception is free and confidential on the NHS. You can get an IUD fitted at a sexual health clinic, some GP surgeries, or some young people's services. You'll usually need to book an appointment first, and the clinician will talk through your medical history to check the IUD is suitable for you.⁵

Before it's fitted, you might be offered a test for sexually transmitted infections and a pregnancy test, since an IUD can't be fitted if there's a chance you're pregnant.⁶

How is an IUD inserted

The appointment itself usually takes around 30 minutes, though the fitting only takes about 5 to 10 minutes. A nurse or doctor will gently insert a speculum, similar to a smear test, then insert the IUD into your womb through your cervix.⁶

Most people feel some discomfort during fitting. Taking paracetamol or ibuprofen an hour beforehand can help, and you can ask about extra pain relief, such as local anaesthetic, if you're worried. You can also bring someone with you for support, and you can ask the clinician to stop at any point.⁶

IUD cost

IUDs are free through the NHS, including the appointment, fitting and any follow-up care. If you choose to go private, costs typically range from around £150 to £300 for the device and fitting, though this varies by clinic and location. It's worth checking directly with a private provider for an up-to-date quote.⁵

Aftercare following IUD insertion

The days and weeks after fitting come with a few things worth knowing, from mild side effects to how to check everything's in place.

What not to do after IUD insertion

You might have period-like cramping and some light bleeding for a few days after fitting, which is normal. Painkillers like paracetamol or ibuprofen can help. Some clinics advise avoiding vaginal sex and tampons for the first few days to reduce the small risk of infection, so it's worth asking your clinician what they recommend for you.

How long does it take for IUD strings to soften

Your IUD has two thin threads that hang down slightly from your womb. These can feel a little firm or noticeable at first, but most people find they settle and become less noticeable within a few weeks as your body adjusts. If anything feels uncomfortable or doesn't seem to improve, it's worth getting it checked by your GP or clinic rather than waiting it out.

How to check IUD strings

The person who fits your IUD will show you how to feel for the threads. It's worth checking a few times in the first month, then regularly after each period. Wash your hands, then use a finger to feel up towards your cervix for the soft threads. You shouldn't feel the hard plastic of the device itself.⁶

If you can't feel the threads, or they suddenly feel longer or shorter than usual, contact a sexual health clinic, your GP or NHS 111 straight away, since you might not be protected against pregnancy.⁶

Can you use tampons or a menstrual cup with an IUD

This is a common question, and guidance can vary slightly between clinics. Some NHS trusts advise avoiding tampons and menstrual cups for the first few weeks after fitting to lower infection risk, while others confirm it's generally safe once you're comfortable, as long as you're careful.

If you do use a menstrual cup, take care with placement. Fitting it too high can trap the IUD threads against the vaginal wall, which risks pulling the device out of place, so make sure the cup sits below the threads and always release the seal gently before removing it. When in doubt, ask your fitting clinic what they recommend for your specific device.

IUD side effects and risks

Most people tolerate an IUD well, but it's worth knowing what's normal and what's not. Common side effects include period-like pain for a few days after fitting, bleeding between periods, and periods that become heavier, longer or more painful, especially in the first few months. This often settles over time.²

Rare risks include pelvic infection, usually within the first three weeks after fitting, and the IUD moving or coming out, usually within the first three months. There's also a small risk of damage to the womb, and a rare chance of ectopic pregnancy if the IUD fails.²

Signs of IUD infection

Contact your GP urgently or call NHS 111 if you have lower tummy pain that painkillers don't help, sudden pain that's getting worse, a high temperature, abnormal or smelly discharge, very heavy bleeding, or if you can't feel your threads or they feel different. These can be signs of infection or a problem with the device, and it's better to get it checked quickly.²

IUD advantages and disadvantages

What's good about it:

• Over 99% effective, with no daily routine to remember
• Works as soon as it's fitted, and lasts 5 to 10 years
• No hormones, so no hormonal side effects
• Safe to use while breastfeeding
• Fertility returns to normal straight away once it's removed¹

What's worth weighing up:

• Periods can become heavier, longer or more painful, particularly early on
• A small chance of pelvic infection or the device moving
• Fitting can be uncomfortable, especially for first-timers
• Doesn't protect against STIs, so condoms are still needed²

Pregnant with an IUD

Getting pregnant with an IUD in place is rare, since it's over 99% effective, but it can happen, and it's worth knowing the signs. If you notice a missed period alongside other pregnancy signs, or unusual pain and bleeding, take a pregnancy test and contact your GP promptly.¹

It's also important to be aware of ectopic pregnancy, where a pregnancy develops outside the womb. This is more likely if an IUD fails. Symptoms can include pain on one side of your lower tummy, vaginal bleeding that looks different to a normal period, and pain in the tip of your shoulder. If you think you might be pregnant and have any of these symptoms, contact your GP or call NHS 111 straight away, even without a positive pregnancy test.

Life after IUD removal

A trained doctor or nurse can remove your IUD at any time, and it's possible to get pregnant as soon as it's taken out. If you're not planning to conceive straight away, use another method like condoms from about a week before removal.⁶

You might also be wondering about weight after removal. There's currently no strong evidence that a copper IUD affects your weight, either while it's in place or after it's removed. Any changes to your cycle after removal tend to settle within a few months as your body readjusts, but your fertility itself returns to previous levels straight away.

Thinking about trying for a baby after your IUD

Once your IUD is out and you're ready to start trying, it's a good moment to think about what comes next. This is exactly where twoplus can help.

The twoplus Applicator Extra is designed for couples trying to conceive at home. It's an at-home insemination kit that deposits sperm close to the cervix, working with your body's own timing rather than replacing it. It's produced in a clean room and is a step some couples choose to try before, or alongside, more involved routes like IUI or IVF, always alongside advice from your GP if you have any concerns about your fertility.

Pairing the Applicator with an ovulation test kit can help you get a clearer picture of your most fertile days, and fertility supplements may support your overall reproductive health as you start trying. Together, these are simple, low-pressure ways to feel more in control of your journey, at home, on your own schedule.

Why twoplus can be a natural next step

Coming off contraception is often the real starting point of trying to conceive, and it's normal to want practical tools that fit into everyday life. twoplus is built around that: straightforward products designed for couples trying at home, without adding extra stress to an already personal process.

Frequently asked questions

Does getting an IUD hurt? Most people feel some discomfort during fitting, similar to period cramps. Painkillers beforehand can help, and you can ask about extra pain relief if you're concerned.⁶

How soon can I get pregnant after having my IUD removed? It's possible to get pregnant as soon as your IUD is taken out, since fertility returns to previous levels straight away.⁶

Can an IUD move or fall out? It's uncommon, but it can happen, usually within the first three months after fitting. Checking your threads regularly helps you catch this early.²

How often does an IUD need to be replaced? This depends on the type, but most last between 5 and 10 years. Your clinic will confirm the exact date when it's fitted.¹

Sources

1. NHS – What is an IUD (intrauterine device) or copper coil?: https://www.nhs.uk/contraception/methods-of-contraception/iud-coil/what-is-it/
   
2. NHS – Side effects of an IUD (intrauterine device) or copper coil: https://www.nhs.uk/contraception/methods-of-contraception/iud-coil/side-effects/
   
3. NHS – What is an IUS (intrauterine system) or hormonal coil?: https://www.nhs.uk/contraception/methods-of-contraception/ius-hormonal-coil/what-is-it/
   
4. NHS – What is the contraceptive implant?: https://www.nhs.uk/contraception/methods-of-contraception/contraceptive-implant/what-is-it/
   
5. NHS – Where to get an IUD (intrauterine device) or copper coil: https://www.nhs.uk/contraception/methods-of-contraception/iud-coil/where-to-get-it/
   
6. NHS – Getting an IUD (intrauterine device) or copper coil fitted or removed: https://www.nhs.uk/contraception/methods-of-contraception/iud-coil/getting-it-fitted-or-removed/