How long does a hormonal coil take to work for endometrial hyperplasia?

The coil releases progestogen inside the womb. This counters the effect of oestrogen on the endometrium and can help the lining become thinner. Bleeding or spotting may be irregular during the early adjustment period, so bleeding alone cannot show whether the hyperplasia has cleared. Your clinician may plan an examination, ultrasound, or endometrial biopsy after treatment has had time to act. The follow-up interval depends on the type of hyperplasia, the biopsy result, your bleeding pattern, and whether pregnancy is being considered.

Attend coil checks and any biopsy or imaging appointment, even if bleeding improves. Keep a simple record of bleeding days, flow, pelvic pain, discharge, and fever. Check that you can feel the threads if your clinician has shown you how, and report a change in their length or a coil you can feel in the vagina. Ask when the womb lining will be reassessed and whether the coil must remain in place for the whole treatment period. Discuss contraception and future pregnancy plans before changing the device.

Seek prompt medical advice for heavy or persistent bleeding, new severe pelvic pain, fever, unusual-smelling discharge, dizziness, or a positive pregnancy test with pain or bleeding. Urgent care is needed for fainting, severe pain, or heavy bleeding that makes you feel weak. These symptoms may indicate infection, expulsion, pregnancy-related complications, or another problem that needs examination. Do not wait for the scheduled review when symptoms are sudden or severe.

What type of hyperplasia was found on my biopsy? When will you check whether the lining has responded? Will I need another biopsy? How should I manage unexpected bleeding? What should I do if the coil threads change or cannot be felt?