No hormonal coil

A hormonal coil releases a progestogen inside the uterus. Declining it may mean choosing a barrier method, a non-hormonal intrauterine device, another contraceptive, or no contraception if pregnancy is desired. The best option also depends on whether heavy bleeding, pelvic pain, endometrial protection, or cycle changes are part of the reason for considering a coil. Conditions such as fibroids, adenomyosis, endometriosis, polycystic ovary syndrome, or perimenopause may change the discussion.

Write down your priorities: pregnancy prevention, lighter bleeding, pain control, avoiding hormones, ease of use, or future fertility. Ask about how each option works, expected bleeding changes, insertion or removal, interactions, and follow-up. If heavy periods are leaving you tired or breathless, assessment for iron deficiency anaemia may be appropriate. Do not stop an existing method until replacement protection is arranged.

Arrange prompt review for very heavy bleeding, severe or worsening pelvic pain, fever, unusual discharge, a positive pregnancy test with pain, or bleeding after menopause. Seek urgent help for collapse, severe pain, or heavy bleeding with weakness. A clinician can check for causes such as fibroids or endometrial problems and discuss treatment safely.

Which non-hormonal and hormonal options fit my priorities? Could my bleeding or pain suggest another condition? How quickly does alternative contraception become effective?