What if a hormonal coil does not relieve painful periods?

The coil may need time to settle, or its hormone effect may not be enough for your symptoms. Pain can also come from conditions such as endometriosis, adenomyosis, fibroids or pelvic infection. Ongoing pain does not by itself show that the coil is unsuitable, and painful periods are not proof of a serious disease.

A clinician may ask when the pain occurs, whether it is getting worse, how heavy the bleeding is and whether you have pain with sex, urination or bowel movements. They may check the threads and examine you; an ultrasound can help assess the coil and pelvic organs when needed.

Keep a short record of pain, bleeding, medicines and any missed activities. Take pain relief only as directed and tell the clinician about stomach, kidney, liver or bleeding problems before using anti-inflammatory medicines. Do not remove the coil yourself.

Book a non-urgent appointment with the clinician who fitted it or another gynaecology service. The discussion may cover changing pain relief, treating heavy bleeding, checking for an underlying condition, or choosing another contraceptive or period-management approach.

Seek urgent medical care for severe or rapidly worsening pelvic pain, fainting, fever, vomiting, unusual or foul-smelling discharge, very heavy bleeding, or a positive pregnancy test with pain or bleeding. Seek prompt review if the threads suddenly feel different or you cannot feel them and pregnancy is possible.

Ask how long the coil should be given to work, whether its position needs checking, which pain pattern needs investigation, and what alternatives fit your contraceptive and pregnancy plans.