“When I counsel women on copper coil insertion, I often advise them to take a simple over-the-counter painkiller like paracetamol one hour before their appointment, if no contraindication. People should also speak to their coil insertion provider about their options before attending for their appointment, as some people have some local anaesthetic applied to the area by their coil inserter which helps to numb the tissues and reduce sensation,” says Dr Macaulay.

“We know that people who feel informed and relaxed have a better experience, highlighting the importance of taking plenty of time to chat through what the procedure involves, discussing concerns and making a plan for each patient. The truth is that there is no significant evidence to show taking painkillers before the procedure does much (though it may help with pain afterwards), nor does the use of local anaesthetic gel. There is some evidence to show the use of anaesthetic creams applied an hour before coil insertion can help and this is an area we need to look into more,” says Dr Sullivan.

“Injecting anaesthetic into the cervix can help, but some patients may prefer to give the fitting a go before having an injection into their cervix, which in itself can be painful. Sedation and general anaesthetic are reserved for difficult fittings as they carry their own risks, but absolutely should be considered for people wanting a coil but who have found it too much when fully conscious. However, it’s important to understand that many coils are fitted in sexual health clinics which are funded very differently to hospitals. We are not trained nor funded to provide sedation and general anaesthetic to our patients and for those needing this sort of care, they’ll need to be referred to a different service.”

IUDs: healthcare experts answer the most important questions