Davina McCall hit the head lines this week as she bravely underwent a coil fitting procedure whilst being filmed. Davina has been a champion of women’s health, having been a front runner in her plight to bring menopause front and centre and get employers, and us as a society, to recognise the huge impacts these hormonal changes can have on a women’s life. She is now taking her cause to accessibility of contraception.
Davina’s first big action was to demonstrate first-hand the coil fitting procedure and any pain associated. Davina, by her own admission, benefitted from a hugely experienced clinician and the use of a cervical block for anaesthetic. Having read many comments on Davina’s Instagram she advocates that all women are entitled to ask for pain relief. Whilst this is not untrue, it is very unlikely the average NHS Nurse or GP, is able to perform a cervical block as so few would have received this training. There are also other options, such as, gas and air (Entonox), which can help not only with the pain but also with allowing you to relax during the procedure. Again, whilst commonly available in NHS settings, gas and air, is rarely stored in a GP surgery’s or sexual health clinics where you are likely to be having a coil fit performed.
It is commonly thought that coil fitting procedures are uncomfortable but not unbearable. Now this may well be the case for the average person, but we must recognise that not all women are the same. Additionally, this is only based on reported post-fitting pain. I’d argue women are a stoic lot and put up with an awful lot before reporting of pain. We need to recognise the importance of pain relief for women during these procedures. The gold standard for pain relief for a gynaecological procedure would be general anaesthetic or an epidural. Now we realise for the majority of women this is probably not necessary in the primary care setting, and is unachievable in the NHS to offer to all women. There are also huge risks involved with these types of anaesthesia. There needs to be a balance between mitigating risks to women, and reducing pain and discomfort.
So, what can realistically be done to help women manage pain during coil fitting procedures?
At Oxona we take pain management seriously. Here is what we do to ensure you are as comfortable as possible:
- All patients should take ibuprofen (3x200mg tablets) about an hour before the procedure to reduce discomfort. If you are unable to take ibuprofen, you may take paracetamol (2x500mg tablets)
- We ensure you fully understand the procedure, and what you will experience afterwards. Our extended appointment lengths give you time to ask questions. Understanding what will happen will help to reduce anxiety, which in turn can help you relax and reduce your pain
- All our patients are given a topical local anaesthetic called Instillagel. This is a gel squeezed onto the cervix. Its active ingredient is lidocaine, a local anaesthetic and this will numb the cervix.
You will be given a choice in other pain relief options.
- Gas and air (Entonox). This is commonly used in childbirth and is an excellent analgesic as it wears off very quickly so is good for short procedures.
- Cervical block. One of our clinician’s, Dr Welch, is able to offer this service in our Chipping Norton clinic. This procedure involves injecting local anaesthetic into the neck of the cervix. This blocks the nerves and all feeling in the cervix. It lasts around 3-4 hours.
Most importantly, we do not disregard your pain. We acknowledge these procedures are painful, uncomfortable and can be distressing for some women. Our clinicians will do everything they can to help minimise any pain. We have the luxury of time in our clinic, we take things slowly, and work with you as a patient.
We also offer a range of coil choices. We realise it is not one size fits all, quite literally. Did you know different coils are different sizes? They are designed to suit different women. All women will have a different sized uterus, a different angled cervix and personal experiences of different hormones. Our expert clinicians can discuss this with you and prescribe a copper or hormonal coil that suits you, your lifestyle and your history of using contraception.
We have in stock a range of copper coils, (including the very smallest possible to get), Mirena, Jaydess, Benilexa, Kyleena, Levosert. We can usually get an initial appointment for women in the same week, with the coil fitting procedure the following week if appropriate to your cycle.
Our private coil fitting procedures cost £330. This includes an initial consultation either in person or on the phone, the procedure and a string check if desired. Our prices include the cost of any pain relief with the coil fitting or local anaesthetic. Please note that in addition to this fee you will need to purchase the coil at cost price. We offer coil fitting in our Oxford clinic and our Chipping Norton clinic. We will be opening our St Albans clinic in July and taking bookings from mid-June.