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Minor Gynaecology Procedure Clinic

Why have I been referred to this clinic?

This clinic sees women who need a procedure in the outpatient setting with or without local anaesthesia (pain relief) for:

  • heavy menstrual bleeding, bleeding between your periods or after intercourse.
  • a cervical polyp (small growths of tissue on the neck of your womb)
  •  cysts or lesions in the vagina or vulva
  • problems with insertion or retrieval of an  intrauterine system (IUS) (a method of contraception)
  • treatment of cervical ectropion (when the cells from the inside of your cervical canal are present in the outside of the neck of the womb) needing treatment.

You will attend a scheduled appointment time. Please allow 1-2 hours for your consultation.  We would also suggest that you arrange for someone to help take you home and that you have the rest of the day off work.

What is the use of the intrauterine system (IUS)?

An IUS is used for contraception, heavy periods and as part of hormone replacement therapy (HRT). It may be used for 4-5 years.

It is a very small, flexible, plastic device which sits inside the womb (uterus). It contains low dose progesterone, a hormone which is used to keep the lining of the womb thin. It has two very fine threads that are used to remove the coil or IUS easily at any time.

Before your appointment:

For most procedures carried out in the clinic it is important that you are not pregnant. If you are sexually active and of child-bearing age, you must use contraception from your last menstrual period before your appointment, otherwise we may not be able to complete your procedure during this appointment. 

If you are coming for an IUS or coil replacement, please abstain from sex for the seven days before your appointment or consistently use condoms during this time.

If you are coming for an IUS or coil insertion:

This can be inserted at any time during the menstrual cycle, but it is ideally inserted within the first 5-14, days as the neck of the womb may be softer and more open and it also helps to avoid insertion whilst you are pregnant. Please contact us to reschedule if needed.

Your appointment may also need to be rescheduled if you have any of the below issues. Please discuss with one of the nurses (telephone numbers provided at the back of the leaflet) as soon as possible if you:

  • are bleeding heavily on the day
  • did not use the appropriate contraception as above
  • have symptoms of infection such as new onset of pelvic pain and/or vaginal discharge (please contact your GP urgently)

For further information please visit: https://www.nhs.uk/conditions/contraception/ius-intrauterine-system/

You can eat and drink normally before your appointment.

For some procedures we may give you a local anaesthetic to numb the area. However, you may still experience some pain after certain procedures, so we advise you take simple pain killers (eg. paracetamol) one hour before the procedure.

What investigations or procedures might I have?

Speculum or vaginal examination:  This will allow the doctor to assess the cervix (neck of the womb) and if needed, apply a local anaesthetic to numb the area to reduce pain and discomfort.

Cauterisation: using heat to treat a layer of cells on the cervix (neck of the womb) under local anaesthetic.  This can only be done if a recent smear test is normal.

Biopsy: small sample of tissue which may be taken from your cervix, lining of the womb, vagina or vulval area. This will be sent to be examined under the microscope. We will give you either a follow up appointment or write a letter with the results.

For vaginal or vulva cysts you may sometimes have a few stitches to stop bleeding. This will not hurt as local anaesthetic will be used.

For insertion or retrieval of an IUS or coil, an ultrasound scan, or a hysteroscopy (use of a camera to look inside of the womb) may be required.

You may need to provide a urine sample for a pregnancy test.

After the procedure:

Some procedures (for example taking a biopsy) can cause bleeding. The bleeding will not be heavy but may last a few days. To reduce the risk of infection, use sanitary towels and not tampons for this bleeding.

You may be offered an antibiotic to reduce the chance of infection. Continue simple pain killers if you experience any discomfort.

Unprotected sexual intercourse may not be advised – please ask your doctor after the procedure.

What are the possible complications of these procedures?

  • Abdominal pain, like a period, is commonly experienced with some procedures.
  • Mild bleeding is commonly experienced. This may stop immediately or persist as spotting or irregular bleeding for a few months in the case of an IUS  or coil insertion.  
  • Less than 1 in 100 chance of infection after the procedure.

In case of a coil or IUS insertion:

  • 1 in 1000 women can have a perforation of the womb at the time of insertion. If you experience ongoing abdominal pain, a scan may be requested and the IUS may need to be removed. Rarely this requires a general anaesthetic.
  • A 1 in 200 chance of failure (if pregnancy should occur, there is a higher risk of an ectopic pregnancy).
  • A 1 in 20 chance of the IUS being expelled. A six-week thread check is recommended. If the threads cannot be felt or seen, a scan can verify if the coil or IUS is in the correct place.

When to contact your doctor after the procedure:

  • If the bleeding is very heavy
  • If you develop a temperature or an offensive smelling discharge
  • You have persistent abdominal or lower back pain not controlled with the medications you have at home.

Although rare, if you experience very heavy bleeding, severe pain or feel dizzy and unwell, you may need to be seen in the Accident and Emergency Department instead.

For Intrauterine system (IUS) information:


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