Among modern women, many use the intrauterine device to prevent unwanted pregnancy in their bodies. But not everyone fully understands principle of operation of the intrauterine device.
The principle of operation of the intrauterine device
The intrauterine device is a kind of gynecological device that mechanically prevents unwanted fertilization of a woman:
The spiral accelerates the progress of the fertilized egg through the fallopian tubes. In such a short period of time, a fertilized egg does not have time to be enriched with all the necessary qualities. These qualities, in turn, with natural conception, contribute to the further fixation of the embryo inside the uterine cavity.
In addition, the intrauterine device mechanically prevents the penetration of the egg into the uterine cavity. A fertilized egg, not finding a cozy place for itself, dies over time and is excreted from the female body during menstruation.
The components that make up the intrauterine device reduce the ability of the spermatozoon to perform its functional duties. This greatly enhances the contraceptive effect of this type of female contraception.
Advantages of the intrauterine device
What are the advantages of the Navy:
The first positive moment when using an intrauterine device is the high efficiency of this method of contraception. About 97% guaranteed.
Spirals are very easy to use and do not require preliminary preparatory measures before sexual intercourse.
The presence of a spiral in the uterine cavity does not affect the normal course of a woman's life.
At the same time, the complete absence of discomfort during intimacy and the prevention of unwanted pregnancy.
The intrauterine device does not affect the lactation period in any way and is perfect for women who have recently given birth and are breastfeeding.
The principle of operation of the intrauterine device does not affect the natural process of the reproductive function of the female body. Namely: during ovulation, the egg continues to mature, and the overgrown layer of the intrauterine epithelium is periodically rejected. The latter is evidenced by monthly menstrual bleeding.
After removing the intrauterine device, a woman can easily become pregnant in the near future.
Disadvantages of the intrauterine device
But this method of contraception has disadvantages:
A spiral is one way or another a foreign body inside the female body. That is, the intrauterine device can be rejected by adjacent tissues. This is evidenced by the occurrence of inflammatory processes in the uterine cavity after the installation of this contraceptive device.
You can not use the intrauterine device for nulliparous women. Due to the possible inflammatory process in the area of the internal genital organs, a woman can forever remain infertile.
May cause more painful periods with heavy bleeding.
Does not guarantee 100% absence of unwanted conception and may lead to ectopic pregnancy.
It should be noted that the installation of an intrauterine device should be carried out only by a gynecologist and after a complete medical examination of the woman. Come to our medical center in Moscow, and we are guaranteed to select the best method of contraception for you, taking into account all the characteristics of your body. Modern medical equipment and the experience of the medical specialists of our clinic will help to detect the presence of diseases of your genital organs even at the earliest stage. This will help to preserve your women's health as much as possible and prevent unwanted consequences after installing the intrauterine device.
In the article we discuss the intrauterine device. We talk about its types, when put, possible side effects. You will find out whether it is possible to get pregnant with an IUD, whether it is harmful to women's health, and what are the consequences after its use.
An intrauterine device (abbreviated as IUD) is a contraceptive device, which is a device made of synthetic material (medical plastic). It is injected into the uterine cavity, due to which pregnancy does not occur.
The dimensions of modern spirals are 24-35 mm. They contain metals that do not provoke inflammation (copper, silver, gold) or the hormone levonorgestrel.
The action of the intrauterine device
The Navy has the following operating principles:
- Suppression of ovarian function and slowing down ovulation. During the use of the intrauterine device, the hypothalamic-pituitary system is slightly stimulated. This provokes some increase in the secretion of levonorgestrel, while maintaining the production of progesterone, estrogen. Along with this, there is an increase in the amount of estrogens, as well as a shift in their peak in the middle of the cycle for several days.
- Obstruction or failure of implantation. During phase 2, there is a noticeable rise in progesterone, and a decrease in the duration of the second phase. There is a cyclic change in the endometrium, but there is a failure of the synchronism of these transformations. The first phase is lengthened, there is a partial maturation of the uterine mucosa, and this does not allow the fertilized egg to penetrate into the endometrium. The presence of copper in the helix helps to increase the absorption of estrogen, and levonorgestrel activates the early maturation of the endometrium, followed by rejection before the egg has time to securely anchor in the uterus. This effect of the IUD is abortive.
- Aseptic inflammation in the uterine cavity, violation of the movement of spermatozoa. The presence of the IUD in the uterine cavity irritates its walls, thereby stimulating the secretion of prostaglandins by the uterus. These substances activate the partial maturation of the endometrium, as well as aseptic inflammation in the uterine cavity. At the same time, the amount of prostaglandins in the cervical mucus increases, which stops the penetration of spermatozoa into the uterine cavity. Due to aseptic inflammation due to the presence of the IUD, the number of leukocytes, histiocytes, macrophages increases. All these cells increase sperm phagocytosis, isolating the fertilized egg, preventing it from implanting in the endometrium.
- Change in the nature of the movement of the egg through the fallopian tube. The secreted prostaglandins accelerate the peristalsis of the uterine tubes. Because of this, an unfertilized egg enters the uterus (its meeting with the sperm occurs in the tube) or fertilized, but at a time when the endometrium is not ready for implantation.
Pros and cons of the intrauterine device
If you are thinking about whether to put an intrauterine device, we suggest that you familiarize yourself with its main advantages and disadvantages.
Advantages
The most important advantage of using the IUD is the ability to forget about the need to protect yourself from unwanted pregnancy for a period of 3 to 10 years, based on the type of spiral. The contraceptive effect occurs immediately after the installation of the spiral. At the same time, the degree of protection against unwanted conception is up to 98 percent.
The coil is easy to install and also easy to remove. It is not necessary to wait until its expiration date ends, you can ask a gynecologist and she will immediately pull it out for you. After the coil is removed, pregnancy usually occurs after several cycles, in some cases in the first menstrual cycle. In this case, the restoration of fertility occurs quite quickly.
Contraception using an intrauterine device allows a woman to decide for herself about planning a child. Your spouse or boyfriend may not be aware that you are using an IUD, since a man does not feel it during intercourse. The spiral does not affect the general condition of the body, does not worsen the course of extragenital diseases.
The IUD does not require daily monitoring, which is convenient compared to birth control pills, which must be taken daily and at a specific time. Taking various medications does not have any effect on the effect of the spiral. With the IUD, you can perform various surgical interventions and even breastfeed the baby.
Flaws
The main disadvantage of the IUD-spiral can only be attributed to the fact that after its installation, the cervix remains open. This is dangerous due to the possibility of pathogenic microorganisms penetrating into it, which provoke inflammatory processes in the small pelvis (endometritis and adnexitis). And this happens regardless of the fact that the spiral is made of metal, which has a disinfecting effect.
In the first few months after the installation of the spiral, a feeling of aching pain in the lower abdomen is possible. This is due to increased sensitivity of the uterus or improperly selected IUD.
The presence of a foreign object in the uterus and regular mechanical damage to the endometrium in the area of contact with the spiral provokes an increase in menstrual flow and the duration of menstruation. In some cases, this later leads to anemia.
Sometimes an ectopic pregnancy occurs during the use of the IUD-spiral. It is quite dangerous, as in some cases it leads to death.
The introduction of a spiral into the uterine cavity leads to thinning of the uterine endometrium. In the future, this adversely affects the ability to become pregnant, increasing the risk of miscarriages. Anomalies in the structure of the female genital organs are a ban on the installation of the IUD, since in this case there is no guarantee of protection against unwanted pregnancy.
Another disadvantage of the intrauterine device is the possibility of its loss. This usually happens during menstruation. Since not everyone can notice the prolapse of the IUD, this can lead to unwanted conception.
The IUD coil does not protect against sexually transmitted infections. Therefore, it is better to put it only if you have a permanent man, and for protection with casual partners, it is better to use a condom.
Only women who have given birth can put a spiral, which makes this method of protection inaccessible to those who have not yet known the delights of motherhood. It is forbidden to insert or remove the IUD by yourself. All manipulations should be carried out by a gynecologist. It should be borne in mind that once every six months you will have to visit a gynecologist to check the spiral.
Sometimes the spiral grows into the uterus. In this case, surgery may be required to remove it.
The intrauterine device brings not only benefits, but also harm. Therefore, it is important to take a responsible approach to its choice, follow all the recommendations of a specialist and remember that you can install an IUD only after childbirth.
Types of intrauterine device
There is no universal IUD that is suitable for all women. The gynecologist chooses the best option for an intrauterine contraceptive, based on the structural features of the uterus and the physiological state of the patient.
There are currently over 50 contraceptive spirals on the market.
All types of Navy are divided into 4 generations:
- inert;
- copper;
- silver, gold;
- hormonal.
Now let's look at each type in more detail.
inert
They belong to the first generation and are obsolete. They are characterized by low efficiency, often fall out and are displaced, for this reason their use is prohibited in many countries. Members of this group:
- plastic Lips loop;
- Mauch steel ring with 2 scrolls;
- double helix Saf-T-Coil.
Copper
This type of vaginal coil belongs to the 2nd generation. This is a small T-shaped or semi-oval device, its core is wrapped with copper wire. The device is easy to install and remove.
The presence of copper in the composition of the product allows you to create an acidic environment in the uterine cavity, as a result of which the activity of spermatozoa is greatly inhibited. Such contraceptives are installed for a period of three to five years.
The most famous models of this series:
- Juno Bio;
- Multiload;
- Nova T.
With silver
Any metal can oxidize and break down. For this reason, to extend the life of the copper IUD, manufacturers began to add silver to its core. Because of this, the spermatotoxic effect is enhanced several times, and silver ions, which have a disinfectant and antibacterial effect, have a beneficial effect on the female body.
The term of use of such a contraceptive is from 5 to 7 years.
Golden
Gold Navy is an alternative to silver and copper items. Its main advantage is complete biological compatibility with a woman's body, the absence of allergic manifestations, and the resistance of the metal to corrosion damage.
The device made of gold has anti-inflammatory properties, perfectly protects against unwanted conception. The service life of such a spiral is from 5 to 10 years, and after its removal, reproductive functions remain in a normal state.
Hormonal
The latest generation of IUDs are hormone-containing devices. According to doctors, they are the most effective means of contraception.
Such an IUD has a T-shape, in its leg there is a hormonal drug (levonorgestrel and progesterone), which is evenly released in small doses into the uterine cavity.
This contraception has no contraindications, because the hormone does not penetrate into the bloodstream, providing only a local effect: it eliminates inflammation, inhibits ovulation, and prevents the fertilization of the egg. You can use such a product from 5 to 7 years.
Naval forms
It is extremely difficult to say exactly which contraceptive spiral is the best. This product is selected individually, based on the characteristics of the structure of the uterus and personal preferences. Before choosing a contraceptive device, be sure to consult a gynecologist.
Below we will talk about the main forms of the Navy and their distinctive features.
T-shaped
They are the most common. They are easy to use, install and remove. The T-shaped product has the shape of a rod, from which 2 flexible shoulders extend.
Hangers help to fix the product in the uterine cavity. At the end of the rod is a special thread, with which you can easily remove the contraceptive.
annular
The device is easily attached in the uterine cavity and removed. There are no additional threads in it, since they are not needed.
Loop-shaped
This form of IUD can be in the form of an umbrella. On the outer edges of this product there are spike-like protrusions, thanks to which the spiral is securely fixed in the uterine cavity, thereby reducing the risk of its falling out.
A contraceptive product in the form of a loop is used by women who have a non-standard structure of the uterus. And in this case, they do not have the opportunity to use the T-shaped IUD.
Installation of an intrauterine device
Naval spiral install:
- giving birth to women after an abortion, if it passed without inflammatory complications;
- women over 35 who have already given birth and have contraindications to taking oral contraceptives;
- women who have a low risk of genital tract infections in the absence of pathologies of the cervix.
For the introduction of a spiral into the uterine cavity, some preparation will be required, since this procedure is a medical intervention. Before installing the spiral, it is necessary to undergo an examination and cure all chronic gynecological diseases.
What examinations need to be done before installing the spiral:
- consultation with a specialist to collect anamnesis;
- gynecological examination to determine the size and position of the uterus;
- Ultrasound of the pelvic organs to detect the presence or absence of inflammation and formations in the uterine cavity and appendages;
- general urine and blood tests;
- bacteriological culture of the discharged vagina, cervix;
- blood tests for HIV infection;
- delivery of a smear for cytology, microflora from three points.
Immediately before the introduction of the spiral, the specialist probes the uterus, measures the length and distance between the uterine angles. Many women ask the question on what day they put the IUD. It is placed on the 3-4th day of menstruation, since during them the cervix is ajar, and this facilitates the process of introducing a contraceptive. In addition, the blood that is released during critical days reduces the possibility of injury to the uterus, and also means no pregnancy at the time of installation.
Slight pain in the lower abdomen after the introduction of the spiral, as well as spotting, are considered the norm, being just a reaction of the uterus to the penetration of a foreign body into it. In the first few days, physical activity is prohibited. You can return to intimate life 7-14 days after the installation of the contraceptive, based on well-being.
After installing the spiral for 2-3 months, small spotting may appear. With the correct installation of the spiral, neither a woman nor a man feel it.
After the introduction of an intrauterine contraceptive, you need to come to the gynecologist for a check-up in a month, then in three months and after that every six months.
IUD removal
Elimination of an intrauterine contraceptive device occurs in several stages. If you do not want to become pregnant, then 7 days before the removal of the IUD, exclude unprotected intimate intercourse. This is due to the ability of spermatozoa to remain active for 2-3 days, as well as the possibility of ovulation after the removal of the IUD. As a result, conception may occur.
It is desirable to remove the spiral on the 3-4th day of menstruation, in which case the pain from the procedure will be minimized. But at the same time, you can remove the product on any day of the cycle, but only if you feel good.
The procedure begins with an examination in the gynecological chair. The specialist examines the uterus to find the tendrils of the IUD. After that, he introduces a dilator to stabilize the uterus, and treats its cavity with antiseptics.
The patient inhales deeply and slowly, after which the doctor hooks the antennae of the product with forceps, gently removing it from the uterine cavity. Now you can easily get the spiral by hand. During critical days, gliding is better.
The total duration of the procedure is several minutes, taking into account the preparation. Normal symptoms after removal of the IUD are muscle spasms, cramps, and slight bleeding. As a rule, these signs disappear within a couple of days. If there are no health problems and if desired, immediately after the removal of the IUD, you can install a new coil.
Many women are concerned about the question of whether it is painful to remove the intrauterine device. According to reviews, inserting an IUD is more painful than removing it. Therefore, as a rule, anesthesia can be dispensed with during the procedure.
What is the best intrauterine device
There are many remedies for unwanted pregnancy in pharmacies. Naval spirals are in particular demand among women.
Depending on your financial capabilities and physiological characteristics, the gynecologist will recommend which is best to put an intrauterine device. Below we will talk about the most popular contraceptive intrauterine devices.
Mirena
Mirena is considered the most effective hormonal IUD. It has a T-shape, so it is suitable for use on most women.
The product has a high degree of protection against unwanted pregnancy, inhibits ovulation, reduces the possibility of ectopic pregnancy, eliminates inflammation in the reproductive system, and regulates the menstrual cycle.
The service life is from 5 to 7 years. Price - 7-10 thousand rubles.
Nova T
Made in a T-shape. In the budget version it is made of plastic and copper, in the expensive version it is made of silver.
The product adversely affects spermatozoa, reduces their mobility and the ability to fertilize an egg. The price of the tool is from 2 thousand rubles, while the service life is no more than 5 years.
Juno
Belarusian doctors were engaged in the development of this spiral. There are many varieties of this spiral on sale, among which are for women in labor and those who do not yet have children. The price of the product ranges from 250-1000 rubles.
The main types of the Juno model:
- Juno Bio Multi - F-shaped with serrated edges. Can be used by women who have given birth and those who have had an abortion.
- Juno Bio Multi Ag - made in a T-shape. The leg of the product is wrapped with copper and silver threads.
- Juno Bio-T is an inexpensive option in the form of an anchor with a copper thread on the stem.
- Juno Bio-T Super - the same as the previous model, but with an antimicrobial composition.
- Juno Bio-T Au - golden spiral, suitable for women with metal allergies.
Goldlily
Goldlily (also called Lily) is an effective non-hormonal product that helps prevent unwanted pregnancies. The main metals of the remedy are gold and copper. These materials release some metal into the uterine cavity, which has an anti-inflammatory effect.
According to the instructions, this intrauterine device can be used for emergency contraception after unprotected or interrupted intercourse during the first days after it. Copper ions have a spermicidal effect.
This spiral is made of polyethylene in a T-shape, wrapped in metal wire. The service life is up to 7 years.
Multiload
This product is made in the form of an umbrella, protrusions of spikes are located on its sides, which help to securely fix the product in the uterine cavity. The leg of the product is wrapped with copper, which inhibits spermatozoa and neutralizes their ability to fertilize.
The spiral can be used in nulliparous. The price of the device is from 3500 rubles.
Side effects
After the installation of the intrauterine device, side effects are extremely rare. Modern IUD manufacturing technologies minimize their risk of formation.
But in some cases, you should not postpone a visit to the gynecologist after the introduction of the spiral, especially if you have such signs:
- pain in the lower abdomen;
- discomfort during intimacy;
- heavy bleeding;
- there are signs of infection (bad smell, unusual vaginal discharge, burning or itching in the perineum);
- spotting during intercourse;
- shortening or lengthening of the threads from the spiral.
Contraindications
It is forbidden to put or use the IUD-spiral in certain cases:
- endometriosis;
- anemia;
- pregnancy;
- diseases of the endocrine system;
- acute inflammatory processes of the penis;
- the presence of an ectopic pregnancy in the past;
- abnormal uterine structure;
- bleeding in the uterus;
- problems with blood clotting;
- formations in the uterine cavity;
- chronic inflammatory processes of the penis;
- cervical dysplasia.
Intrauterine device - photo
Price
Several factors affect the final cost of installing an IUD. Among them - the type of product and the clinic in which the installation will take place. This type of contraception is affordable for most women.
In some antenatal clinics, the IUD is installed free of charge. It will not be superfluous to know that taking oral contraceptives, as a rule, is more expensive than the IUD.
You can buy a spiral in a pharmacy or online store. How much it costs is affected by the model, material, manufacturer, the presence or absence of side effects. The price of an IUD ranges from 300-10,000 rubles.
Prevention of unwanted pregnancy, or contraception, helps a woman maintain her health:
- reduces the frequency of abortions;
- helps to plan pregnancy and prepare for it;
- in many cases, it has an additional therapeutic effect.
One type of contraception is intrauterine. It is used most often in China, the Russian Federation and Scandinavia. In everyday speech, the concept of "intrauterine device" is often used.
Advantages of intrauterine contraception:
- relatively low cost;
- long period of use;
- rapid restoration of the ability to bear children after the removal of the spiral;
- the possibility of use during breastfeeding and with concomitant diseases;
- therapeutic effect on the endometrium (when using a hormonal intrauterine system);
- preservation of the physiology of sexual intercourse, lack of preparation, fullness of sensations during intimacy.
Types of intrauterine devices
Means for intrauterine contraception are of two types:
- inert;
- medical.
Inert intrauterine contraceptives (IUDs) are plastic products of various shapes that are inserted into the uterine cavity. Their use has not been recommended since 1989, when the World Health Organization declared them ineffective and dangerous to women's health.
Currently, only coils containing metals (copper, silver) or hormones are used. They have a plastic base of different shapes, close to the shape of the inner space of the uterus. The addition of metals or hormonal agents can increase the effectiveness of the coils and reduce the number of side effects.
In Russia, the following VMCs have gained the greatest popularity:
- Multiload Cu 375 - has the shape of the letter F, covered with a copper winding with an area of 375 mm 2, designed for 5 years;
- Nova-T - in the form of the letter T, has a copper winding with an area of 200 mm 2, designed for 5 years;
- Cooper T 380 A - copper-containing T-shaped, lasts up to 8 years;
- hormonal intrauterine system "Mirena" - contains levonorgestrel, which is gradually released into the uterine cavity, providing a therapeutic effect; calculated for 5 years.
Less common are IUDs that secrete medroxyprogesterone or norethisterone.
Which intrauterine device is better?
This question can be answered only after an individual consultation, taking into account the woman's age, her state of health, smoking, the presence of gynecological diseases, future pregnancy planning and other factors.
Mechanism of action
The principle of operation of the intrauterine device is the destruction of spermatozoa and the violation of the process of attachment of the embryo in the uterine cavity. Copper, which is part of many IUDs, has a spermatotoxic effect, that is, it kills spermatozoa that have entered the uterus. In addition, it enhances the capture and processing of spermatozoa by special cells - macrophages.
If fertilization does occur, the abortive effect of the contraceptive begins, preventing the implantation of a fertilized egg:
- contractions of the fallopian tube increase, while the fertilized egg enters the uterus too quickly and dies;
- the presence of a foreign body in the uterine cavity leads to aseptic (non-infectious) inflammation and metabolic disorders;
- as a result of the production of prostaglandins in response to a foreign body, the contractility of the walls of the uterus is activated;
- when using an intrauterine hormonal system, endometrial atrophy occurs.
The Mirena intrauterine system constantly secretes the hormone levonorgestrel at a dose of 20 mcg per day from a special tank. This substance has a progestogenic effect, inhibits the regular proliferation of endometrial cells and causes its atrophy. As a result, menstruation becomes scarce or completely disappears. Ovulation is not disturbed, the hormonal background does not change.
Is it possible to get pregnant if there is an intrauterine device? The effectiveness of intrauterine contraception reaches 98%. When using copper-containing products, pregnancy occurs in 1-2 women out of a hundred within a year. The effectiveness of the Mirena system is several times higher, pregnancy occurs in only 2-5 women out of a thousand during the year.
How to put an intrauterine device
Before inserting an IUD, you need to make sure that you are not pregnant. The procedure can be carried out regardless of the phase of the menstrual cycle, but best of all on the 4th-8th day of the cycle (counting from the first day of menstruation). Be sure to analyze smears for microflora and purity, as well as ultrasound to determine the size of the uterus.
The procedure takes place on an outpatient basis without anesthesia. This is a virtually painless procedure. In the first days after the introduction of the spiral, aching pains in the lower abdomen caused by uterine contractions may disturb. The first and 2-3 subsequent periods may be heavy. At this time, spontaneous expulsion of the spiral is not ruled out.
After artificial abortion, the spiral is usually installed immediately after manipulation, after childbirth - after 2-3 months.
The introduction of an IUD after a caesarean section is carried out six months later to reduce the risk of infectious complications. Spirals can be used during breastfeeding, which is their great advantage.
After the introduction of the IUD for a week, a woman is prohibited from:
- intense physical activity;
- hot baths;
- taking laxatives;
- sex life.
The next examination is scheduled for 7-10 days, and then in the absence of complications after 3 months. A woman should independently check the presence of IUD threads in the vagina after each menstruation. An examination by a gynecologist is enough to pass once every six months, if there are no complaints.
Removal of the intrauterine device
Removal of the IUD is carried out at will, with the development of certain complications or after the expiration of the period of use. In the latter case, you can introduce a new contraceptive immediately after removing the previous one. To remove the IUD, an ultrasound is first performed and the location of the helix is clarified. Then, under the control of a hysteroscope, the cervical canal is expanded and the spiral is removed by pulling on the "antennae". If the "antennae" breaks off, the procedure is repeated in the hospital. If the intrauterine device penetrates the uterine wall and does not cause complaints, it is not recommended to remove it unnecessarily, as this can lead to complications.
Complications of intrauterine contraception
Side effects of the intrauterine device:
- pain in the lower abdomen;
- genital infection;
- uterine bleeding.
These symptoms do not develop in all patients and are considered complications.
Pain in the lower abdomen
Occur in 5-9% of patients. Cramping pain, accompanied by bloody discharge, is a sign of spontaneous expulsion of the IUD from the uterine cavity. To prevent this complication in the period after the introduction, nonsteroidal anti-inflammatory drugs are prescribed.
Constant intense pain occurs if the contraceptive does not match the size of the uterus. In this case, it is replaced.
Sudden sharp pains may be a sign of perforation of the uterus with the penetration of part of the spiral into the abdominal cavity. The frequency of this complication is 0.5%. Incomplete perforation often goes unnoticed and is diagnosed after unsuccessful attempts to remove the IUD. With complete perforation, an emergency laparoscopy or laparotomy is performed.
genital infection
The frequency of infectious and inflammatory complications (and others) ranges from 0.5 to 4%. They are difficult to tolerate, accompanied by severe pain in the lower abdomen, fever, purulent discharge from the genital tract. Such processes are complicated by the destruction of the tissues of the uterus and appendages. For their prevention, broad-spectrum antibiotics are prescribed for several days after the introduction of the IUD.
Uterine bleeding
uterine bleeding develops in 24% of cases. Most often it is manifested by heavy menstruation (menorrhagia), less often - intermenstrual blood loss (metrorrhagia). Bleeding leads to the development of chronic iron deficiency anemia, manifested by pallor, weakness, shortness of breath, brittle hair and nails, dystrophic changes in internal organs. To prevent bleeding, two months before the installation of the spiral and within 2 months after that, it is recommended to take combined oral contraceptives. If menorrhagia results in anemia, the IUD is removed.
The onset of pregnancy
IUD reduces the likelihood of pregnancy. However, if it does occur, the risk is higher than among other women.
If pregnancy occurs during the period of using the spiral, there are three scenarios for the development of events:
- Artificial termination, because such a pregnancy increases the risk of infection of the embryo and in half of the cases ends in spontaneous abortion.
- Removal of the IUD, which can lead to spontaneous abortion.
- Preservation of pregnancy, while the spiral does not harm the baby and is released along with the fetal membranes during childbirth. This increases the risk of pregnancy complications.
The ability to conceive and bear a child is restored immediately after the removal of intrauterine contraception, pregnancy occurs within a year in 90% of women who have not used other methods of contraception.
Indications for use
This type of contraception in nulliparous women can cause serious complications that prevent future pregnancy. An intrauterine device for nulliparous women can be used only if it is impossible or unwilling to use other methods. For such patients, mini-coils containing copper are intended, for example, Flower Cuprum.
It does not make sense to install an IUD for a short time, so a woman should not plan a pregnancy for the next year or longer.
IUDs do not protect against sexually transmitted diseases. On the contrary, they are believed to increase the risk of developing and worsen the course of such diseases.
Most often IUDs are used in the following situations:
- increased fertility, frequent pregnancies against the background of an active sexual life;
- temporary or permanent unwillingness to have children;
- extragenital diseases in which pregnancy is contraindicated;
- the presence of severe genetic diseases in a woman or her partner.
Contraindications to the intrauterine device
Absolute contraindications:
- pregnancy;
- endometritis, adnexitis, colpitis and other inflammatory diseases of the pelvic organs, especially acute or chronic with constant exacerbations;
- cancer of the cervix or body of the uterus;
- previous ectopic pregnancy.
Relative contraindications:
- uterine bleeding, including heavy menstruation;
- endometrial hyperplasia;
- congenital or acquired deformity of the uterus;
- blood diseases;
- severe inflammatory diseases of internal organs;
- previously occurring spontaneous expulsion (expulsion) of the IUD;
- intolerance to the components of the spiral (copper, levonorgestrel);
- no childbirth.
In these situations, the appointment of an intrauterine hormonal system is often justified. Its use is indicated for endometrial pathology, heavy bleeding, painful menstruation. Therefore, the gynecologist will be able to choose the right intrauterine device after examining and examining the patient.
The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!
Every woman has a moment when she thinks about becoming a mother. But for many girls, sexual life begins before they are ready for motherhood, and for family life in general. Especially in modern women, the planning of a child is postponed until the full realization of oneself in other areas of life.
Well, if a woman has already become a mother, and maybe more than once, then there are few who want to repeat this feat a dozen more times and give birth every year. That is why, since ancient times, people have adapted to not getting pregnant without desire. In order to deceive nature, unpretentious methods of contraception were invented (from the Latin word contraceptio - exception). They started with various essential oils, fruit juices, tampons, lotions, broken contact, cloth pouches (precursor to the condom) and so on.
As you can see, the spiral affects all the processes necessary for conception:
- vitality and speed of movement of spermatozoa;
- egg maturation and ovulation;
- attachment of the fetal egg to the endometrium.
Pros and cons of using intrauterine devices
| Advantages of the IUD | Disadvantages of the Navy |
| Convenient to use, the spiral is set for a period of 3 to 10 years or more. It does not require daily procedures, special hygiene care and drinking pills by the hour. In a word, for a long time you can not think about contraception at all and not be afraid of an unwanted pregnancy, but enjoy your sexual relationships. | Not suitable for all women, as it has a number of contraindications. For some women, the spiral does not take root. |
| High Efficiency Method: pregnancy occurs in only 2 out of 100 cases. Inert spirals give lower efficiency, and when using hormonal intrauterine systems, the risk of getting pregnant is reduced to zero. | Yet there is a risk of unplanned pregnancy with a spiral. In addition, the spiral may fall out and the woman may not notice it. But only the removal of appendages or ligation of the fallopian tubes and a complete renunciation of sexual activity gives a 100% result. |
| Preservation of childbearing function immediately after removal of the IUD. | From the use of non-hormonal spirals, it is recommended to refrain from young and nulliparous women., since as a side effect, inflammatory changes in the endometrium of the uterus and appendages may develop, reducing the chances of becoming pregnant in the future. |
| Does not affect the quality of sexual life, that is, sexual attraction, sexual intercourse for both partners and orgasm. | An IUD can cause painful and heavy periods. While hormonal spirals, on the contrary, solve the problems of painful periods. But gestogen spirals can lead to the absence of menstruation, which also negatively affects women's health. |
| Low cost. At first glance, it may seem that some types of spirals are an expensive pleasure. But given the long period of use, this method will be much more economical than those that require application during each sexual intercourse, daily and monthly. | Possible side effects from the use of spirals, unfortunately, their development is not uncommon. |
| IUDs can be used after childbirth during lactation when oral hormonal agents are contraindicated. | Increases the risk of developing inflammatory processes genitals, also the spiral does not protect against sexually transmitted diseases. |
Additionally for hormonal intrauterine systems:
| Increases the risk of developing an ectopic pregnancy. The use of hormonal coils significantly reduces the risk of pathological pregnancy. |
| The procedure for inserting an IUD requires a trip to the gynecologist's appointment, brings discomfort and pain, in nulliparous women, the pain syndrome is especially pronounced, sometimes local anesthesia is required. |
Indications for the installation of an intrauterine device
1.
Temporary or permanent prevention of unwanted pregnancies, especially if the family already has children. Intrauterine devices are ideal for women who have given birth and have a single sexual partner, that is, for those who have a very low risk of contracting sexually transmitted diseases. 2. Frequent unwanted pregnancies, ineffectiveness or inattention of a woman in the use of other contraceptives.
3. Prevention of pregnancy after childbirth, especially cesarean section, after medical abortions or spontaneous miscarriages, when the onset of the next pregnancy is temporarily not desirable.
4. A woman has temporary or permanent contraindications to pregnancy.
5. The presence in the family history of genetic pathologies that a woman does not want to inherit (hemophilia, cystic fibrosis, Down syndrome and many others),
6. For hormonal intrauterine devices - some gynecological pathologies:
- uterine fibroids, especially if it is accompanied by profuse spotting and uterine bleeding;
- profuse painful periods;
- estrogen replacement therapy at the onset of menopause or after removal of the appendages, in order to prevent the growth of the endometrium.
Contraindications
Absolute contraindications to the use of all intrauterine devices
- The presence of pregnancy at any time, suspicion of a possible pregnancy;
- oncological pathologies of the genital organs, as well as breast cancer;
- acute and chronic inflammatory diseases of the female genital organs: adnexitis, colpitis, endometritis, including postpartum, salpingitis and so on, including the presence of sexually transmitted diseases;
- a history of ectopic pregnancies;
- allergic reactions to the materials from which the spiral is made;
- tuberculosis of the reproductive system;
Relative contraindications to the use of non-hormonal coils
- if the woman does not yet have children;
- a woman is sexually promiscuous and belongs to the risk group for contracting sexually transmitted diseases;
- childhood and adolescence*;
- the woman's age is over 65;
- uterine bleeding and heavy painful periods;
- anomalies in the development of the uterus (for example, a bicornuate uterus);
- hematological diseases (anemia, leukemia, thrombocytopenia and others);
- growths of the endometrium, endometriosis;
- urethritis, cystitis, pyelonephritis - acute or exacerbation of a chronic course;
- benign tumors of the uterus and appendages (submucosal fibroids and uterine fibroids);
- prolapse of the intrauterine device or the development of side effects after the previous use of the device.
Relative contraindications to the use of hormonal intrauterine devices (systems):
- cervical dysplasia;
- anomalies in the development of the uterus;
- urethritis, cystitis, pyelonephritis - acute or exacerbation of a chronic course;
- fibromyoma of the uterus;
- liver disease, liver failure;
- severe cardiovascular pathologies: malignant arterial hypertension, condition after a stroke or heart attack, severe heart defects;
- migraine;
- decompensated (uncontrolled) diabetes mellitus;
- thrombophlebitis of the lower extremities;
- the woman's age is over 65 years.
When can I put a spiral after childbirth, caesarean section, abortion?
The intrauterine device can be placed already on the 3rd day after uncomplicated physiological childbirth. But usually gynecologists recommend waiting until the end of the discharge of lochia (on average 1-2 months). So it will be safer. After childbirth, the uterus recovers, so early insertion of the coil increases the risk of side effects and early rejection of the device. To start using the hormonal intrauterine system, you need to withstand 2 months after the birth of the baby, this is necessary not only for the complete restoration of the uterus, but also for the normalization of the hormonal background. After a caesarean section, the spiral can be installed in the uterine cavity only after 3-6 months. It takes time for the postoperative scar to form.
After a medical termination of pregnancy (up to 12 weeks), it is better to install the IUD within seven days after the start of the next period after the abortion. But the gynecologist may offer to install the spiral immediately after the abortion, without getting up from the gynecological chair. This is possible, but in this case, the risk of developing side effects of the intrauterine device associated with the complications of the abortion itself increases significantly. After a miscarriage, the decision on the appropriateness and safety of installing a spiral is made only by a doctor, he individually assesses the situation, analyzes the cause of spontaneous abortion, weighs the pros and cons. If it is necessary to use a spiral after a miscarriage, it is installed in the uterine cavity during the next menstruation.
Is an intrauterine device installed after the age of 40?
An intrauterine device can be used for any woman who is ovulating, has her menstrual cycle, and is likely to become pregnant. Hormonal intrauterine systems are also installed in the period after the onset of menopause to obtain a therapeutic effect. Therefore, 40 years is not a limitation for the use of the IUD. According to the instructions, IUDs are not recommended for women over 65 years of age, but this restriction appeared only due to insufficient research on the use of intrauterine devices at an older age.How is an intrauterine device installed?
The intrauterine device is installed only by a gynecologist in a gynecological office. Before the introduction of the IUD, the doctor assesses the possibility and risk of side effects of using this contraceptive, explains to the woman about the possible reactions of the body to the introduction of one or another type of spiral. Before intrauterine contraceptives are installed, a woman needs to be examined to completely exclude a possible pregnancy and contraindications.Desirable examination before installing an intrauterine device:
- gynecological examination and palpation (palpation) of the mammary glands;
- smear from the vagina, if necessary, sowing on the microflora;
- cytological examination of smears from the cervix;
- Ultrasound of the pelvic organs;
- in some cases, a pregnancy test or blood test to determine the level of hCG;
- Ultrasound of the mammary glands (for women under the age of 40) or mammography (after 40 years).
Preparing for installation
Usually, special preparation for the introduction of the spiral is not required. If inflammatory diseases are detected, you will first need to undergo a course of appropriate therapy.Immediately before the procedure, it is necessary to empty the bladder.
On what day of menstruation is it better to install an intrauterine device?
Intrauterine contraceptives are usually installed during menstruation or towards its end, that is, within 7 days from the onset of menstruation. The optimal time is 3-4 days. This is necessary in order not to miss the onset of pregnancy.An intrauterine device can be installed as emergency contraception, that is, if a woman has had unprotected intercourse and suggests an unwanted pregnancy. In this case, the device is introduced in the period after ovulation, this can prevent the attachment of the fetal egg in 75% of cases.
Intrauterine device insertion technique
Any spiral packed in a vacuum package is sterile. You need to check the expiration date. The spiral must be opened immediately before installation, otherwise it loses its sterility and can no longer be used. The IUD is a one-time use device, its reuse is strictly prohibited.In most cases, local anesthesia is not required. Cervical anesthetics can be used in nulliparous women and when placing hormonal intrauterine systems, as they are wider.
The insertion technique for different types of spirals may differ. The installation features of each spiral are described in detail in the device instructions.
1.
A speculum is inserted into the vagina to fix the cervix.
2.
The cervix is treated with disinfectants.
3.
With the help of special forceps, the cervical canal (the canal in the cervix that connects the vagina with the uterus) is straightened, the cervix is opened.
4.
A special probe is inserted through the cervical canal into the uterine cavity to accurately measure the length of the uterus.
5.
If necessary, the cervix is anesthetized (for example, with lidocaine or novocaine). The introduction of the spiral itself begins after 4-5 minutes, when the anesthetic takes effect.
6.
The spiral is introduced using a special conductor with a piston. A ring is set on it on a scale according to the size of the uterus, this is necessary in order not to damage its walls. Then a conductor with a spiral is inserted into the uterus. Having reached the corresponding mark, the doctor pulls the piston a little towards himself in order to open the shoulders of the spiral. After that, the spiral is moved directly to the wall of the fundus of the uterus. When the gynecologist is satisfied that the device is installed correctly, the guidewire is slowly and gently pulled out. When installing some spirals (for example, annular ones), the opening of the shoulders is not required, so the spiral is inserted to the wall of the uterine fundus, and then the conductor is simply pulled out.
7.
The threads of the spiral are cut into the vagina at a distance of 2-3 cm from the cervix.
8.
The procedure is over, it usually takes 5-10 minutes.
Does installing an intrauterine device hurt?
The procedure itself, of course, is unpleasant, brings some discomfort. But the pain felt is tolerable, it all depends on the woman's pain threshold. These sensations can be compared to painful menstruation. Abortion and childbirth are more painful.After insertion of the intrauterine device
Ultrasound photo: Intrauterine device in the uterine cavity.
- The uterus completely gets used to the IUD within a few months, so during this period there may be some changes in women's health, you need to listen to your body.
- In some cases, a course of antibiotic therapy will be required after the introduction of the spiral, for example, if chlamydia is suspected, if there is another chronic infection of the genitourinary system.
- Bloody spotting and pulling pains in the lower abdomen or in the back can be disturbing for 1 week after the introduction of the spiral. To relieve spasms, you can take No-shpu.
- The hygienic regimen is normal, it is necessary to wash with intimate hygiene products twice a day.
- You can have sex only 8-10 days after the installation of the intrauterine device.
- For several months, you can not lift weights, engage in intense physical activity, overheat (sauna, bath, hot baths).
- It is necessary to periodically probe the threads of the spiral, control their length, it should not change.
- After 2 weeks, it is better to visit a gynecologist so that he can see if everything is fine.
- Menstruation in the first months after the installation of the spiral can be painful and plentiful. Over time, menstruation normalizes.
- When using hormonal intrauterine systems, after six months or several years, the disappearance of menstruation (amenorrhea) is possible. After the first loss of the cycle, pregnancy must be excluded. The menstrual cycle will be restored immediately after the removal of the spiral.
- If you have any complaints, you should consult a doctor.
- In the future, an examination by a gynecologist is necessary every 6-12 months, as for any healthy woman.
Can an intrauterine device fall out?
If the intrauterine device is not inserted correctly or if it does not take root, the intrauterine device may fall out. This must be followed. The most common prolapse of the IUD occurs during menstruation or after heavy physical exertion. Therefore, it is important to control whether the spiral threads are in place, inspect sanitary pads.How long is the use of an intrauterine device?
The term for which intrauterine contraception is installed differs depending on the type of spiral. - Inert IUDs - usually installed for 2-3 years.
- Copper spirals - up to 5 years.
- Copper spirals with silver and gold - 7-10 years or more.
- Hormonal intrauterine systems - up to 5 years.
It is not recommended to use the IUD after the expiration date due to the risk of the spiral growing into the uterine tissue. Hormonal spirals lose their properties due to the depletion of the hormonal drug. This reduces the effectiveness of the intrauterine device, which can lead to an unplanned pregnancy.
Intrauterine devices (copper, hormonal): installation, principle of operation, efficiency (Pearl index), expiration date. How to check if the spiral is in place - video
Removal and replacement of the intrauterine device
Indication for IUD removal:- the period of use has expired, while the replacement of the intrauterine device is possible;
- a woman is planning a pregnancy;
- there were side effects from the use of an intrauterine device.
Coil removal often does not require anesthesia, local anesthesia will be required when removing or replacing hormonal coils. The doctor fixes the cervix with a gynecological speculum, and then, using a special tool (forceps), grabs the spiral threads and carefully pulls out the device, while gently stretching the cervix.
Usually this procedure goes without difficulty, the woman experiences less pain than with the introduction of a spiral. But there are situations when the spiral is not so easy to pull out, then the doctor expands the cervical canal and facilitates the removal of the IUD. You can also face the problem of thread breakage, then the doctor inserts a special hook through the cervix, with which he removes the foreign body from the uterine cavity.
But there are situations when the doctor simply does not detect the thread of the spiral. The question arises, is there a spiral in the uterus at all? If yes, where is she? For this, a woman is offered to do an ultrasound of the pelvic organs, if necessary, x-rays. Sometimes there are cases that the spiral is outside the uterine cavity (with perforation of its wall), then a laparoscopic operation is urgently needed to remove the foreign body.
Coil replacement intrauterine contraception can be carried out immediately after the removal of the old spiral, the risk of developing any complications does not increase.
Special instructions before removing and replacing the intrauterine device:
- timely replacement of the IUD facilitates the procedure and guarantees continuous contraceptive action;
- the procedure is best done during menstruation;
- removing the coil during or before ovulation increases the risk of pregnancy;
- before replacing the coil, other methods of contraception (condom, oral contraceptives or spermatocidal preparations) must be used 7 days in advance to prevent an unwanted pregnancy.
Possible side effects
The intrauterine device is a modern, convenient and effective method of contraception. But it is also a foreign body, to which our body can react with undesirable reactions. In most cases, intrauterine contraception is well tolerated, but some women may be intolerant to this method and develop side effects, some of which can have a very negative impact on health and lead to severe pathologies. To reduce the risk of developing these side effects will help the choice of the type of spiral suitable for this woman, a detailed assessment of contraindications to its introduction, its timely removal and, of course, sufficient professionalism of the gynecologist who will install this device in the uterine cavity. Possible side effects and complications when using an intrauterine device
| Side effect | Reasons for development | How often does it occur? | Treatment of adverse reactions |
| Pain in the lower abdomen immediately after the insertion of the IUD | Often. |
|
|
| Prolapse of the spiral from the uterine cavity or expulsion |
| Often. |
|
| Painful and heavy periods |
| Up to 15%. |
|
Inflammation of the genital organs (colpitis, endometritis, salpingitis, adnexitis):
|
| Up to 1% of cases |
|
| Severe uterine bleeding |
| Very rarely |
|
Anemia:
|
| Very rarely. |
|
| Fibroids development |
| Rarely. |
|
| Risk of ectopic pregnancy |
| 1:1000 | Surgical treatment, removal of the fallopian tube. |
| Soreness during intercourse, difficulty in achieving orgasm. |
| Up to 2%. | Removal of the coil or replacement with a hormonal IUD. |
| The onset of pregnancy | The IUD is not 100% effective. | From 2 to 15%. | Individual approach. |
Perforation (puncture) of the walls of the uterus:
| Damage to the walls of the uterus during the introduction, operation and removal of the spiral. Increase the risk of uterine perforation:
| Very rarely. | Surgical treatment and emergency medical care. |
| Ingrown spiral into the wall of the uterus |
| Up to 1%. | Removal of the spiral through the cervix using special tools. Sometimes laparoscopic surgery may be required. |
| Copper intolerance or Wilson's disease | individual intolerance or allergy to copper. | Rarely. | Replacement with another type of contraception or hormonal intrauterine device. |
Additional side effects from the use of a hormonal intrauterine system (associated with the hormone progestogen):
- absence of menstruation (amenorrhea), after the removal of the spiral, the menstrual cycle is restored;
- High risk of ectopic pregnancy, ultrasound monitoring is necessary.
- Such a pregnancy can end in an early miscarriage, which is associated with the effect of the spiral on the endometrium, to which the fetal egg is attached.
- The IUD can cause intrauterine infection of the fetus, as well as intrauterine growth retardation and pregnancy fading.
- High risk of fetal malformations during pregnancy with a hormonal spiral.
Also, an allergic reaction may develop on the introduction of a progestogen, requiring urgent removal of the spiral from the uterus.
Intrauterine device (IUD): composition, action, indications, possible negative consequences from the use - video
Intrauterine device (IUD): mechanism of action, dangerous complications (therapist's opinion) - video
How can a pregnancy proceed with an intrauterine device?
As it has already become clear, intrauterine contraceptives do not protect 100% from pregnancy. Most of these “lucky women” have a normal pregnancy, the child can independently push the spiral out in the second trimester and even be born with it in their hands, for some children this is such a toy. But not everything is always so smooth, and if a woman decides to keep such a pregnancy, she should be ready for various problems.
Basic principles of pregnancy management with a spiral:
1.
Difficulties arise with the diagnosis of pregnancy, the woman is confident in her contraception. And menstrual irregularities with IUDs are not uncommon, which leads to the fact that pregnancy can be diagnosed late, when abortion is already difficult. Therefore, it is very important to listen to your body and, with the slightest deviations, changes and hints of pregnancy, consult a doctor.
2.
At the request of the woman, a medical abortion can be performed.
3.
The spiral is not an indication for medical termination of pregnancy. The choice is up to the woman, because in most cases, pregnancy with a spiral proceeds normally and without complications. But still, the doctor must evaluate the possible risks of pregnancy and may recommend terminating it.
4.
The IUD may be removed during pregnancy. The copper coil is often not removed as it does not affect fetal development. The hormonal spiral throughout pregnancy will release hormones that can lead to abnormalities in the development of the fetus. The gynecologist can remove the coil if its threads are preserved and it is removed from the uterus easily and without hindrance.
5.
Such a pregnancy requires constant monitoring by doctors, regular monitoring of the ultrasound of the fetus is necessary.
Possible risks of pregnancy with an intrauterine device:
How to choose a good intrauterine device? Which spiral is best?
Your gynecologist should deal with the selection of the type of spiral, its size and manufacturer. Only he can determine the indications and contraindications for the use of a particular intrauterine contraceptive, the individual characteristics of your body. But if the woman is absolutely healthy, then the doctor can provide an IUD to choose from. Then many questions arise. "Which spiral to choose, copper or hormonal?" Here, a woman needs to choose between effectiveness and possible side effects. The hormonal coil has more possible side effects associated with the progestogen, but they are temporary and stop after a few months. And the contraceptive effect of using such a spiral is much higher. If a woman has fibroids, then the hormonal spiral is a method not only of contraception, but also of treatment. A copper coil with silver and, especially, with gold, has a higher efficiency than a conventional copper device, and the risk of side effects is lower, this is such a middle ground between a hormonal and a copper coil.
"And how much does an intrauterine device cost?" For many women, the issue of economy is of great importance and determines the choice of a spiral. Copper coils are much cheaper than hormonal systems. Also, spirals with silver and gold have a high cost.
"Which spiral is used longer?" The longest you can use spirals with silver and gold, up to 7-10 years or more. Hormonal spirals are usually used for no more than 5 years.
"Which spiral will not affect the next pregnancy?" Any spiral can lead to problems with future pregnancies, this is an ectopic pregnancy, and infertility due to the inflammatory process. The risk of developing an ectopic pregnancy during the use of the IUD is higher with hormonal coils due to the action of the progestogen. Copper spirals give a greater risk of complications in the form of inflammation of the uterus and appendages. When removing the IUD, ectopic pregnancy often occurs after the use of copper coils.
"Which spiral is painless?" During the installation and removal of the spiral, the woman experiences some pain. But this should not fundamentally affect the choice of the IUD. With the introduction of the hormonal system, these painful sensations are more pronounced, which is why local anesthesia is used. Local anesthesia can be carried out with the introduction of a copper spiral in women who are especially impressionable and emotional.
Overview of various modern intrauterine devices: Juno, Mirena, Goldlily, Multiload, Vector extra, spirals with gold and silver
| Name | Description | Validity | ||
An intrauterine device is a contraceptive device that is installed directly into the uterine cavity. The drug mechanically prevents the spermatozoa from going their way and meeting the egg, and also prevents the implantation of the fetal egg, if conception does occur. Today, hormonal intrauterine systems (Mirena) are very popular. Such a contraceptive, among other effects, partially suppresses ovulation, thereby significantly reducing the likelihood of an unwanted pregnancy.
So, here are the most frequently asked questions about - everything you wanted to know from the doctor, but still did not dare to ask.
Which spiral is better: hormonal or non-hormonal?
Today they are considered much more effective and reliable means. The Pearl Index of the Mirena intrauterine system is less than 1, while for copper-containing IUDs it is up to 3. The final choice of the spiral is carried out together with the attending physician, taking into account all possible indications and contraindications.
Benefits of hormonal coils:
- Provide reliable protection against unwanted pregnancy (Pearl index is less than 1, while for copper-containing IUDs - up to 3).
- Change the menstrual cycle: menstruation becomes scarce and painless. Perhaps the development of amenorrhea, when menstruation completely stops. This improves the general condition of the woman and reduces the risk of anemia.
- They have a therapeutic effect, are used for some gynecological diseases.
Advantages of non-hormonal spirals:
- They do not contain progesterone in their composition, which means that undesirable effects associated with its effect on the body are excluded.
- They are cheaper than hormonal intrauterine systems.
What is Mirena?
Does the intrauterine device have an abortive effect?
The main mechanism of protection against unwanted pregnancy is an obstacle to the movement of spermatozoa (and inhibition of ovulation for the Mirena system). If conception does occur, the fertilized egg will most likely not be able to attach to the thinned endometrium, and a miscarriage will occur at a very early date. In this scenario, the intrauterine device can be considered an abortive system, but in practice, such an outcome is extremely rare. The effectiveness of the IUD is quite high, and in most cases, the conception of a child does not occur.
Is it possible to get pregnant with a spiral?
Yes, it happens. In rare cases, such a pregnancy goes well, and the woman manages to carry the child to the due date. The expectant mother should be observed by a gynecologist, monitor the condition of the fetus and monitor her own feelings. Quite often ends in miscarriage in the first trimester. This statement is true for both Mirena and non-hormonal IUDs.
Can there be an ectopic pregnancy against the background of a spiral?
The spiral, located in the uterine cavity, increases the risk of ectopic pregnancy. The following symptoms indicate the location of the fetal egg outside the uterus:
- delayed menstruation;
- pain in the lower abdomen (usually on the side of the affected tube);
- bloody discharge from the genital tract.
Ultrasound will help to make an accurate diagnosis.
Does the partner feel the spiral during sex?
With the correct installation of the intrauterine device, it is not felt in any way during intimacy. In rare cases, the partner may notice the tendrils of the IUD. In this case, you need to see a doctor. The doctor will carefully trim the long antennae, and the problem will be solved.
How to properly check the spiral?
After the end of menstruation, gently insert two fingers into the vagina and try to feel the antennae of the spiral. Thin threads are deep in the vagina, but usually a woman can find them inside. If the antennae are not determined, you need to see a doctor.
What if the tendrils of the helix are not palpable or visible in the vagina?
The tendrils of the spiral must be accessible to the woman for self-recognition. If the antennae cannot be felt with your fingers, you should immediately consult a doctor. At the appointment, the doctor will find out if the spiral is in place and, if necessary, correct its location in the uterus.
Who should install and remove the spiral?
Only an obstetrician-gynecologist should insert and remove the intrauterine device. Independent insertion or removal of the IUD is prohibited!
The introduction of an intrauterine device is carried out in the first days of the cycle. At this time, the cervix is slightly ajar, and the contraceptive easily passes into the uterine cavity. Removal of the IUD is carried out after 5 years or more (depending on the type of spiral). With the development of complications, the contraceptive can be removed at any time directly at the doctor's appointment.
Is it possible to put a spiral on nulliparous women?
For women who have not experienced the joy of motherhood, an intrauterine device is not placed. The exception is Mirena. The hormonal system can only be installed for therapeutic purposes and according to strict indications, when other methods are ineffective or unavailable. The fact is that the intrauterine device naturally leads to the development of aseptic inflammation, which is highly undesirable before the first pregnancy.
Is it possible to put the Mirena hormonal coil in diabetes mellitus?
Yes it is possible. Diabetes mellitus is not a contraindication to the installation of a spiral. Before using the IUD, it would be useful to consult an endocrinologist and undergo the necessary examination.
Is it possible to put a spiral with uterine myoma?
The intrauterine system can be installed with a subserous tumor or interstitial myoma, located entirely in the muscle layer. In the case of a submucosal node that deforms the uterine cavity, its preliminary removal is indicated. Before installing the IUD, it is necessary to undergo ultrasound and other examinations. the hormonal system Mirena is usually introduced.
Is it possible to put Mirena with submucous myoma?
Submucosal, or submucosal, fibroids are located close to the endometrium or even extend into the uterine cavity. With this localization of the node, the spiral is not placed. Installation of Mirena is possible after removal of fibroids.
For how long is the spiral inserted and what will happen if it is not removed on time?
The intrauterine device is usually placed for a period of 5 years. After this time, it is necessary to remove the IUD, otherwise complications may develop:
- inflammation of the uterus and appendages;
- damage to the cervix;
- infertility.
With a long stay in the uterine cavity, the spiral can grow into the walls of the organ, and it will be possible to get rid of the IUD only by surgery.
Long-term use of Mirena is also not recommended. After the expiration date, the hormone levonorgestrel ceases to be secreted, and the contraceptive effect ends. An unwanted pregnancy is possible. All other risks associated with long-term use of the spiral also remain.
Can I use an intrauterine device for emergency contraception?
Yes it is possible. The IUD is inserted within 5 days after unprotected intercourse according to the standard scheme. Since the installation of the spiral requires a complete examination of the patient, this method has not found wide application.Used as postcoital drugs .
The IUD is not used as an emergency contraceptive:
- in nulliparous women;
- with inflammatory diseases of the pelvic organs;
- during unprotected intercourse with a high risk of contracting STIs.
Is it possible to put the Mirena spiral to a nursing mother (during lactation)?
Yes it is possible. The spiral does not affect lactation, the hormone levonorgestrel does not penetrate into breast milk. The selected method of contraception is not dangerous for the child. Before installing the spiral, a doctor's consultation is necessary.
When can I put an intrauterine device after childbirth, caesarean section, abortion?
The term for installing the spiral or the Mirena hormonal system:
- After - after 6 weeks.
- After caesarean section - after 3-6 months.
- After an abortion - on the day of termination of pregnancy.
On what day of the cycle is the intrauterine device placed?
The IUD is inserted on the 5th-7th day of the menstrual cycle. At this time, the cervix is slightly open, which facilitates the introduction of the spiral. In addition, during this period, the risk of unwanted pregnancy is minimal.
Does it hurt to put an intrauterine device?
With the introduction of the IUD, there may be slight pulling pains in the lower abdomen, which disappear within half an hour. No special treatment is required. If the pain persists or worsens, you should immediately consult a doctor.
Does it hurt to remove an intrauterine device?
Removing the IUD from the uterus is a somewhat unpleasant, but not at all painful process. The procedure takes a few minutes and does not cause discomfort to the woman. Anesthesia is not required. After removing the spiral, moderate pulling pains in the lower abdomen may be felt, which disappear within a day.
How does the menstrual cycle change after the introduction of the spiral?
After insertion of a copper-containing IUD, the amount of discharge during menstruation may increase slightly. Conversely, the use of the Mirena hormonal system reduces the intensity of bleeding. Perhaps the onset of amenorrhea - the complete absence of menstruation, and this is a variant of the norm.
Is it possible to use tampons if there is a spiral?
In the first month after the insertion of the IUD, it is better to use sanitary pads. In the future, you can safely enter tampons during menstruation. The coil is in the uterus, the tampon is in the vagina, and these two devices do not touch. Even if the tampon touches the antennae of the contraceptive, this does not threaten the woman with anything dangerous.
What to do if menstruation did not come against the background of the spiral (Mirena)?
When using the Mirena system, some women experience amenorrhea - the complete absence of menstruation for a long time. This is normal, and after the coil is removed, the menstrual cycle will be restored. Treatment is not required.
In certain cases, the absence of menstruation may indicate pregnancy. It is recommended to do a test or donate blood for hCG.
Can I play sports with an IUD?
Yes, the intrauterine device does not interfere with physical activity, training in the gym, visiting the pool and playing sports. Restrictions are imposed only in the first month after the installation of the IUD. During this period, it is recommended to refrain from physical activity. In the future, you can lead a normal life without restrictions.
Can intrauterine contraception lead to cancer?
To date, there is no evidence that the IUD (including Mirena) provokes the development of malignant tumors of the uterus or appendages. With existing neoplasms of the reproductive organs, the spiral is not placed.
Is Mirena compatible with other medicines?
It is known that some drugs (antibiotics, aspirin) reduce the contraceptive effect of the IUD. Consultation of the attending physician is necessary. If a long course of taking a potentially dangerous drug is required, it is recommended to additionally use condoms or spermicides during treatment.
Do I need to take a break from using an intrauterine device?
With good tolerance and the absence of contraindications, a break is not made. A new spiral can be introduced on the day the previous one is removed. According to indications, the doctor may recommend taking a break (for example, with the development of inflammatory processes in the uterus or vagina).
When can I have sex after installing an intrauterine device?
In the first seven days, it is recommended to refrain from intimacy or use a condom. Unprotected contact during this time can lead to unwanted pregnancy. In the future, there are no restrictions on sexual activity.
How much does it cost to install a spiral?
The cost of an intrauterine device is from 500 to 10 thousand rubles (for Mirena).
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