Like a spiral in the uterus. The process of installing an intrauterine device, side effects, consequences. Pros and cons of this method of contraception

Of all today, the intrauterine device is perhaps the most effective option. The reliability of this method according to the latest data is 99%! Such a high rate has not been beaten by any other method of contraception. And numerous positive reviews about the intrauterine device speak only in its favor.

The intrauterine device is a miniature device that is made of polyethylene with the addition of barium sulfate. The last component provides the possibility of X-ray control. Next, let's try to figure out which intrauterine device is better.

Types of intrauterine devices

Basically, there are the following types of intrauterine devices:

Copper-containing;
Gold-bearing;
Silver-containing;
hormone-containing (levonorgistrel).

If we judge which intrauterine device is better, then we can say with confidence that the last type of this contraceptive should be chosen. He is the most reliable. In addition to the mechanism of action of the spiral, the effect of hormonal contraceptives is added. One such intrauterine device is the Jaydes system.

How does an intrauterine device work

How the intrauterine device works can be understood from the following facts:

Spirals affect the ability of spermatozoa to pass through the uterine cavity;
They act on the peristalsis of the fallopian tubes;
Spirals prevent implantation (attachment of the fetal egg to the wall of the uterus).

Intrauterine device pros and cons

As most of the positive reviews about the spiral from pregnancy testify, its main advantages are:

High efficiency and reliability;
Acts immediately after administration;
Not directly related to sexual intercourse;
Does not affect breastfeeding;
Does not interact with any medications;
Examination by a doctor (if there are no complaints) is required once a year;
It is a relatively inexpensive method of contraception.

However, if we consider all the pros and cons of intrauterine devices, we can distinguish the following disadvantages:

A gynecological examination of the patient is required prior to insertion;
Testing for sexually transmitted infections is required;
The participation of a trained specialist is mandatory both for the introduction and removal of the spiral;
Increased menstrual bleeding and pain in the first few months (for copper coils);
Independent expulsion, that is, the exit of the spiral, is not ruled out;
May increase the risk of inflammatory processes in the female genital organs.

The above side effects of intrauterine devices are extremely rare and usually they are of a short-term nature.

Who cannot use an intrauterine device

Pregnant women;
Women who have abnormal uterine bleeding;
Women who have genital tract infections;
Women who have had acute pelvic inflammatory disease or septic abortion within three months;
Women with congenital uterine anomalies or tumors;
Patients who have genital cancer;
Women who have more than one sexual partner (greater risk of contracting sexually transmitted diseases).

Start of use and removal of the intrauterine device

How to choose a suitable intrauterine device will tell the doctor of the antenatal clinic. The choice is made on an individual basis. If the menstrual cycle is regular, the intrauterine device can be inserted for 12 days from the onset of menstruation (not only during menstruation) or on any day of the menstrual cycle if the woman knows for sure that she is not pregnant.

Removing the coil is a simple procedure. Produced on an outpatient basis by a trained medical professional. The intrauterine device is removed by gradually pulling on the control threads using a surgical clamp. This contraceptive must be removed after the time indicated in the instructions for its use, or earlier if the woman so desires. The timing of the use of intrauterine devices is determined by their type and manufacturer's instructions. Usually terms are from 3 (copper-bearing) to 10 years (gold-bearing).

The intrauterine device (IUD) is one of the most common ways to prevent unwanted pregnancy. And this is not surprising, because the reliability of this method of contraception is more than 95%.

According to WHO, about 75 million women currently prefer the IUD because of its effectiveness and safety. But the installation of a spiral is an intervention in the body, so this procedure certainly has its pros and cons, which should be studied before using it.

What is an intrauterine device (IUD)

Intrauterine device- This is a small device made of plastic and metal, which is inserted into the uterus of a woman in order to protect against unwanted pregnancy. Silver or copper, which is covered with a spiral, protect the uterine cavity from infection and enhance the contraceptive effect.

There are many different types of intrauterine devices that differ in size, shape, materials, for example: a loop, a spiral, a T-shaped, a ring, a horseshoe, etc. The T-shaped IUD is currently the most common. It prevents sperm from entering the uterus by shortening the ovulatory period and prevents the attachment of a fertilized egg to the uterine endometrium.

They also produce hormonal intrauterine devices, which combine the advantages of oral and intrauterine contraception. Instructions for use are attached to any intrauterine device. Only a doctor can pick up, install, and also remove a spiral from the uterine cavity. The IUD can be worn up to 10 years, but usually it is put on for 3-4 years. Most often, gynecologists recommend women such spirals as Mirena, Multiload, Nova T.

How does an intrauterine device (IUD) work?

The principle of operation of the intrauterine device is to prevent the implantation and development of the embryo in the uterus. The spiral creates the effect of the presence of a foreign body that prevents sperm from entering the uterine cavity and fertilizing the egg. If fertilization has occurred, the spiral makes it impossible for the egg to attach to the uterine endometrium.

Which spiral is better and how to choose the right IUD, only the doctor decides, taking into account the individual characteristics of your body. After the introduction of the spiral into the uterine cavity, it begins its work immediately. The contraceptive effect of the IUD is based on the following mechanisms of action:

Abortive effect

The spiral increases the tone of the uterine muscles, preventing the attachment of a fertilized egg. It also enhances the peristalsis of the fallopian tubes, and therefore the fertilized egg has time to enter the uterus when the endometrium is not yet ready for this. If fertilization does occur, the pregnancy will be terminated by spontaneous miscarriage at an early stage.

The effect of aseptic inflammation

After the introduction of the spiral, leukocytes begin to rise in the uterus, perceiving it as a foreign body. Leukocyte infiltration of the endometrium makes implantation of the egg impossible. In addition, leukocytes and macrophages enhance the process of absorption of spermatozoa, providing an even more pronounced contraceptive effect.

The effect of creating enzyme disorders

The intrauterine device changes the composition of enzymes in the endometrium of the uterus and creates unfavorable conditions for fertilization in it.

The effect of preventing the penetration of spermatozoa into the uterine cavity

The ends of the threads of the intrauterine device make it difficult for sperm to enter the cervical canal. In the hormonal coils in the cervix, mucus also thickens.

ovulation inhibition effect

The spiral creates the conditions for blocking ovulation by influencing the hypothalamic-pituitary system.

Installation of an intrauterine device

An intrauterine device can be installed in women who have given birth after an abortion, if the abortion has passed without inflammatory complications, in women who have given birth after 35 years of age, who have contraindications to taking oral contraceptives, and in women with a low risk of genital tract infections in the absence of cervical pathologies.

The procedure for inserting a spiral into the uterine cavity is a medical intervention that requires some preparation. Before installing a spiral, a woman should be well examined and cured of all chronic gynecological diseases.

Examination before the installation of the IUD includes:

consultation with a doctor to collect an anamnesis of the patient;
gynecological examination to determine the size and position of the uterus;
Ultrasound of the pelvic organs to exclude formations and inflammatory processes in the uterine cavity and its appendages;
clinical blood and urine tests;
blood tests for HIV, syphilis, hepatitis;
delivery of smears for cytology, microflora from 3 points, bakposev of the discharged vagina and cervix;

Immediately before the insertion of the IUD, the gynecologist should probe the uterus and measure the length and distance between the uterine angles. The spiral is inserted on the 3rd-4th day of menstruation, since during the critical days the cervix is ajar, which facilitates the introduction of the IUD. Also, the blood released during menstruation reduces the risk of trauma to the uterus and means no pregnancy at the time of the installation of the spiral.

Slight pain in the lower abdomen after the introduction of the spiral and spotting is the norm, this is just a reaction of the uterus to the introduction of a foreign body. In the early days, the patient is not recommended physical activity. Sex life after the installation of the IUD can begin in 1-2 weeks, depending on how you feel.

In the first few months after the installation of the spiral, spotting may appear. If the coil is installed correctly, neither the woman nor her sexual partner should feel it. A medical examination after the introduction of the spiral must be done first once a month, then every three months and then every six months.

Side effects after IUD insertion

Side effects after the installation of the spiral in the uterine cavity occur infrequently. Modern technologies for the manufacture of intrauterine devices reduce the risk of their occurrence to a minimum. But nevertheless, you need to see a doctor after the introduction of the spiral, if you have:

profuse bleeding;
pain in the lower abdomen;
suspicion of pregnancy;
pain or bleeding during intercourse;
there were symptoms of infection (unusual vaginal discharge, itching, burning, unpleasant odor);
the threads from the spiral shortened or lengthened

Contraindications for IUD insertion

pregnancy;
ectopic pregnancy in the past;
acute or chronic inflammatory processes of the genital organs;
endometriosis;
cervical dysplasia;
anomaly in the structure of the uterus;
formations in the uterine cavity;
uterine bleeding;
anemia;
blood clotting disorder;
endocrine diseases (diabetes, thyroid problems)

Pros and cons of the intrauterine device

Advantages of the intrauterine device

The most important advantage of using the IUD is long-term protection against unwanted pregnancy (for a period of 3 to 10 years, depending on the type of spiral). The contraceptive effect occurs immediately after the device is installed. The spiral protection method is very effective, the protection rate reaches 98%.

The spiral is easy to install and this process is reversible, i.e. at the request of the patient, the spiral can be removed at any time at the request of the woman. Pregnancy after the removal of the spiral usually occurs after several cycles, and sometimes even in the first menstrual cycle, fertility is restored fairly quickly.

IUD contraception gives a woman the opportunity to make her own decisions about planning children. The sexual partner will not be able to find out about the presence of a spiral in a woman's body, since it is not felt. Additional precautions for the IUD are not required. The spiral in no way affects the general condition of a woman, does not worsen the course of extragenital diseases.

The convenience of using the IUD is that it does not need daily monitoring, as, for example, with birth control pills. Installed and forgotten for several years. Other drugs and preparations do not affect the contraceptive effect of the IUD. In the presence of a spiral, any surgical manipulations can also be carried out. The spiral is not contraindicated in lactation.

The price of installing an intrauterine device varies depending on the type of device and the chosen clinic, but in general, this method of protection is available to all segments of the population. In some antenatal clinics, spirals are installed for women completely free of charge. Taking oral contraceptives is sometimes much more expensive.

Cons of the intrauterine device

Perhaps the main disadvantage of using the IUD is that after the introduction of the helix, the cervix remains ajar, which is fraught with the penetration of pathogenic microorganisms into it. This, in turn, can cause an inflammatory process in the small pelvis: the uterus (endometritis) and its appendages (adnexitis), even though the spiral is made of a metal that has a disinfecting effect.

The first few months of using the spiral, a woman may feel aching pain in the lower abdomen. The cause of pain after the installation of the IUD is either an increased sensitivity of the uterus, or an incorrectly selected type of spiral. The presence of a foreign object in the uterus, as well as permanent mechanical damage to the endometrium of the uterus at the point of contact with the spiral, prolongs menstruation and the amount of menstrual flow. In rare cases, this is fraught with anemia.

Unfortunately, sometimes when using an IUD, an ectopic pregnancy can occur - a condition when a fertilized egg is attached not in the uterus, where it should be, but in the fallopian tubes. The consequences of an ectopic pregnancy are extremely dangerous, even fatal, if the pregnancy was not detected early.

When a spiral is inserted into the uterine cavity, the uterine endometrium becomes thinner, which adversely affects the possibility of becoming pregnant in the future and increases the risk of spontaneous miscarriages. Any anomalies in the structure of the genital organs of a woman are a contraindication for the installation of a spiral, since one hundred percent protection against pregnancy cannot be guaranteed.

Another significant drawback of the IUD is the likelihood of the spiral falling out. This usually happens during critical days. Since the prolapse of the spiral is extremely rare for a woman, an unwanted pregnancy is possible. The intrauterine device does not protect against genital infections, so it is a method of contraception, but with dubious partners, additional protection with condoms should be used.

The spiral is placed only in women who have already given birth, respectively, as a method of contraception, not everyone is suitable. It is absolutely impossible not to insert or pull out the spiral on your own. All manipulations with the intrauterine device should be carried out only by a specialist. Once every six months, a woman is recommended to be examined by a gynecologist for preventive purposes.

Thus, the intrauterine device as a method of protection may not be suitable for every woman, since there are a number of contraindications and serious side effects when using it. Therefore, the choice and installation of the IUD requires careful preparation and consultation of a qualified doctor.

The intrauterine device, as you can see from the video, looks like a T-shape. It is placed in the cervix, as seen in the photo and only by a gynecologist. At the end of the spiral there is a thread necessary for its further removal.

Types of spirals

The video shows that the coils for the uterus can be of two types: containing hormones and coated with copper. The photo shows the Mirena hormonal coil. It contains a synthetic substitute for progesterone - levonorgestrel, which is constantly released in the uterine cavity in small quantities. The intrauterine device of the hormonal type is effective for 5 years, its installation is more reliable in comparison with the copper one.

The video shows that in some cases, women are placed with a hormonal coil for therapeutic purposes. The cost of a hormonal coil is higher than copper, but copper, in turn, is more common. The copper intrauterine device has a plastic case, with a wire wound around it.

Copper spirals are very effective in protecting against pregnancy, they can be in the uterine cavity for up to ten years.

How the spiral works

The video shows how both types of helix damage spermatozoa, preventing the mechanical attachment of a fertilized egg in the uterine cavity. The hormonal appearance of the spiral makes the mucus in the cervical canal more viscous, providing protection against the penetration of spermatozoa. The hormonal type intrauterine device prevents the implantation of the egg and the thickening of the endometrium.

Installing a spiral in the uterine cavity reduces the volume of menstrual flow, reduces pain during menstruation. Copper coils damage sperm cells by exposing them to copper ions and releasing enzymes, leukocytes and prostaglandins in the uterine cavity, which also block sperm activity.

Indications for the installation of a spiral

The form says that this type of contraception is suitable for many women, including adolescents and nulliparous. The installation of a spiral in the uterine cavity can be carried out immediately after childbirth (ten minutes after the placenta is delivered), four weeks after childbirth (postpartum delayed installation), after an abortion (conscious or spontaneous).

The intrauterine device is suitable for girls with the following features:

Postponed surgery on the pelvis.
An ectopic pregnancy that has occurred.
Migraine.
Deep vein thrombosis disease.
Presence of arterial hypertension.
Diabetes.
Anemia.
Endometriosis.
Smoking.

The installation of a spiral in the uterine cavity is unacceptable for such phenomena:

Serious anatomical changes in the uterine cavity.
Pregnancy.
Vaginal bleeding without an accurate diagnosis.
Infectious diseases of the small pelvis.
Gestational trophoblastic disease with persistently elevated levels of beta hCG.

Depending on the type of use of the spiral in the uterus, there may be some contraindications. For example, the video recommends against using a copper coil in the presence of Wilson's disease, and hormonal coils should not be inserted into the uterus of women with liver tumors and breast cancer.

Complications after installing the spiral

The intrauterine device, as can be seen from the video, very rarely causes complications, the most common of which is its spontaneous expulsion from the uterine cavity. It happens in 2-10% of all moments. Patients are advised to frequently check for the presence of a coil in the uterus by checking for threads emerging from the cervical canal. A rarer complication, as seen in the video, is the failure of the technique - the onset of pregnancy, despite the presence of a spiral.

When using a hormonal spiral, the failure of the method is 0.2% in the first year of its use. When using a copper coil, the probability of pregnancy in the first year of occurrence is 0.8%. when using an intrauterine device, an ectopic pregnancy most often occurs.

If the development of pregnancy occurs in the uterus, then the spiral must be removed. If this is not done, there is a high probability of miscarriage. In rare cases, there may be a complication such as perforation of the uterine wall. It appears in 0.1% of cases.

During manipulation during the installation of the spiral, vasovagal reflux may develop, which may be accompanied by vomiting and loss of consciousness.

What you need when installing a spiral

The video says that before installing this type of spiral, it is recommended to consult a gynecologist. The examination is carried out on a chair, inflammatory diseases in the small pelvis, diseases transmitted during sex should be excluded, colposcopy and Pap test, conventional and transvaginal ultrasound of the uterus and appendages, ultrasound of the liver (if a hormonal coil is installed) and ultrasound of the mammary glands. This is required to assess possible contraindications to the installation of the spiral. You must first do a pregnancy test.

Spiral installation process

As shown in the photo, the installation of the spiral does not require much time and the presence of anesthesia. When installing the spiral into the uterine cavity, discomfort may occur, which should pass after a few hours.

The most tangible discomfort may occur in women who have not given birth before, and in those who have passed a long time after the completion of the last menstruation. In general, such a procedure for installing a spiral passes safely and painlessly. To confirm the correct installation of the spiral, it is recommended to conduct a second ultrasound after its installation.

When should you visit a doctor?

After about four weeks, as the intrauterine device was installed, a second visit to the gynecologist is required for the woman. During the doctor's visit, a discussion is held about any possible concerns that have appeared after the installation of the spiral in the uterus. The position of the helix in the uterine cavity must be checked.

When is the best time to put a spiral?

You can install an intrauterine device on any day of the menstrual cycle, but the first seven days after the start of menstruation are considered the best period. This is due to the fact that at this time the possibility that the intrauterine device can be placed during pregnancy is excluded. There are frequent cases of spontaneous exit of the spiral from the uterine cavity, if its installation was carried out in the second phase of the cycle.

When to Remove a Spiral

You can remove the spiral at any time when there is a desire to conceive a child. Also, the spiral must be removed after a certain number of years of its stay in the uterine cavity, replacing it with a new one. The number of years the IUD can remain in the uterus varies from three to ten, depending on manufacturers' recommendations and the type of intrauterine device.

The intrauterine device is an effective remedy for unwanted pregnancy. Depending on preferences, you can choose a copper or hormonal coil. In no case do not try to install the spiral yourself, only a gynecologist should do this!

(Navy) by a gynecologist in the uterine cavity. At the end of the spiral, a special thread is fixed, which goes through the uterine canal and then out into the vagina. It serves to make it convenient for the doctor to remove the spiral if necessary.

Types of Navy

There are two types of intrauterine devices that are most common:
- hormonal coils (containing a special hormone levonorgestrel), such coils act for 5 years, while also performing a therapeutic function;
- copper-coated coils are very IUDs that can stay in the uterine cavity for up to 10 years.

The principle of operation of the Navy

All types of spirals have the ability to mechanically prevent the implantation of a fertilized egg in the uterine wall, as well as damage spermatozoa. Hormonal coils change the consistency of the mucus in the cervical canal, making it more viscous. Due to this, penetration into the uterus is almost impossible. In addition, hormonal spirals help to reduce the amount of secretions and reduce their intensity.

Copper-coated coils cause damage to spermatozoa by exposure to copper ions, as well as the release of prostaglandins, enzymes and leukocytes into the uterine cavity, which have the ability to block the activity of sperm.

Why put the Navy

For the prevention of unwanted pregnancy, the intrauterine device is the most effective means. It can also be used within 5 days of unprotected intercourse. The effectiveness is much higher than that of tablets for emergency prevention of pregnancy.

The spiral is removed at the moment when the woman is ready. It is also necessary to remove and replace with a new coil, after a certain number of years after its installation, this time ranges from 3 to 10 years, depending on the type of coil and recommendations of its manufacturer.

IUD contraception is considered the most appropriate for most, including nulliparous and adolescents. You can install a spiral immediately after, 10 minutes after the placenta leaves, and also after a spontaneous or conscious abortion.

Contraindications for the installation of the IUD are: pregnancy, any anatomical changes in the uterine cavity, unexplained bleeding and pelvic infections. In the presence of these contraindications, complications are possible after the installation of the IUD.