Which intrauterine device is better to install? Intrauterine device - learn more about this type of contraception

An intrauterine device is a device that is inserted into the uterus and serves to protect against unwanted pregnancy. It is made of special plastic and wrapped with copper and silver threads. The first intrauterine devices were used before our era, and similarities to modern devices appeared back in 1926, when the German doctor Gräfenber proposed the use of copper intrauterine rings for contraception. In the 1960s, an American doctor developed an elastic device that did not injure the organ during installation.

Regular IUDs are T-shaped and have two strands at the end for easy removal, but in recent years round models have begun to appear.

Modern devices are made of safe inert plastic, which is wrapped with thin copper wire. In addition to plastic, the spiral may include gold, silver and other additives. They are designed to reduce the risk of uterine inflammation.

It is better to install the IUD in the first days after menstruation, that is, at the beginning of the cycle.
A few days before installation, it is recommended to use pain-relieving suppositories.
After insertion of the IUD, abdominal pain may appear due to contraction of the uterus. This is how the organ reacts to a foreign body.
In some cases, discharge appears.
The woman should rest for half an hour after the procedure.
You need to limit physical activity for a few days.
The first examination must be completed one month after the procedure. A return visit to the gynecologist is recommended after 3 months, and then every six months.

Advantages:

easy installation;
long time of use;
efficiency;
rapid restoration of fertility after extraction;
there is no need for constant monitoring.

Flaws:

no protection against sexually transmitted diseases;
there is a risk of the structure shifting;
women who have not given birth before are not recommended to install the IUD;
the device can cause rupture of the uterine wall;
there remains a risk of intrauterine pregnancy;
possible worsening of PMS and discomfort during menstruation;
heavy menstruation (menorrhagia).

Before inserting an intrauterine device, you need to undergo an examination. The doctor prescribes tests, probes the uterine cavity, and measures the distance between the nodes. The main testing method is ultrasound. Only a gynecologist can install and remove the IUD. The installation is carried out on the 3-4th day of menstruation, when the cervix is dilated and the risk of injury is reduced. One spiral can be worn for up to 10 years.

The effectiveness of the intrauterine device is about 98%. IUDs are recommended for women who have given birth and who have a relationship with one sexual partner, since the device does not protect against sexually transmitted diseases.

Precautionary measures

The main disadvantage of intrauterine devices is a large number of contraindications and serious side effects. Unlike other methods of contraception, the range of use of spirals is significantly limited. Use caution in women with heart defects; additional antibiotic therapy is recommended.

Contraindications to contraception using the IUD:

allergy to copper and other components;
infertility;
pregnancy;
injuries after childbirth;
disruptions in the menstrual cycle, severe PMS;
pathologies of the uterus (endometriosis, fibroids, malformations);
pathologies of the cervix (polyps, erosions, dysplasia);
vaginal infection;
promiscuous sex life, which increases the risk of contracting STDs;
inflammatory processes;
bleeding;
severe anemia;
oncological diseases of the genital organs.

During the consultation, you should inform the doctor about long-term therapy with glucocorticosteroids, non-steroidal anti-inflammatory drugs and immunosuppressants. It must be remembered that the intrauterine device does not protect against sexually transmitted diseases.

Side effects:

Keeping the IUD in the uterus for a long time increases the risk of inflammation. In combination with sexually transmitted diseases, this can lead to serious complications.
Changes in the endometrium of the uterus persist for a long time, therefore, after removal of the IUD, the likelihood of miscarriage and infertility remains.
The presence of the spiral in the cervical canal helps in the spread of vaginal microflora and the creation of an infectious focus in the mucous membrane of the cervix. This is how polyps are formed.
When an intrauterine device is combined with cervical erosion, severe complications are possible.
Regular sexual activity, even when using an IUD, often leads to conception and spontaneous miscarriages in the first week of fetal development. These miscarriages have subtle symptoms: heavy menstrual flow, irregularity and painful menstruation.
Since inserting an IUD is a surgical procedure, there is a possibility of perforation of the uterus.
If a woman has cervical ruptures, the IUD may spontaneously fall out.
Preserving a pregnancy that occurs while wearing an intrauterine device is not always possible.

Types of intrauterine devices

Copper

Copper IUDs release small amounts of copper into the uterine cavity, which prevents sperm from entering the fallopian tubes and changes the endometrium of the uterus to prevent the attachment of an egg in the event of fertilization. Copper intrauterine devices are not dangerous to health because they release one hundredth of the amount of copper taken from food per day.

Advantages of copper intrauterine devices:

No other method of contraception provides such long-term protection (except sterilization). The service life of a copper-containing intrauterine device is 3-5 years.
Low price.
It can be installed even in the presence of various diseases (except for systemic blood disorders).
The effect is completely reversible. Fertility is fully restored 3 months after removal of the device.

Copper spirals may include gold or silver. These components extend the life of the contraceptive system, and antiseptic sprays prevent the development of infections.

Hormonal

Hormonal intrauterine devices are similar to conventional ones, but a cylinder with levonorgestrel was introduced into their design. The effectiveness of such devices is higher because they act similarly to birth control pills, however, hormonal IUDs can cause disturbances in the cycle. There may be an increase in discharge or its complete absence.

The hormonal intrauterine device is suitable for those patients who have contraindications to oral contraceptives (migraine). The service life of such funds is limited to five years.

How and when to install

You need to trust the insertion of an intrauterine device to an experienced doctor, since the process can seriously injure the uterus. The gynecologist must carry out the installation correctly, because the effectiveness of the protection will depend on this.

When can an intrauterine device be installed:

last day of menstruation;
2-3 days after the end of menstruation;
20 minutes after artificial termination of pregnancy;
6 weeks after IPB;
immediately after birth;
45 days after birth;
3 months after cesarean section.

Before the procedure, the doctor sends the patient for examination. When there is suspicion of inflammation, you need to get tested and treated. The intrauterine device can only be inserted in a sterile clinic environment. A few days before the procedure, you should stop having sexual intercourse, douching, and using vaginal suppositories.

The IUD is inserted in the first week of the cycle, when the cervix is soft, which will facilitate installation. The whole procedure takes 10 minutes. The doctor treats the cervix with an antiseptic. After inserting the spiral, two nylon threads are brought out through the canal, which are cut 3-4 cm from the cervix. They can be used to track the position of the spiral, and in the future they will help to remove it.

As the doctor uses instruments to tighten and straighten the cervix during the process, the woman may feel tingling and pain in the abdomen. However, these are necessary manipulations for the correct installation of the intrauterine device. A week after the procedure, the woman can return to normal sexual activity.

Urgent removal of the spiral

The intrauterine device should be removed when pregnancy occurs, infectious and inflammatory diseases develop, severe uterine bleeding and abdominal pain occur. Displacement of the spiral into the cervical canal and abdominal cavity is also an indication for emergency removal of the structure.

Alarms during use:

pain in the lower abdomen;
heavy and prolonged bleeding;
suspicion of pregnancy;
pain and bleeding during intercourse;
symptoms of infection (discharge, fever);
lengthening or shortening the threads of the intrauterine device.

Periodically you need to check the position of the spiral along the threads. The doctor explains the specifics of the check after installing the system. In the first month, checks are carried out weekly, and then after each menstruation. If the threads disappear or move, there is a risk of exposure.

Popular models

You need to entrust the choice of an intrauterine device to a gynecologist. The most commonly used devices are Nova T, Mirena, Juno Bio and Multiload, but the attending physician may recommend another brand at his discretion.

Multiload

The Multiload intrauterine device is non-hormonal and has a semi-oval shape. The design is equipped with soft spikes for attachment to the walls of the uterus and protection against spontaneous prolapse. The product is recommended for uterine lengths from 5 to 9 cm. The side elements of the structure are very flexible, which allows it to be installed in a high position. The spiral rests on the bottom of the organ without stretching the cavity. This spiral provides effective protection for 5 years.

The effectiveness of Multiload is due to the effect of the components of the spiral on sperm: the activity of lysosomes increases and aseptic inflammatory changes occur. In the uterine cavity, copper atoms are oxidized, and the oxides dissolve. During the day, 30 mcg of copper is released from the coil, which is enough for a local effect, but not enough to increase the level of ceruloplasmin.

In the first months after installation of the Multiload contraceptive device, the risk of infectious and inflammatory diseases of the pelvic organs is increased. If characteristic symptoms appear, you should take antibiotics and use additional protection. If the symptoms do not subside after a day, the coil is removed. In case of severe inflammation, the structure is removed immediately.

The effectiveness of the Multiload spiral may be reduced when treated with glucocorticosteroids, non-steroidal anti-inflammatory drugs, and immunosuppressants. These drugs act on the antiseptic inflammation that develops in the uterus when exposed to the spiral. If doctors prescribe any drugs from these groups, additional barrier protection must be used.

Juno Bio

The Juno contraceptive device creates conditions under which a fertilized egg cannot attach to the uterine lining. The spiral is contraindicated for inflammation, tumors, benign formations in the uterus, endometriosis, and uterine bleeding of unknown etiology.

Juno Bio spirals are divided into several models:

The design of Juno Bio-T is made of plastic, copper and monofilament thread, which makes it possible to control the position of the spiral in the uterus and facilitates its removal. The spiral has the shape of an anchor. The monofilament thread helps regulate the condition of the coil and makes removal easier. Service life – 5 years.
Juno Bio-T Super spirals have a similar design, but are additionally treated with antimicrobial agents and propolis to protect against infections. Thanks to the contrast of the copper wire, it is possible to perform ultrasound and x-rays. Service life – 5 years.
Juno Bio-T with silver has a flexible plastic base, which is wrapped in a thread of copper and silver. It was this composition that made it possible to increase the service life of the device (up to 7 years).
The ring-shaped spiral has a copper rod that helps control the process of inserting the structure. The diameter of the ring is 18 or 24 mm. The effectiveness of the product is ensured for 3.5-7 years.
The ring-shaped spiral with silver has 18 mm in diameter. Thanks to silver, the oxidation of copper slows down, which extends the service life of the spiral (5-7 years).

Nova T

Intrauterine devices of this brand are made of elastic plastic and copper braid. Thanks to the flexibility of the tips, installation of the structure is carried out safely and accurately. The device does not cause discomfort during sexual intercourse.

The Nova T spiral provides effective protection comparable to taking hormonal drugs. The action of the spiral is due to the toxic effect of copper on sperm. The disadvantages of the device include the possibility of allergies, infections of the genitourinary system and iron deficiency anemia. In 3% of cases, the development of endometritis and uterine perforation is noted. Nova T spirals are not recommended for patients over 35 years of age.

Mirena intrauterine device

The Mirena contraceptive device has the shape of a T-shaped rod with flexible shoulders and a special ring for removal. The rod contains a container with levonorgestrel. The container shell is made of a special material that ensures uniform removal of the drug into the uterine cavity.

The Mirena spiral is the most expensive on the list, but the most effective. This is due to its dual action: both as a spiral and as an oral contraceptive. Mirena provides protection against conception for 5 years. Since the IUD releases a low concentration of the hormone, it is indicated even in cases where conventional hormonal contraceptives cannot be taken.

During heavy menstruation, the Mirena system has a therapeutic effect, makes the discharge scanty, and the process itself painless. The content of progestin hormones reduces the risk of ectopic pregnancy and reduces blood loss during menstruation. Hormonal IUDs are also indicated in the presence of fibroids, endometriosis, and adenomyosis. Mirena is contraindicated for acute and chronic inflammation in the genital organs, acute hepatitis, thrombophlebitis and thromboembolic disorders.

Side effects of gestagens:

headache;
depression;
changes in body weight;
increased sensitivity of the mammary glands.

Usually, side effects disappear 3-6 months after installation of the hormonal IUD. The main disadvantage of the Mirena intrauterine device is considered to be an increased risk. In 20% of women, due to suppressed endometrial growth, menstruation completely disappeared. As a rule, the cycle is restored a year after the installation of the coil. Spotting, non-cyclical discharge may occur.

It is impossible to say for sure which intrauterine device is the best. There are no universal contraceptives. Despite all the advantages of this method of contraception, the presence of any of the contraindications puts a categorical ban on the use of spirals.

One of the best contraceptives today is the intrauterine device. Most often, plastic and copper are used for its manufacture, and more expensive models are created using gold and silver. The spiral reliably protects against pregnancy and has an anti-inflammatory effect. To understand which intrauterine device is better, you need to study the mechanism of its action, advantages, disadvantages and features of use.

Operating principle

The intrauterine device has a detrimental effect on sperm, as a result of which the egg remains unfertilized. In addition, since the IUD is located in the uterus, there is no room left for the egg to implant, and it leaves the female body with the next menstruation.

The contraceptive effect of the intrauterine device remains permanent.

Modern IUDs release female hormones, gestagens or copper ions, into the uterine cavity. These active substances enhance the contraceptive effect.

Installation Features

Before installing the IUD, the gynecologist is required to conduct an examination, determine the size and position of the uterus, and also take the necessary tests.

The intrauterine device is best installed on days 3-10 of the menstrual cycle.

At this moment, the cervix is slightly open, so the procedure is quick and easy. The spiral is inserted using a special guide. Control threads are left in the vagina. The whole process lasts 5-7 minutes. After the procedure, a woman may experience slight bleeding from the vagina, which is a natural reaction of the body. The spiral is placed for about five years, after which it must be removed.

After installing the IUD, you need to regularly check the length of its threads and visit a gynecologist every six months. During the week after installation, sexual rest and lack of physical activity are recommended.

Kinds

Intrauterine devices can be different. The main difference is the material of manufacture, sizes and shapes. The most common options:

The spiral has a T-shape and is made of flexible polyethylene. The contraceptive contains the following active ingredients:

copper;
silver;
barium sulfate;
iron oxide.

Nova T is a physiological coil that neutralizes the ability of sperm to fertilize an egg. The intrauterine device is installed only by a gynecologist, and its service life ranges from 30 months to 5 years. The main advantages of the Nova spiral:

begins to operate from the moment of installation;
does not affect sexual activity;
does not affect breastfeeding;
after removal of the spiral, the ability to bear children returns in the next cycle;
requires only one follow-up visit to the gynecologist after installation;
economical.

A domestically produced spiral, the operating principle of which is based on the fact that a small device made of plastic with copper and silver is inserted into the uterine cavity. As a result, the process of attachment of the egg to the uterus is blocked, and the motor function of sperm is inhibited.

There are the following types of Juno Bio spiral:

Juno Bio-T is made of plastic and has a T-shape. Copper wire is wound around the base of the spiral and a monofilament thread is secured. Duration of operation – 5 years.
Juno Bio-T Super - supplemented with an antimicrobial composition that contains propolis. The duration of contraception is 5 years.
Juno Bio-T Ag – a copper-silver wire is located on a vertical rod, and a monofilament thread is also fixed. Duration of operation – 7 years.
Juno Bio is ring-shaped - the diameter of the plastic ring is 24 or 18 mm. Inside it is copper wire and monofilament thread. Duration of use – from 3 to 5 years.
Juno Bio ring-shaped with Ag – plastic ring diameter – 18 mm. Inside the ring there is a copper-silver wire with a monofilament thread. Duration of use – from 5 to 7 years.

had abortions;
gave birth often;
have a large uterus.

Multiload

This type of IUD is a non-hormonal intrauterine contraceptive device and is shaped like a semi-oval, where the branches end in spike-like protrusions, allowing the IUD to better secure itself in the uterus. Multiload is made of polyethylene with the addition of copper, which makes sperm inactive. This contraceptive is indicated for women with a uterus length of six to nine centimeters. Its lifespan ranges from 3 to 5 years.

The most effective and expensive intrauterine device, which will reliably protect against unwanted pregnancy for five years. Mirena is T-shaped and consists of a plastic rod with a container containing the hormone levonorgestrel and a hanger. The hormone is dosed at 14 mcg per day from a container into the uterine cavity. This amount of the substance is enough for a contraceptive effect.

increased sensitivity;
liver pathologies;
infectious diseases of the excretory system;
otosclerosis;
hormone-dependent swelling;
predisposition to thromboembolism.

Removing the spiral

When the spiral expires, it must be removed. Sometimes the procedure is performed earlier, for the following reasons:

Displacement of the spiral inside the uterus. The first sign is a change in the length of the antennae.
Pregnancy - extraction is carried out in both normal and ectopic pregnancies.
The desire to have a child.
Growth of uterine tumor after installation of the IUD.
Inflammation of the uterus and its appendages.

Removing the IUD is a painless procedure, but only if the woman is healthy. It should only be performed by a doctor.

First, he examines the woman, assesses the condition of the spiral and the possibility of eliminating it. Direct removal of the spiral is carried out using several methods:

During menstruation with local anesthesia,
Using hysteroscopy,
Through the abdominal cavity, if it is not possible to get the device through the vagina.

Side effects

The most common side effects after installation of the IUD are:

increased menstrual flow and increased duration:
the appearance of menstrual or ovulatory pain;
increased risk of developing infectious diseases.

The risk group includes women who:

do not follow the rules of intimate hygiene;
have a partner who is a carrier of the infection;
suffered from inflammatory diseases of the reproductive system;
have not yet had labor activity.

If side effects are severe, the doctor may remove the IUD and choose another method of contraception.

The key to the safety and effectiveness of the intrauterine device is to contact a highly qualified gynecologist and pay attention to your body.

Contraindications

The intrauterine device is an effective means of protection against unwanted pregnancy. There are various contraindications.

Absolute contraindications imply a woman’s complete refusal to use this method of contraception. Relative contraindications imply careful use of the intrauterine device.

Let's look at them in more detail.

Absolute contraindications:

infectious diseases of the reproductive system, both acute and chronic;
pathologies, uterine fibroids or polyps;
oncological diseases of the genital organs;
pathological uterine bleeding;
allergic reaction to copper;
pregnancy;
adolescence.

Relative contraindications:

ectopic pregnancy in the past;
menstrual irregularities;
pathologies of the cardiovascular system;
endometriosis;
coagulopathy;
promiscuity;
scars on the uterus or its small size;
absence of pregnancies.

In all of the above situations, it is important for a woman to think about the feasibility and safety of using an intrauterine device.

Of the various methods of contraception, let's discuss intrauterine contraceptives (IUDs), also known as . This type of contraception is considered the most effective.

What is the Navy

An intrauterine device is a small device made of plastic with the addition of copper, silver, gold, and is an intrauterine contraceptive device. IUDs with the addition of precious metals are more effective and contribute more to reducing the inflammatory process, but their cost is higher than usual.

The main function of the IUD is to prevent sperm from entering the uterus. And copper, which is part of the spiral, promotes the production of natural liquid spermicide in the female body, thanks to which the movement of sperm stops and does not allow them to reunite with the egg. In case of failure and if the connection of two cells nevertheless occurs, then the number of endometrium begins to decrease, while the egg does not have the opportunity to attach to the wall of the uterus.

As you know, in certain cases, doctors may not recommend, or even prohibit the use of a particular drug, so, IUDs also have a list of contraindications for which installation is not recommended, here is the list:

Pregnancy;
Diseases or the presence of pathologies in the pelvic organs;
Erosive defect of the cervix;
Oncological neoplasms located in the uterine cavity or cervix;
Bleeding of unknown origin.

The use of an IUD is also not recommended for women who have not yet given birth. A refusal may be an increased risk of an inflammatory process in the uterus, which sometimes leads to pain that occurs during the installation of this medical product and possibly with further use. For nulliparous women, the only exception is a contraindication to pregnancy if it is impossible to use other methods of birth control.

A unique IUD that would suit any woman has not yet been created. To select the optimal option in accordance with the individual physiological characteristics of the patient’s body, a consultation with a gynecologist is necessary.

It is precisely because of the structural features of the uterus and the presence or absence of deviations in its development that the specialist chooses the appropriate type of remedy. Types of intrauterine devices are divided into 4 generations:

The first generation is an inert IUD. The “Lipps loop” was very popular at the time - it looked like a Latin S and was made of polyethylene. They had low efficiency and frequent cases of expulsions;
The second generation is a copper IUD. Acts as a spermicide and stimulates the myometrium. In the uterine cavity, the environment becomes acidic due to copper, due to which the activity of sperm is significantly reduced. However, due to the rapid release of metal, this product is changed every 2-3 years;
The third generation includes intrauterine devices, which contain silver in addition to copper. High efficiency and increased period of use up to 5 years;
The fourth generation is an intrauterine hormonal device. It has the shape of the letter T. The IUD leg contains the hormone levonorgestrel or progesterone, which is released into the uterus daily, suppressing the maturation and subsequent release of the egg, also affecting the endometrium. The incidence of inflammatory diseases of the genitals is significantly reduced, and hyperpolymenorrhea is reduced. The period of use of this IUD is from 5 to 7 years.

Spirals can also be divided by appearance, that is, by their shape:

T-shaped spirals;
means in the form of a loop;
ring-shaped intrauterine device;
IUD in the form of a spiral or umbrella.

Types of IUDs.

IUDs that have become popular, price

T-shaped spirals are most widespread. This type also includes Mirena, which contains the hormone levonorgestel, which is released into the body at 24 mcg per day, evenly. The effect lasts for 5 years. This product costs 7-10 thousand rubles.

Multiload is an oval-shaped product with protrusions with spikes, for more convenient strengthening in the uterus, on the walls, accordingly reducing the risk of expulsion. Cost – 2-3 thousand rubles.

Nova T is an IUD with an appropriate shape (T-shaped) containing copper. Its price is up to 2 thousand rubles and the period of use is 5 years.

Insertion of intrauterine devices

Passing the necessary tests and ultrasound to exclude diseases, pregnancy or pathologies that are included in the list of contraindications for the use of these devices is the main condition before installing the necessary and suitable spiral.

The installation of the IUD is carried out by a gynecologist on days 5-7 of the menstrual cycle, and a contraceptive intrauterine ring (such as Juno Bio) can be inserted on days 3-4 of the cycle. Before the insertion procedure, the uterine cavity is washed with a special solution, after which the depth of the uterine cervix is measured and the IUD is inserted. The threads located on the spiral are shortened, leaving short “antennae” of up to 2 cm, for control and subsequent removal. The whole process takes about 10 minutes.

Advantages and disadvantages of using an IUD

Highly effective (up to 99%), no need to monitor every day. This method works from 3 to 10 years, depending on the type of IUD, and does not affect the process of conception after removal;
Control of the “antennae” of the IUD to prevent expulsion.

Negative aspects are also present

The appearance or intensification of pain during insertion and further use;
Increased discharge during menstruation, as well as the appearance of “spotting” between menstruation;
Vaginal discharge with an uncharacteristic odor may appear;
Possible ectopic pregnancy;

Extraction

The IUD can be removed at any time if the patient so desires. Before undergoing the extraction procedure, you also need to undergo a series of tests.

Reason for patients’ refusal to install the IUD

A categorical refusal may be related to religious considerations; according to these women, the IUD operates on the principle of early abortion, since sometimes the process of conception occurs. In this case, it is necessary to recommend hormone-containing spirals.

Video: Intrauterine device

In the article we discuss the intrauterine device. We talk about its types, when it is placed, and 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 the consequences are after using it.

An intrauterine device (IUD for short) 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 IUD has the following operating principles:

Suppression of ovarian function and slowing down ovulation. When using an intrauterine device, the hypothalamic-pituitary system is slightly stimulated. This provokes a slight increase in the secretion of levonorgestrel, while maintaining the production of progesterone and estrogens. At the same time, there is an increase in the amount of estrogen, as well as a shift in their peak in the middle of the cycle by 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 in the synchronization of these transformations. The first phase lengthens, partial maturation of the uterine mucosa occurs, and this prevents the fertilized egg from implanting into the endometrium. The presence of copper in the IUD helps increase the absorption of estrogen, and levonorgestrel activates early maturation of the endometrium with subsequent rejection before the egg has time to securely attach itself to the uterus. This effect of the IUD is abortifacient.
Aseptic inflammation in the uterine cavity, impaired sperm movement. The presence of an IUD in the uterine cavity irritates its walls, thereby stimulating the secretion of prostaglandins by the uterus. These substances activate partial maturation of the endometrium, as well as aseptic inflammation in the uterine cavity. At the same time, the amount of prostaglandins increases in the cervical mucus, which stops the penetration of sperm into the uterine cavity. Due to aseptic inflammation due to the presence of the IUD, the number of leukocytes, histiocytes, and macrophages increases. All these cells increase sperm phagocytosis, isolating the fertilized egg, preventing its implantation into the endometrium.
Changes in the nature of the movement of the egg along the fallopian tube. The released prostaglandins accelerate the peristalsis of the uterine tubes. Because of this, an unfertilized egg enters the uterus (its meeting with a 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 install an intrauterine device, we suggest that you familiarize yourself with its main advantages and disadvantages.

Advantages

The most important advantage of using an IUD is the ability to forget about the need to protect yourself from unwanted pregnancy for a period of 3 to 10 years, depending on the type of device. The contraceptive effect occurs immediately after installation of the IUD. Moreover, the degree of protection against unwanted conception is up to 98 percent.

The spiral is easy to install and also easy to remove. You don’t have to wait until its expiration date expires; you can ask your gynecologist and she will get it for you right away. After removal of the IUD, pregnancy usually occurs after several cycles, in some cases during the first menstrual cycle. In this case, 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 realize that you are using an IUD, since the man cannot feel it during intercourse. The spiral does not affect the general condition of the body in any way and does not worsen the course of extragenital diseases.

An IUD does not require daily monitoring, which is convenient compared to birth control pills, which must be taken daily at specific times. Taking various medications does not have any effect on the action of the spiral. With an IUD, you can perform various surgical interventions and even breastfeed your baby.

Flaws

The main disadvantage of the IUD is the fact that after its installation the cervix remains open. This is dangerous due to the possibility of penetration of pathogenic microorganisms into it, which provoke inflammatory processes in the 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 installation of the IUD, you may experience aching pain in the lower abdomen. This is due to increased sensitivity of the uterus or an incorrectly 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 coil provokes increased menstrual flow and the duration of menstruation. In some cases, this later leads to anemia.

Sometimes, while using an IUD, an ectopic pregnancy occurs. It is quite dangerous, as in some cases it is fatal.

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 get pregnant, increasing the risk of miscarriages. Anomalies in the structure of the female genital organs are a prohibition for the installation of an IUD, since in this case there is no guarantee of protection against unwanted pregnancy.

Another disadvantage of the intrauterine device is the possibility of it falling out. As a rule, this happens during menstruation. Since not everyone is able to notice the prolapse of the IUD, this can lead to unwanted conception.

The IUD does not protect against sexually transmitted infections. Therefore, it is better to use it only if you have a regular man, and for protection with casual partners, it is better to use a condom.

The IUD can only be inserted into women who have given birth, which makes this method of birth control inaccessible to those who have not yet experienced the delights of motherhood. It is prohibited to insert or remove the IUD 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 IUD.

Sometimes the IUD 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 specialist’s recommendations and remember that an IUD can only be installed 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.

Currently, more than 50 contraceptive IUDs can be found on sale.

All types of IUDs 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 become dislodged, for this reason their use is prohibited in many countries. Representatives of this group:

plastic Lipps loop;
Mauch steel ring with 2 scrolls;
double helix Saf-T-Coil.

Copper

This type of vaginal device belongs to the 2nd generation. This is a small T-shaped or semi-oval device, its rod is wrapped in 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 sperm activity is greatly inhibited. Such contraceptives are prescribed 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 collapse. For this reason, to extend the life of the copper IUD, manufacturers began to add silver to its rod. Because of this, the sperm toxic effect is enhanced several times, and silver ions, which have a disinfectant and antibacterial effect, have a beneficial effect on the female body.

The period of use of such a contraceptive is from 5 to 7 years.

Gold

Gold Navy is an alternative to silver and copper products. Its main advantage is complete biological compatibility with the woman’s body, the absence of allergic manifestations, and the metal’s resistance to corrosion damage.

The gold device has anti-inflammatory properties and 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 normal condition.

Hormonal

The latest generation of IUDs are hormone-containing devices. According to doctors, they are the most effective means of contraception.

Such an IUD is T-shaped; its stem contains 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, having only a local effect: it eliminates inflammation, inhibits ovulation, and prevents fertilization of the egg. This product can be used for 5 to 7 years.

Navy uniforms

It is extremely difficult to say exactly which contraceptive device is the best. This product is selected individually, based on 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 IUD 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 hangers extend.

The hangers help fix the product in the uterine cavity. At the end of the rod there is a special thread with which you can easily remove the contraceptive.

Ring-shaped

The device is easily attached to the uterine cavity and removed. There are no additional threads in it, since they are not necessary.

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 loss.

A contraceptive product in the form of a loop is used by women who have a non-standard uterine structure. And in this case, they do not have the opportunity to use a T-shaped IUD.

Installation of an intrauterine device

The IUD is installed:

women who gave birth after an abortion, if it passed without inflammatory complications;
women over 35 years of age 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 cervical pathologies.

Inserting a spiral into the uterine cavity will require some preparation, since this procedure is a medical intervention. Before installing the IUD, it is necessary to undergo an examination and cure all chronic gynecological diseases.

What examinations need to be completed 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 seeding of vaginal discharge, cervix;
blood tests for HIV infection;
submitting a smear for cytology, microflora from three points.

Immediately before inserting the spiral, the specialist probes the uterus, measures the length and distance between the uterine angles. Many women ask what day the IUD is placed on. It is placed on the 3-4th day of menstruation, since during them the cervix is slightly open, and this facilitates the process of introducing a contraceptive. In addition, the blood that is released during menstruation reduces the possibility of injury to the uterus, and also means that there is no pregnancy at the time of installation.

Mild pain in the lower abdomen after insertion of the IUD, as well as spotting, are considered normal, 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 installing the contraceptive, depending on how you feel.

After installing the IUD, slight spotting may appear for 2-3 months. When the spiral is installed correctly, neither the woman nor the man feels it.

After the introduction of an intrauterine contraceptive, you need to come for an examination by a gynecologist in a month, then after three months and after that every six months.

Removal of the IUD

Removal of the intrauterine contraceptive device occurs in several stages. If you do not want to get pregnant, then 7 days before the removal of the IUD, exclude unprotected intimate relations. This is due to the ability of sperm to remain active for 2-3 days, as well as the possibility of ovulation occurring after the IUD is removed. As a result, conception may occur.

It is advisable to remove the IUD on the 3-4th day of your period, in this 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 well.

The procedure begins with an examination in a gynecological chair. The specialist examines the uterus to find the tendrils of the IUD. After this, a dilator is inserted to stabilize the uterus and its cavity is treated with antiseptics.

The patient inhales deeply and slowly, after which the doctor grabs the tendrils of the product with forceps, carefully removing it from the uterine cavity. Now you can easily reach the spiral by hand. During critical days, gliding occurs better.

The total duration of the procedure is several minutes, taking into account preparation. Normal symptoms after IUD removal include muscle spasms, cramping, and minor bleeding. Typically, these signs disappear within a couple of days. If there are no health problems and if desired, a new IUD can be installed immediately after removal of the IUD.

Many women are concerned about whether it hurts to remove the intrauterine device. According to reviews, inserting an IUD is more painful than removing it. Therefore, as a rule, you can do without anesthesia during the procedure.

Which is the best intrauterine device?

Pharmacies offer many remedies for unwanted pregnancy. IUDs are in particular demand among women.

Depending on your financial capabilities and physiological characteristics, the gynecologist will recommend which is best to place 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 can be used by most women.

The product has a high degree of protection against unwanted pregnancy, suppresses ovulation, reduces the possibility of developing 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 - from silver.

The product has a detrimental effect on sperm, reduces their motility and the ability to fertilize an egg. The price of the product is from 2 thousand rubles, while the service life is no more than 5 years.

Juno

Belarusian doctors were involved in the development of this spiral. There are many varieties of this spiral on sale, including for women in labor and those who do not yet have children. The price of the product ranges from 250-1000 rubles.

Main types of Juno model:

Juno Bio Multi - made in F shape with jagged 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 shape of an anchor with a copper thread on the rod.
Juno Bio-T Super is the same as the previous model, but with an antimicrobial composition.
Juno Bio-T Au - golden spiral, suitable for women with allergies to metals.

Goldlily

Goldlily (also called Lily) is an effective non-hormonal product that helps prevent unwanted pregnancy. The main metals of the product 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 sexual intercourse during the first days after it. Copper ions have a spermicidal effect.

This spiral is made of polyethylene in a T-shape, wrapped with metal wire. The service life is up to 7 years.

Multiload

This product is made in the shape of an umbrella; there are protrusions of spikes on its sides, which help to securely secure the product in the uterine cavity. The leg of the product is wrapped in copper, which inhibits sperm and neutralizes their ability to fertilize.

The spiral can be used in nulliparous women. The price of the device starts from 3,500 rubles.

Side effects

After installation of an intrauterine device, side effects are extremely rare. Modern technologies for manufacturing IUDs minimize the risk of their formation.

But in some cases, you should not postpone a visit to the gynecologist after inserting the IUD, especially if you have the following symptoms:

pain in the lower abdomen;
discomfort during intimacy;
heavy bleeding;
there are signs of infection (unpleasant odor, unusual vaginal discharge, burning or itching in the perineum);
bleeding during sexual intercourse;
shortening or lengthening the threads from the spiral.

Contraindications

It is prohibited to install or use an IUD in certain cases:

endometriosis;
anemia;
pregnancy;
diseases of the endocrine system;
acute inflammatory processes of the genital organ;
previous history of ectopic pregnancy;
abnormal uterine structure;
bleeding in the uterus;
problems with blood clotting;
formations in the uterine cavity;
chronic inflammatory processes of the genital organ;
cervical dysplasia.

Intrauterine device - photo

Price

Several factors influence the final cost of IUD installation. These include the type of product and the clinic where the installation will take place. This type of contraception is affordable for most women.

In some antenatal clinics, IUDs are installed free of charge. It will not hurt to know that taking oral contraceptives, as a rule, is more expensive than the IUD.

You can buy a spiral at a pharmacy or online store. How much it costs depends on the model, material, manufacturer, and the presence or absence of side effects. The price of an IUD ranges from 300-10,000 rubles.

The intrauterine device (abbreviated IUD) has been popular for quite a long time among women of childbearing age who have given birth. And despite the high contraceptive effect, most women doubt the need to install an IUD, arguing their refusal by the occurrence of side effects and complications.

With the correct choice of the IUD, the professionalism of the doctor (introduction procedure), taking into account indications and contraindications, this remedy is indeed the most successful method of contraception, which does not require strict self-discipline, as, for example, when taking hormonal pills.

An intrauterine device is

An intrauterine contraceptive device or intrauterine device is a device made of synthetic material (medical plastic), which is inserted into the uterine cavity, which prevents the development of an unwanted pregnancy in it. Modern IUDs are small in size, from 24 to 35 mm, and contain either non-inflammatory metals (copper, silver or gold) or the hormone levonorgestrel (LNG-IUD).

Historical reference

The development of an intrauterine method of contraception began in 1909, when Dr. Richter proposed using a contraceptive made from two silk threads connected by a bronze thread. The invention was not popular. Since 1920, the gynecologist Grafenburg began experiments, creating structures from silkworm threads, and later constructed a ring of silk threads, which was braided with silver wire. But a serious drawback of the ring was its spontaneous expulsion (loss).

Later, in 1961, Dr. Lippes produced an IUD of a serpentine configuration (double S), and although the device is called a Lippes loop or Lipps, its zigzag shape is more like a spiral, which gives the name to modern intrauterine devices - intrauterine device.

Mechanism of action

The intrauterine device has several mechanisms of action:

Inhibition of ovulation, suppression of ovarian function

While wearing an IUD, the hypothalamic-pituitary system is slightly activated, which leads to a slight increase in LH secretion, but to the preservation of the production of estrogen and progesterone. At the same time, there is an increase in estrogen content and a shift in their peak in the middle of the cycle by 1 - 2 days.

Preventing or disrupting implantation

In the second phase, there is a more significant increase in progesterone, but a decrease in the duration of the second phase. Although the endometrium changes cyclically, the synchrony of these transformations is disrupted: the first phase is lengthened, and secretory changes are delayed (incomplete maturation of the uterine mucosa), which prevents the introduction of a fertilized egg into the endometrium. Due to the copper content in the coil, the absorption of estrogen is enhanced, and the LNG-IUD stimulates the early maturation of the endometrium and its rejection, when the egg has not yet had time to securely attach itself in the uterus. This is the abortive effect of the spiral.

Impaired sperm movement and aseptic inflammation in the uterus

The IUD, while in the uterus, irritates its walls, which provokes the uterus to secrete prostaglandins of biologically active substances). Prostaglandins not only stimulate the release of LH and inadequate maturation of the endometrium, but also aseptic inflammation in the uterus. At the same time, the level of prostaglandins increases in the cervical mucus, which inhibits the penetration of sperm into the uterine cavity. As a result of aseptic inflammation, which arose in the uterine cavity in response to the insertion of the IUD as a foreign body, the content of leukocytes, macrophages and histiocytes increases. All of these cells enhance phagocytosis (devouring) of sperm and isolate the fertilized egg, preventing it from implanting in the endometrium.

Changes in the nature of movement of a fertilized or unfertilized egg through the fallopian tube

The released prostaglandins accelerate the peristalsis of the fallopian tubes, as a result of which either an unfertilized egg enters the uterus and meets the sperm in the tube, or a fertilized one, but too early, when the endometrium is not yet ready for its implantation.

Types of intrauterine devices

Intrauterine devices can be of various types, and differ both in shape and in the content of medicinal substances or metal in it.

In addition, as new intrauterine devices are developed, all IUDs are divided into 3 generations according to the time of their appearance:

1st generation IUD

Such spirals are made of plastic and do not contain any metal, so they are classified as inert (neutral). The contraceptive effect is achieved only by provoking aseptic inflammation and preventing the implantation of a fertilized egg. The Lippes loop belongs to the first generation. But their use has been prohibited by WHO since 1989 due to the low contraceptive effect, the high likelihood of developing inflammatory diseases of the uterus and appendages, and spontaneous expulsion.

2nd generation Navy

The second generation of spirals includes metal-containing ones. First, IUDs containing copper appeared, which has an anti-anidation effect, that is, it prevents implantation. Copper-containing spirals consist of plastic (the basis of the IUD), the leg of the spiral is wrapped with copper wire. Depending on the amount of copper, these intrauterine devices are divided into low-copper IUDs and high-copper IUDs. Later, spirals began to be made with silver content in the lumen of the leg or with gold, in the form of a wire wrapped around the leg. Silver- and gold-containing IUDs are considered more effective in terms of contraception (the contraceptive effect reaches 99%), prevent the development of inflammatory diseases, and the duration of action increases to 7–10 years.

3rd generation Navy

The latest generation of IUDs includes intrauterine devices that contain a progestin, levonorgestrel. Their other name is LNG-IUD. Popular hormone-containing intrauterine devices are Mirena and the LNG-20 IUD. LNG-IUDs not only have an almost 100% contraceptive effect, but also have a therapeutic effect (therefore they are recommended for women with small uterine fibroids or endometrial hyperplasia).

Spiral shapes

IUDs differ not only in composition, but also in shape. Today there are about 50 types of spirals of different shapes. The form and composition of the intrauterine contraceptive is recommended and selected by the doctor based on medical history, body type, individual anatomical characteristics, and other things. Therefore, it is difficult to decide “on the spot” which intrauterine device is better. Popular spiral shapes:

Semi-oval

Another form of intrauterine contraceptive is called an umbrella or horseshoe. There are small spikes on the external protrusions - the “shoulders” of the spiral, which allow the device to be securely fixed in the uterine cavity and prevent its expulsion.

Among the advantages, one should note their almost painless insertion (the spiral is well configured when passing through the cervical canal, and straightens out in the uterine cavity), rare spontaneous falls of the device due to the spikes on the “shoulders,” and a minimum of painful sensations when worn. “Horseshoes” are ideal for women who have a history of spontaneous childbirth or women whose cervix is “nulliparous” (after surgical birth).

Round or semicircular

Another name for such contraceptives is a ring or half ring. In China, IUD rings that do not have “antennae” and have one curl are popular.

From practice: Ring-shaped spirals are quite inconvenient. Mostly, patients complain of pain, in some cases quite significant, at the time of insertion of the spiral. The “ring” is poorly configured and passes through the cervical canal with difficulty, which causes pain. In addition, women with a history of only one birth often complained of painful menstruation. Therefore, in my opinion, this form of contraception is absolutely not suitable for women after a cesarean section or who have only one independent birth. But multiparous patients did not complain either during insertion or during wearing. The contraceptive effect, despite the shape of the device, remains high.

T-shaped

Perhaps the most common type of spirals in Russia. Externally, the contraceptive resembles the letter “T”, that is, it has a rod wrapped in copper or silver (gold) wire and 2 “shoulders”. If we talk about the best intrauterine devices, then this form is the most preferable, it is so easy to insert, comfortable to wear (the woman does not experience discomfort), removed without problems and securely fixed in the uterus due to the flexibility of the “shoulders”.

In my opinion, the T-shaped spiral has only one drawback - its percentage of spontaneous expulsion is higher than that of spirals of other shapes. Recommended for women after a cesarean section or after a single spontaneous birth (the cervical canal is more or less closed, which reduces the risk of prolapse).

Review of popular IUDs

Mirena

Contains the most active of gestagens - levonorgestrel, which gives the spiral antiestrogenic and antigonadotropic properties, in addition to a high contraceptive effect. Levonorgestrel suppresses the proliferation of the endometrium and causes its atrophic changes, therefore this contraceptive is administered more often for therapeutic purposes (for dysfunctional uterine bleeding, heavy and prolonged periods, dysmenorrhea, uterine fibroids, premenstrual syndrome). Mirena is also used as hormone replacement therapy in post- and perimenopause. Guaranteed service life 5 years. Its shape is T-shaped.

The average price of Mirena spirals is 12,000 rubles.

Juno Spiral

Has many varieties:

Juno Bio-T in the form of a horseshoe or ring with a copper component;
Juno Bio-T Ag in the shape of a horseshoe or the letter “T” with a copper-silver component;
Juno Bio-T Super, made in the shape of a “T” letter, contains copper and propolis, which provides an anti-inflammatory effect;
Juno Bio-T Au – contains gold, suitable for women with allergies to metals.

Due to its composition, this type of spirals has a general antiseptic effect, that is, the risk of inflammatory diseases of the uterus and appendages is quite low. Therefore, the Juno spiral is recommended for patients with chronic adnexitis or endometritis.

The average price of a Bio-T Ag spiral is 400 rubles.

Nova-T Cu Ag

Guaranteed service life up to 5 years. It is made in the shape of the letter “T”, the leg of the device is wrapped in copper wire with a silver core (silver slows down the corrosion of copper, lengthening the life of the spiral).

An effective contraceptive with a fairly long wearing period. Recommended for young women with 1-2 births and previous inflammatory diseases of the uterus or appendages.

The average price of a Nova-T spiral is 2500 rubles.

Multiload

Made in the shape of a horseshoe with spikes on the outer surface of the hanger. The rod of the device is wrapped with copper wire. There are 2 types of Multiload spirals available (depending on the copper surface area): Cu-250 (copper area 250 square mm) Cu 375 (375 square mm). The validity period is 5 and 5 – 8 years, respectively.

Perhaps the best spiral of all those on the market today. It is easy to insert and wear, the duration of action is long, the contraceptive effect is high, and it has antiseptic properties (due to copper). As a rule, gynecologists recommend Multiload to women who decide to introduce the device for the first time.

The average price in Moscow is 3,500 rubles.

Gravigard – Cu-7

Made in the USA in the shape of the number 7, the leg is covered with copper wire (copper area 200 cubic mm). Installed for 2 – 3 years.

Since the device has only one “shoulder”, it is inserted almost painlessly, therefore it is suitable for nulliparous women, including those whose first birth ended in a cesarean section. The risk of the IUD falling out in this case is very low, but it is recommended to wear Gravigard Cu-7 for women with high parity (three or more births).

Validity period of the IUD

How long can a spiral last? A similar question worries all women who decide to use this contraceptive method. The service life of the IUD varies for different types of intrauterine contraceptives and depends on the amount of metal or drug included in their composition (in the absence of side effects while wearing the device):

Duration of use depends on the total surface area of the copper. The validity period ranges from 2 – 3 years to 5 – 8 years.

Service life from 5 to 7 years.

Validity period is from 5 to 7 years, longer wearing is possible, up to 10 years.

LNG-IUD

Contraceptive and therapeutic effects are guaranteed for 5 years of wearing the contraceptive, but persist for 1 to 2 years after the end of the official validity period.

Insertion of an intrauterine contraceptive device

Before you decide to install an intrauterine device, you should visit a gynecologist and undergo the necessary examination:

a thorough history taking and gynecological examination to identify contraindications for the use of an intrauterine device;
taking smears for microflora from the cervical canal, urethra and vagina;
PCR for sexually transmitted infections (according to indications);
CBC (exclude anemia, allergic reaction - increase in eosinophils and hidden inflammatory process);
UAM (rule out urinary tract infection);
Ultrasound of the pelvis (exclude gynecological diseases, pregnancy, including ectopic, and uterine malformations);
colposcopy (according to indications: background processes of the cervix).

On the eve of the procedure for introducing a contraceptive, it is recommended:

maintaining sexual rest for 2 – 3 days before the procedure;
refusal to douche and use intravaginal products (suppositories, tablets and creams);
refusal to use intimate hygiene products.

The IUD is inserted at the end of menstruation, approximately on the 4th - 5th day, which prevents its loss (menstrual bleeding decreases, and the external pharynx still remains slightly open, which facilitates the introduction of a contraceptive).

Administration procedure

the patient is placed on a gynecological chair, a Simps speculum is inserted into the vagina, exposing the cervix, the cervix and vagina are treated with an antiseptic (the procedure is performed on an outpatient basis and is practically painless);
the cervix is fixed with bullet forceps, the length of the uterus is measured with a probe;
a plastic conductor (attached to the IUD) is inserted into the cervical canal, which is advanced into the uterine cavity, then the contraceptive is pushed out with a plastic piston (ideally, the spiral should rest against the uterine fundus with its “shoulders”); if the spiral is T-shaped, the “hangers” are first tucked into the conductor (by pulling the threads from the back side of the conductor);
the conductor is carefully removed, long threads protrude from the cervix into the vagina, which are cut to the required length, creating “antennae” - they will protrude from the external pharynx, which is necessary for self-control of the presence of the IUD in the uterus;
the entire administration process takes no more than 5 minutes.

After introduction

the doctor records the date of installation, the model of the device in the outpatient card and informs the patient of its validity period;
control appearance is scheduled after 10 days;
sexual rest, refusal to lift heavy objects, take laxatives and hot baths for 14 days after insertion of the intrauterine device;
refusal to use vaginal tampons (7 – 10 days).

Immediately after the procedure, the woman is recommended to sit, and if necessary, lie down, for 15 to 30 minutes. Pain in the lower abdomen may occur (contractions of the uterus in response to the presence of a foreign body in its cavity), which should disappear on their own after 30 - 60 minutes.

A woman should be checked regularly (once every six months) by a gynecologist and independently monitor the location of the contraceptive (feeling the “antennae” with her fingers at the external pharynx). If the “antennae” cannot be felt or the lower end of the device is felt (incomplete spontaneous expulsion), you should urgently contact a specialist. Other reasons to see a doctor are:

delayed menstruation (possible pregnancy);
bleeding or intermenstrual discharge with blood;
pain in the lower abdomen (intense during menstruation and discomfort outside of menstruation);
fever, signs of intoxication;
the appearance of pathological vaginal discharge (with an odor, greenish or yellowish in color, foamy, abundant);
pain during coitus;
increased menstrual blood loss (lengthened periods, increased volume of blood lost).

Contraindications and complications

The introduction of an intrauterine contraceptive has a number of contraindications.

The absolute ones include:

pregnancy or suspicion of it;
genital cancer, suspicion of it or hereditary predisposition;
acute and exacerbation of chronic inflammatory diseases of the genitals;
promiscuous sex life (high probability of contracting sexually transmitted infections);
bleeding from the genital tract of unknown etiology;

Relative ones include:

inflammatory processes in the past of the uterus/appendages;
chronic inflammatory diseases of the uterus/appendages;
painful periods;
heavy, prolonged menstrual or intermenstrual bleeding;
hyperplastic processes of the endometrium;
endometriosis;
underdevelopment of the uterus and malformations (septum in the uterus, bicornuate or saddle-shaped uterus);
ectopic pregnancy in the past;
cervical deformity, anatomical isthmic-cervical insufficiency;
anemia and other blood diseases;
absence of childbirth;
taking immunosuppressants;
chronic inflammatory general diseases, including tuberculosis;
cardiovascular diseases;
cervical canal stenosis;
submucosal fibroid;
intolerance to metals or hormones;
spontaneous expulsion of the IUD in the past.

Side effects and complications

Possible complications and adverse reactions during or after insertion of an intrauterine device include:

cervical injury, bleeding and perforation of the uterus during the introduction of a contraceptive;
intense pain during menstruation, during sexual intercourse, during the intermenstrual period;
spontaneous expulsion of the contraceptive;
cycle disturbances (extension of menstruation, heavy periods, intermenstrual bleeding);
pregnancy, including ectopic;
chronic endometritis and adnexitis after removal of the IUD, infertility;
anemia (with hyperpolymenorrhea);

Advantages and disadvantages

The use of intrauterine contraception has its advantages and disadvantages, like any other method of protection against unwanted pregnancy.

Advantages of the Navy

acceptable price;
duration of use;
financial savings (no need to constantly buy birth control pills and condoms);
does not require strict self-discipline (constant taking of pills);
rapid restoration of reproductive function after removal;
high efficiency (up to 98 – 99%);
the occurrence of a contraceptive effect immediately after administration;
the possibility of emergency contraception after unprotected coitus;
therapeutic effect (for fibroids, heavy periods, intrauterine adhesions - synechiae);
relaxation during intimacy (lack of fear of getting pregnant);
suitable for contraception in the postpartum period;
absence of adverse reactions and complications when taking into account contraindications and correct selection and administration of a contraceptive;
compatibility with medications and alcohol;
anti-inflammatory effect due to the content of copper, silver, gold and propolis.

Disadvantages of the IUD

increased risk of ectopic pregnancy (except LNG-IUS);
the risk of spontaneous (and unnoticed by the woman) loss of the contraceptive;
increased risk of contracting sexually transmitted infections and the occurrence of adnexitis/endometritis during casual sexual intercourse;
an increase in the volume and duration of menstrual blood loss and the development of anemia;
risk of damage to the uterus or cervix when inserting or removing a contraceptive;
requires regular checking for the presence of a spiral;
the onset of intrauterine pregnancy and, as a rule, the need to terminate it;
the main effect of the IUD is abortifacient, which is not acceptable for religious women;
the introduction and selection of the spiral is carried out by a specialist.

Insertion of the IUD after...

Optimal timing for insertion of an intrauterine contraceptive device:

6 weeks after spontaneous childbirth (healing of the wound site in the uterus after separation of the placenta and formation of the cervical canal);
six months after surgical birth (final healing of the uterine scar and its consistency);
after 35 years in the absence of contraindications or in the presence of endometrial hyperplastic processes (LNG-IUS);
after an abortion, either immediately or during the first menstruation;
after unprotected coitus for 5 - 7 days.

Question answer

Question:
I want to try installing an IUD. What is the best spiral?

No gynecologist will give an unambiguous answer to such a question. The doctor observing you can only recommend one or another form of device with a certain composition. The choice depends on previous inflammatory diseases of the pelvic organs, hormonal disorders (whether there were dysfunctional bleeding, disruptions in the cycle or hyperplastic processes), the number of births and their resolution (independent or surgical), constitutional characteristics (physique, uterine curvature) and other factors. And even after a thorough study of the medical history and examination, it is impossible to say with confidence that this particular spiral will be suitable. When choosing a device, you should focus not on the price (the more expensive, the better) and not on the advice of friends (I have this shape and brand, no problems), but on the doctor’s recommendations. Choosing and installing an IUD is comparable only to choosing shoes. Until you try it on, you won’t know whether the shoes fit or not, it doesn’t matter that the size matches (the shape of the last, the width of the foot, the instep, and much more are important). The same can be said about spirals. Even after successful insertion and safe wearing for a month, such severe pain may occur during menstruation that the patient runs to the doctor with a request to remove the device.

Question:
When I independently checked the presence of a spiral, I did not feel the “antennae”. What to do?

You need to see a gynecologist. It is possible that the IUD fell out without you noticing, so pregnancy is possible. But it is possible that the “antennae” simply “hid” in the cervical canal, and the gynecologist will remove them with tweezers and gently pull them.

Question:
Is it possible to get pregnant while using the IUD?

Yes, this method does not have a 100% contraceptive effect. Pregnancy is possible in 1–2% of women. Its risk is especially high with incomplete spontaneous expulsion, when not only “antennae” protrude from the external pharynx, but also the rod of the spiral.

Question:
When and how is the spiral removed?

If wearing a contraceptive does not cause discomfort and does not cause side effects, then it is removed either after the expiration date or at the request of the woman, on any day of the cycle (preferably during menstruation - less painful). Removal is performed by a gynecologist by grasping the “antennae” with tweezers or a forceps and pulling them towards himself. A situation is possible when the spiral threads are not visible in the outer pharynx or come off when grasped with a forceps. Then the IUD is removed with a special hook, inserted into the uterine cavity and hooking the contraceptive onto the “shoulders”. Sometimes the situation requires short-term hospitalization to remove the device with a hook and subsequent curettage of the uterine cavity (significantly exceeding the period of wearing the IUD, failure of an attempt to remove the device on an outpatient basis, uterine bleeding or excessive growth of the endometrium, confirmed by ultrasound).

Question:
How quickly is the ability to become pregnant restored after the device is removed?

The timing of fertility restoration varies from person to person. But the occurrence of a desired pregnancy is observed in 96% of women throughout the year.

Question:
How long does it take for a spiral to take root?

If the IUD is selected correctly, taking into account the size and length of the uterus, contraindications and anatomical features, then it “takes root” in about 1 – 3 months.

Question:
The husband complains of the feeling of the spiral threads during sexual intercourse. Is this normal and what should I do?

If your husband does not like these sensations, perhaps you were left with too long “antennae” after the introduction of the contraceptive. You can contact your gynecologist with a request to shorten them somewhat (but there is a high probability of their subsequent disappearance in the cervical canal, which will complicate self-monitoring for the presence of a spiral).

Question:
When can a new coil be installed after removing the old one?

If the IUD did not cause adverse reactions, a new one can be installed in a month, but better after 3, to make sure that the menstrual cycle is normal and undergo additional examination.