What is the female spiral? Reliability as a means of contraception. Insertion of an intrauterine device

Intrauterine device or IUD for short (although it would be more correct to call the device an intrauterine screw) - this is a contraceptive with one of the most high degrees efficiency. It consists of plastic and/or one or more metals, as well as control threads. Some IUDs contain hormones.

The effect of the intrauterine device is that the device placed in the uterine cavity changes its neutral environment to a slightly acidic one. This affects the mobility of male germ cells and their ability to fertilize. And if conception does occur, the IUD prevents the embryo from attaching to the walls of the uterus (abortive effect of contraception).

Intrauterine device - types

Non-hormonal intrauterine devices

There are a great many such spirals. If necessary, they can be ordered by:

• Composition.

IUDs come in plastic and plastic-metal types. Of the metals used in the latter, copper, silver, gold or combinations thereof are used. For women with metal allergies, a plastic spiral, for example, Goldlily Plastic, is suitable. True, the level of protection of such a system is somewhat lower than that of its plastic-metal counterparts: within a year, pregnancy occurs in 4 out of 100 women versus 1 out of 100 women using metal coils.

Therefore, if there are no contraindications, then it is more advisable to install an IUD with metal. The use of copper alone in an IUD is considered a thing of the past; in tandem with silver or gold, the spiral works much better.

• Form.

The most common are T-shaped IUDs. It is believed that, due to their shape, they are best located in the uterine cavity of most women. Ladies who, due to the structure of the uterus, are not suitable for a T-shaped IUD, are usually prescribed a semi-oval spiral, such as Multiload.

There are also ring-shaped, S-shaped and many other intrauterine devices.

• Size.

Typically, IUDs come in one size. However, some brands produce several sizes of one type of hormonal IUD. It is reasonable to buy an IUD based on the size of the uterus - it reduces the risk that the contraceptive may not be suitable.

Hormonal intrauterine devices

• These are intrauterine therapeutic systems. In addition to protection, they have therapeutic effect. Spirals with hormones are prescribed for the treatment of uterine fibroids, with painful heavy menstruation, for the prevention or treatment of endometrial proliferation.
• The degree of protection against unplanned pregnancy with IUDs with hormones is very high. Under the influence of hormones, the mucus in the cervical canal of the cervix thickens, preventing the movement of sperm. And the endometrium becomes thinner, due to which in rare cases fertilization of the egg, the embryo is not able to implant into the wall of the uterus.
• Due to the effect of hormones on the endometrium, approximately 20 women out of 100 experience amenorrhea by the end of the first year of wearing a hormonal intrauterine system. It does not harm the body, menstrual function some time after removal of the spiral it will be restored. But you need to be more sensitive to your body, because due to the lack critical days You may not notice the onset of pregnancy.
• Hormonal IUDs are T-shaped and contain the hormone-like substance levonorgestrel. The brightest representatives of hormonal IUDs are the Mirena and Levonov intrauterine devices. Degree of protection from unwanted pregnancy with such contraceptives is extremely high: only one woman out of 1000 becomes pregnant during the year.

Reasons for decreased effectiveness of the intrauterine device

• Incorrect installation. It is ideal if the spiral is installed by an experienced gynecologist. A few weeks after the procedure, it is worth doing a control ultrasound to ensure the correct location of the IUD.
• Displacement or loss of the spiral. If the doctor's recommendations are not followed, the device may become dislodged or fall out. Every month it is necessary to check the presence and length of spiral garters in the vagina. If they lengthen or shorten, then most likely the spiral has shifted and you should visit a doctor. If the antennae of the spiral cannot be felt at all, this means that it either fell out or due to the displacement of the IUD.
• Incorrect coil size or shape.
• Using an IUD beyond the manufacturer's recommended period. The spirals are designed to last from 3 to 7 years. But gynecologists recommend not using an intrauterine contraceptive for more than 5 years, even with a longer service life.

If you notice a delay of menstruation for several weeks (while wearing a non-hormonal IUD), nausea, dizziness and other signs of pregnancy, you should immediately consult a doctor.

Benefits of intrauterine devices

Non-hormonal intrauterine devices are ideal in cases where high protection against unplanned pregnancies is required, but oral contraceptives use is undesirable or even prohibited. For example: for the protection of breastfeeding mothers, heavy smokers (especially those aged 35 years and older), women with breast tumors, diabetics and others.

Hormonal intrauterine devices have the same advantages as oral contraceptives, but without their disadvantages. The dose of hormones is small, since the drug acts locally, there is no effect on the stomach, lactation, and there is no need to take daily pills. On the hormonal IUD intrauterine price relatively high, but the effect lasts 5 years.

Contraindications to the installation of any intrauterine device

1. Malformations of the uterus.
2. Oncological pathologies of the reproductive system.
3. Inflammatory, infectious processes in the vagina. When using the IUD, the usually closed cervix is ​​slightly open, which makes it easier for pathogens to enter its cavity.
4. Ectopia, cervical dysplasia. Before installing the IUD, the cervix must be healthy.
5. Bleeding of unknown origin.
6. Pregnancy. Before installation, you should make sure that there is no existing pregnancy.
7. Acquired immunodeficiency syndrome.

Contraindications to the installation of a non-hormonal IUD

• Long-lasting, abundant and painful menstruation.
• Anemia.
• Nulliparous women. Women who do not have children rarely get non-hormonal IUDs.
• Promiscuous sexual intercourse. The IUD does not protect against infections and is therefore not recommended for women who have more than one sexual partner.

Contraindications to the installation of an intrauterine device with hormones

• Mammary cancer.
• Relapses or acute diseases organs of the urinary system.
• Liver failure.
• Serious illnesses of cardio-vascular system.
• Decompensated diabetes mellitus.
• Migraine.
• Thrombophlebitis of the lower extremities.
• Age over 65 years.

Possible side effects or complications associated with wearing an intrauterine device

• Damage to the uterine wall. Happens to approximately one woman out of 100. The culprits are the thinning walls of the uterus and the unprofessionalism of the gynecologist. Women who have repeatedly given birth or had abortions are at risk.
• Bleeding.
• Heavier, more painful menstruation, reduction menstrual cycle. These side effects occur frequently during the first six months of wearing the IUD. But over time, with a properly selected IUD, discomfort during menstruation goes away or is significantly reduced.
• Daub, bloody issues in the intervals between menstruation.
• Intrauterine pregnancy. A conventional IUD reduces, but does not eliminate, the possibility of fertilization. Due to the effect of the IUD on the uterus and fallopian tubes, women are at risk ectopic pregnancy increases slightly. With a hormonal IUD, the risk of ectopic pregnancy is significantly lower.
• Pregnancy. You should definitely not try to maintain a pregnancy if it occurs while using a hormonal IUD. In other cases, the risks are assessed by a doctor. The opinions of gynecologists regarding attempts to remove the IUD from the uterine cavity or cervical canal during pregnancy vary. Some people advise trying to remove the spiral early stages gestation. This may provoke spontaneous abortion, however, if this is not done, the likelihood of injury increases significantly membranes and miscarriage at any time, premature birth. The risk of infection of the fetus through a loosely closed cervix increases. Also, as the uterus grows, the likelihood of injury from the intrauterine device increases. Others insist that if the spiral is located in such a way that the likelihood of interfering with the development of the fetus is low, then it is not worth interfering. Even with an IUD installed, it is possible to carry a child to term.
• Problems with pregnancy after use intrauterine device . They happen rarely, the IUD in such cases is an indirect culprit. By itself, it cannot lead to further problems with conception and pregnancy, but infections that easily penetrate the uterine cavity can do so. Therefore, when wearing a spiral, a woman should especially carefully monitor her sexual health.

Installation of an intrauterine device

The installation or removal of an intrauterine device is carried out in a hospital setting by a gynecologist. This short procedure does not require hospitalization. Often, the IUD is installed either a couple of days before the start of the menstrual cycle, or last days menstruation, when the cervix is ​​more pliable and/or slightly open. It is also possible to install an IUD in the first 10 minutes after an abortion, after 6 weeks from the date of natural birth or 12 weeks after caesarean section.

After removing an expired IUD, you can immediately insert a new intrauterine device.

• Preparing for an IUD insertion is easy. A few days before the procedure, it is advisable to abstain from sexual intercourse. Also, you should not use skincare products for intimate areas and medications (except when otherwise prescribed by a gynecologist).
• In the first week after installation of an intrauterine contraceptive, it is prohibited
  have sex, take a bath, visit a bathhouse or sauna, perform heavy physical exercise, douche, take medical supplies With acetylsalicylic acid in the composition, lift weights, use tampons. It is advisable to avoid the last two points throughout the entire period of wearing the spiral.

The most common intrauterine devices

The best intrauterine device is the one that fits. This can be either a budget non-hormonal option or an expensive therapeutic system. When choosing a contraceptive such as an intrauterine device, it would be useful to read reviews, but the final decision should be made based on the recommendations of a gynecologist, own analyzes and well-being.

• One of the most available options considered a contraceptive Belarusian production intrauterine device "Juno". The brand offers non-hormonal IUDs in several varieties. The classic “Junona Bio-T” is a ring and T-shaped plastic-copper IUD with a service life of 3 and 5 years, respectively. “Junona Bio-T Super” is a plastic-copper T-shaped spiral with a monofilament thread with a service life of 5 years. "Junona Bio-T Ag" is a plastic-copper-silver IUD with a validity period of 7 years.
  Sterilization of spirals of this TM is radiation.
• Another common option is the non-hormonal intrauterine device “Multiload” (Multiload CU-375) from a Dutch manufacturer. It has the shape of a semi-oval with branches along the perimeter. Made of polyethylene and copper, sterilized by gamma rays. The service life of Multiload is 5 years.
• The golden intrauterine device is not exotic these days. Several brands use gold in contraceptives, the most famous is Hungarian intrauterine device "Goldlily" Exclusive" (Goldlily–Exclusive). This is a T-shaped contraceptive made of plastic and an alloy of gold and copper in equal proportions. Available in several sizes. This spiral is preferable for women with a tendency to allergies and inflammation. The standard service life is 5 years.
• Intrauterine hormonal device "Mirena"- a kind of legend in the world of contraceptives of this kind. This intrauterine therapeutic system is manufactured in Germany. Mirena is a T-shaped design made of plastic and metal, enriched with a progesterone analogue.

Conclusion

A modern, highly effective means of protecting against unplanned pregnancy is the intrauterine device. It is impossible to say for sure which spiral is better; the most suitable option is selected individually.

The intrauterine device is a contraceptive that is inserted into the uterine cavity. Suitable only for women with a normal menstrual cycle and no signs of hormonal disorders. For nulliparous girls This method of contraception is not used.

The intrauterine device is a proven means of contraception

Pros and cons of the IUD

If the IUD is installed in accordance with the requirements of medical protocols, then the woman does not feel this contraceptive.

Advantages of the IUD:

• efficiency – from 80 to 99% depending on the type of device;
• long-lasting effect – service life is from 3 to 5 years;
• reversibility – after removal, fertility is restored within 1–2 cycles;
• is not felt by either a woman or a partner;
• the presence of VSM is not a contraindication to taking other medicines, surgical treatment;
• no additional contraception required;
• variety of models and prices - from budget to expensive.

Despite a large number of advantages, this method of protection has a number of disadvantages.

Disadvantages of the IUD:

• the body of the uterus remains slightly open, which facilitates the penetration of pathogenic flora;
• foreign device in the uterus;
• prolongation of menstruation, increase in the volume of blood released;
• the risk of ectopic pregnancy increases 4 times;
• expulsion – spontaneous falling out of the device;
• the likelihood of perforation of the uterine wall;
• does not protect against STDs;
• existing pregnancy - the coil is in the way normal development child, increases the risk of complications during childbirth. Often such pregnancies have to be terminated surgically.

Types of intrauterine devices

On appearance– in the photo – this is a small device made of plastic and metal, T-shaped or ring-shaped, as well as in the form of a loop or umbrella. The classification of intrauterine concepts depends on the metal from which it is made, the content of medications, and its shape.

Plastic intrauterine device

As contraception improved, 3 generations of IUDs were identified:

1. Plastic, it acted on the principle of blocking the implantation of the fertilized egg. The effectiveness is low, so it is currently prohibited for use.
2. Metal-containing devices. There are devices with copper wire, silver and gold. The latter are more effective and their validity period is up to 10 years.
3. Hormone-containing devices. Efficiency is 100%. In addition, they provide therapeutic effect and are one of the forms of treatment for endometriosis.

What does the IUD look like:

1. Semi-oval or umbrella-shaped - equipped with corrugations or spikes, which allows the spiral to be securely held in the uterine cavity. The introduction of such a form is painless, since it is installed in a folded state, and then placed inside in an unfolded state. Suitable for women who have given birth and for patients after caesarean section.
2. Round or ring – possible upon installation painful sensations. Not recommended for women after cesarean section, with 1 birth history.
3. In the shape of the letter "T" - has a gold, silver or copper base and plastic hangers. It is easy to install and does not cause discomfort to the woman. But the risk of spontaneous loss is higher than with other varieties. Recommended for patients after cesarean section or with a history of 1 birth.

The principle of operation of intrauterine devices

All vaginal devices have a complex mechanism of action. This makes it possible to increase the effectiveness of the IUD.

The device blocks the passage of sperm into the uterine cavity, damages them, reduces the lifespan of the egg and prevents the fertilized egg from attaching to the uterine wall.

The mechanism of action of the spiral on the body:

1. Inhibition of ovulatory processes. With the use of the device, there is a slight increase in LH production. But the amount of estrogen and progesterone does not change. This inhibits the production and maturation of eggs.
2. Prevention of implantation. When using a spiral, the cyclical formation of the endometrium is disrupted. The first phase of the cycle is lengthened, so the mucous membrane is not ready for the attachment of the embryo.
3. Interfering with the movement of sperm. After installation of the IUD, aseptic inflammation develops. The level of leukocytes and the production of phage cells increase. They actively destroy trapped sperm and isolate the egg.
4. Changes in the nature of movement of germ cells in fallopian tubes Oh. Minor hormonal disorders, Availability foreign object promote changes in peristalsis fallopian tubes. As a result, the egg either does not enter the uterus or penetrates into the period of immature endometrium.

The principle of operation of the intrauterine device

Review of the best IUDs

It is better to install the device that the gynecologist selected based on the patient’s medical history. Popular brands of contraceptive medical devices:

Nova T

Non-hormonal T-shaped coil. Material of manufacture: copper and silver. The use of 2 types of wire allows you to increase the life of the IUD up to 5 years.

Nova T - non-hormonal IUD

Intended for women with a history of 1–2 births, as well as episodes of adnexitis and other inflammatory diseases of the reproductive organs. average cost 4 thousand rubles.

Jaydess

Spiral with levonorgestrel and silver ring. The manufacturer is the Bayer concern. The device is valid for 3 years. The mechanism of action is based on the thickening of mucus in cervical canal, inhibition of sperm activity. Not used in nulliparous women.

Packaging Navy Jaydess

The probability of loss within 3 years is 1%. The most significant side effect is the cessation of menstruation. In the territory Russian Federation The Jaydess device is not for sale. The price in Ukraine is 2000 hryvnia.

Multiload

Copper non-hormonal T-shaped coil. Allowed during the period breastfeeding. On pharmaceutical market presented in 2 types of devices with different surface areas of copper wire - 250 mm and 375 mm. The service life of the first type is 5 years, the second – up to 8 years. The main side effect is an increase in the volume of menstrual flow.

Multiload - T-helix with copper

After installing the equipment, it is not advisable to use tetracycline antibiotics or NSAIDs. This reduces the effectiveness of the contraceptive. The cost of the device is 3800 rubles.

Juno

This brand has several types of contraceptives. Horseshoe and T-shaped products are produced with copper, silver and gold wire, containing propolis as an anti-inflammatory agent. Approved for use in patients with chronic diseases fallopian tubes, endometritis.

Packaging IUD Juno

The cost of the device depends on the material from which it is made. Copper and silver - on average 550 rubles, gold - up to 4 thousand. rubles

Mirena

Hormonal T-coil with levonorgestrel. The drug suppresses the development of the endometrium. This product is positioned as remedy for menstrual disorders, endometriosis.

Hormonal T-shaped device Mirena

Prescribed to women over 40 years of age. Smoking reduces the effectiveness of the device. The spiral works for 5 years. The cost of the device is 14 thousand. rubles

How to install a spiral?

Installation of a gynecological device for pregnancy is carried out only in conditions medical institution. The procedure does not require hospitalization.

Preparation

Before installing the spiral, you should go through comprehensive examination at the gynecologist. This will eliminate inflammatory processes and contraindications to implantation of the device.

Preparation consists of the following steps:

• examination by a doctor with collection of vaginal discharge for examination;
• PCR analysis - to exclude STDs - is carried out only if there are complaints from the patient;
• blood and urine tests;
• Ultrasound and colposcopy - to assess the condition reproductive system, exclusion of possible pregnancy.

Before the procedure, sexual intercourse is prohibited for 2 days and the use of antibacterial drugs local action.

Before installing the spiral, a colposcopy is performed

Installation

The introduction of an intrauterine contraceptive device is carried out on the 4th–5th day of menstruation. During this period, the uterus is slightly open, which makes installation of the device easier. The duration of the procedure is 5 minutes.

Sequence of operations:

1. The patient is positioned on the examination chair.
2. Speculums are inserted into the vagina, and the cervix is ​​treated with an antiseptic solution.
3. The doctor uses a probe to measure the length of the uterus.
4. A plastic conductor is inserted, which is included with the device. The IUD is pushed into the uterine cavity using a piston.
5. The device is removed. Threads are released into the vagina. They are cut to the required length. The patient needs them to control the location of the spiral in the reproductive organs.

The doctor will note the date of installation of the equipment on the chart. After 10 days, a follow-up examination of the patient is indicated.

Sexual activity is allowed to begin 14 days after installation of the IUD. It is not advisable to use sanitary tampons during this cycle.

Side effects

Side effects can develop immediately after implantation of the device, but also against the background of long-term use of the spiral.

Possible complaints after insertion of the IUD:

• pain during menstruation, during sexual intercourse, outside of menstruation;
• uterine and ectopic pregnancy;
• anemia;
• individual reactions to the hormonal components of the device;
• allergic reactions to metal components of the spiral.

After inserting an IUD, you may experience pain during your period.

Contraindications to installing a contraceptive

Contraindications to the use of this method of contraception are divided into absolute and relative.

It is prohibited to install anti-pregnancy devices in the following cases:

• reproductive organ cancer;
• pregnancy;
• suspicion of pregnancy;
• inflammatory processes in the acute stage;
• uterine bleeding of unknown origin;
• having multiple partners, promiscuity in sexual relations.

The IUD cannot be installed if there is inflammation in the uterus.

Relative contraindications to insertion of an IUD:

• history of chronic inflammatory processes of the reproductive system;
• a history of ectopic pregnancy;
• menstrual irregularities, heavy menstruation;
• malformations of the uterus;
• endometriosis;
• inflammatory processes in other organs;
• spontaneous loss of a contraceptive in the past;
• narrowing of the cervical canal;
• fibroids;
• diseases of the cardiovascular system, blood.

Possible consequences

Possible consequences and complications after installing a female contraceptive:

• injuries during the equipment installation procedure, development of bleeding;
• spiral loss;
• menstrual irregularities;
• pregnancy, which usually ends in surgical abortion;
• development of chronic inflammatory processes after removing the contraceptive and while using the device;
• unsuccessful attempts to remove the device, ending with surgical curettage of the uterine epithelium;
• infertility.

If the IUD is removed incorrectly, curettage of the uterus may be necessary.

The IUD is removed after its expiration date, when side effects develop, at the woman’s request, during pregnancy, when inflammatory processes develop, or when tumors appear in the body of the uterus and other parts of the reproductive system.

The procedure is performed only in a medical facility during menstruation.

Removal of the spiral is carried out only in a medical institution

Possible options for removing the spiral:

• outpatient – ​​control threads are captured by the instrument and the IUD is removed from the uterus;
• using a hysteroscope under anesthesia;
• laparoscopically through abdominal cavity- if it is impossible to remove medical equipment through the cervical canal.

You should not remove the equipment yourself, even if you clearly feel the control threads - this is fraught with injuries to the epithelium and body of the uterus, and the cervical canal.

The intrauterine device (you can find the abbreviation IUD) is a popular contraceptive that is considered one of the best ways prevent unwanted pregnancy. The vaginal IUD is a tiny device, about the length of a matchbox, that will help you plan your life.

Pros and cons of this method of contraception

If a woman decides, she should definitely know the pros and cons of installing and wearing it. The main advantage of installing an IUD is that it protects against unwanted pregnancy much more effectively than many other contraceptives. Its constant presence inside a woman’s body eliminates the danger of forgetting to take precautions. The spiral is absolutely imperceptible during sexual intercourse. In addition, this product is relatively cheap, considering that it lasts from 3 to 10 years.

The IUD does not have any hormonal effects on the female body. Application of some birth control pills has a number of contraindications, such as breastfeeding and smoking. The IUD has no such contraindications. However, there are also IUDs that contain hormones. They prevent not only pregnancy, but also many inflammatory diseases genital organs, control bleeding during menstruation, and prevent ectopic pregnancy.

It is impossible to insert an IUD yourself at home. This opens up a small number of disadvantages. This type of contraception is only allowed for women who have given birth. An IUD against pregnancy can in no case protect against sexually transmitted infections, since it only works as a contraceptive. The spiral is a foreign body inside the female body, so it can cause discomfort and side effects.

Action of the IUD

How does contraception work? The principle of its operation is as follows. The IUD has a detrimental effect on male reproductive cells, depriving them of reproductive function. The mechanism of action of the intrauterine device also extends to the uterine mucosa, depriving it of the ability to create conditions for the appearance of an embryo.

The validity period of the contraceptive is from 3 to 5 years. When the warranty period passes, the coil in the uterus wears out and loses its properties. She needs to take it out.

Which IUD should you choose?

Today contraceptive device- small device. It is made from synthetic material or non-ferrous metals. IUDs no larger than 4 centimeters in size. In shape, it is most often similar to the shape of the uterus, that is, T-shaped.

IUDs come in both hormone-free and hormone-containing varieties. The spiral is selected individually, depending on the characteristics of the body. There is no one-size-fits-all IUD that is best for every woman. However, each of them has its own advantageous characteristics. The most popular types of spirals are:

1. T Cu 380 A. The material from which the IUD is made is copper. It has a fairly long validity period - up to 10 years. The mechanism of action of such a spiral is that it releases copper, which in turn suppresses sperm and affects female reproductive ability.
2. Multiload Cu 375. Features a shape that allows it to sit firmly in the uterus. This IUD is considered the most reliable choice for active women or women with structural features of the genital organs, when there is a risk of the usual-shaped IUD falling out.
3. Combined IUD. These are Nova - T (Nova-T) and T de Plata 380 NOVAPLUS. They are made of plastic and silver or plastic and copper. These varieties do not contain hormones.
4. VIP coil T de Oro 375 Gold. It contains a piece of gold.
5. Mirena is a hormonal IUD. It contains a special container that releases the pregnancy hormone levonorgestrel. This IUD can last up to 5 years.

It is better to entrust the question of choosing a contraceptive device to a specialist. He knows best which IUD to recommend specifically for your case. Do not think that the more expensive the IUD, the more effective it is - the action of the spirals is almost equally good. When choosing an IUD, tell your doctor about the characteristics of your body. For long and heavy periods, it may be better to use hormonal IUDs. However, we must not forget about other individual properties of the organism.

What side effects may occur?

Surely many women are interested in the question: is the IUD harmful? After installing the IUD, a number of side effects may occur. Some women experience complications, but this only happens in 5 cases out of 100. The vast majority of women are satisfied with the installation of an IUD, since it is a very effective and convenient method of contraception.

Once the IUD is installed, in extremely rare cases, the following may occur: negative reactions, such as uterine perforation or endometritis.

Some time after installing the IUD, the following side effects may occur:

• During menstruation, pain in the lower abdomen intensifies;
• menstruation becomes heavier than before;
• among menstrual period Red spotting may occur.

Such reactions only apply to IUDs that do not contain hormones. When using a hormone-containing IUD, changes in the female body are possible, such as:

• delay of menstruation for several months;
• the appearance of bleeding between menstruation.

Contraindications to the use of the spiral

Not everyone is given an IUD for pregnancy and not always. Not every woman will be allowed to have it installed. Sometimes the contraceptive device has contraindications. It is undesirable or impossible to insert an IUD:

• women with infectious or inflammatory diseases of the genital organs, as well as cervical erosion;
• sick oncological diseases reproductive organs;
• women who have uterine malformations;
• young ladies or nulliparous women;
• women who randomly change sexual partners.

There may be exceptions for each specific case, but the decision to install an IUD can only be made by a gynecologist.

To prevent unwanted pregnancy and further abortion, the IUD will help prevent its occurrence for a long time. Abortion harms the female body, so sometimes doctors themselves can offer this option. If an abortion does occur, and in order to prevent an unwanted pregnancy, you should ask your doctor about the possibility immediately after the procedure or after some time.

A woman after childbirth. Female body should recover after childbirth. He is ready for a new fertilization in a few months, but it will be difficult for him to undergo another pregnancy right away. To do this, young mothers, especially breastfeeding ones, are recommended to either take tablets with progestins, which does not always have a positive effect on the health of the body, or get an IUD. A hormone-free IUD is one of the best ways to protect against unwanted pregnancy for nursing mothers.

Preparatory stage and installation of the spiral

Before installing the spiral, you must consult with your doctor on all issues related to the choice of the spiral, possible side effects, its validity period, and other nuances that interest you. Before the procedure there should be no sexual intercourse for at least 24 hours. You can't use it either chemicals For intimate hygiene in any form, do douching and other care procedures women's health. A couple of days before installing the IUD, it is also forbidden to use such topical medications as vaginal suppositories and tablets, aerosols, ointments, creams, etc.

If the woman is not pregnant and healthy, the doctor decides to install an IUD.

IUDs are placed on an outpatient basis. Typically, the IUD is inserted a few days before the start of menstruation, since this is the time when the cervix best allows the IUD to be inserted.

Immediately after examining the mirror, the doctor will fix the cervix special device and inserts the coil. Sometimes the installation of an IUD can be accompanied by discomfort and pain, like before menstruation. Painful sensations pass very soon.

In order to prevent any possible infection, the gynecologist prescribes antibiotics.

In order to make sure that the spiral is securely fastened in the right place, there are preventive inspections. The first of them is prescribed 1 month after the introduction of the spiral. The next one is in six months, and then inspections occur once a year.

Rules for a woman’s behavior after installing the IUD (valid for 5 days):

• sexual intercourse is prohibited;
• douching should not be done;
• You can only wash in the shower, and not in a hot bath;
• Do not exercise vigorously or lift weights;
• You should not take medications containing acetylsalicylic acid.
• consult a doctor in emergency cases.

Important: it is not advisable to use tampons during menstruation (if a woman has an IUD installed), it is better to use pads.

If after installing the IUD your health has changed: the temperature has risen, the stomach hurts, discharge has begun unpleasant smell- You must immediately consult a doctor for help.

What is an IUD?

An intrauterine device (IUD) is a small plastic device inserted into the uterus to prevent pregnancy. Modern models are made of plastic and contain metal or medicinal product(copper, silver, gold or progestin).

What types of intrauterine devices are there?

Modern intrauterine devices are small plastic or plastic-metal devices. Their dimensions reach approximately 3x4 cm. Typically, copper, silver or gold are used to make spirals.

The appearance of most spirals resembles the shape of the letter “T”. The T-shaped shape of the spirals is the most physiological, as it corresponds to the shape of the uterine cavity.

1-27 — variants of spiral shapes. One thing in common is that they all play the role of “ foreign body».

28 - Lipps loop. Spirals of this exact shape were common in the USSR. They were produced in three sizes. It was very inconvenient to insert them, since the disposable conductor, which is now attached to each spiral and is made of transparent polymer, was missing; they used a metal conductor, with which it was difficult to control the insertion process. Therefore, complications such as perforation (perforation) of the uterus occurred more often than at present.

29-32 — T-shaped spirals or “teshki” are modern modifications of metal-containing spirals. 33 - also “teshka”. An extremely convenient option for insertion and removal. Due to the fact that the “shoulders” are pulled into the conductor, the manipulation is almost painless.

34-36 - multi-loud or umbrella coils. They perform their function perfectly, but when inserting and removing them, the cervical canal is often injured. There are also cases of defragmentation (when the “hangers” come off the rod).

Which spirals are better?

There is no ideal spiral that would suit everyone without exception. This issue is decided by the gynecologist individually for each woman.

How does the IUD work?

The effect of the IUD consists of several factors:

• thickening of cervical mucus (i.e. mucus of the cervical canal), which makes it difficult for sperm to penetrate into the uterine cavity;
• a change in the properties of the endometrium (the mucous membrane of the uterine cavity), which makes it unsuitable for the implantation (of) an egg;
• due to the effect of a foreign body, the peristalsis of the fallopian tubes increases, which accelerates the passage of the egg through them, during which time it does not have time to reach the degree of maturity required for implantation.

How to use an IUD?

During a short, simple procedure, the doctor inserts an IUD into the uterine cavity.

If you want to make sure that the IUD is in the uterus, you can insert your fingers into the vagina and feel the plastic strings attached to the IUD.

If pregnancy is desired, you can ask your doctor to remove the IUD. Your fertility will be restored immediately.

What are the advantages of this method of contraception?

• High efficiency, comparable to the effectiveness of hormonal contraception. To some extent, the IUD is more reliable hormonal pills, since there is no danger of missing pills. When using a spiral, a woman does not require any action at all to maintain contraceptive effect, and, therefore, any possibility of error or accident is excluded.
• Provides protection from pregnancy for a long time (from 5 to 7 years depending on the type of IUD).
• Use is not associated with sexual intercourse.
• Compared to all other contraceptive methods, the intrauterine device is the cheapest contraceptive method. Despite the fact that the cost of one IUD is many times higher than the cost of one package of birth control pills or one regular package of condoms, its cost is recalculated over 5 years ( normal term wearing one spiral) shows its undeniable superiority in economic terms.
• Unlike birth control pills, metal or plastic IUDs, which do not contain hormones, have absolutely no overall “hormonal” effect on the body, which many women (in some cases justifiably) fear. For this reason, IUDs, which do not contain hormones, are recommended as the primary method of birth control for women over 35 years of age, who actively smoke, or have other conditions that make it impossible to use birth control pills but require very high level protection against unwanted pregnancy.
• The spiral is not felt at all during sexual intercourse and does not interfere with partners.

What are the disadvantages of the method?

• Unlike, for example, a condom, an IUD does not protect against sexually transmitted diseases.
• Installation and removal of the IUD should only be performed by a doctor.
• After installation of the IUD, side effects are possible.

What side effects might there be?

Installation of an intrauterine device can lead to some complications, but not all women wearing the device develop complications. Modern research show that more than 95% of women wearing IUDs consider them to be a very good and convenient method of contraception and are satisfied with their choice.

During or immediately after installation (for all types of spirals):

• Perforation of the uterus (extremely rare);
• Development of endometritis (very rare).

During the entire period of use of the spiral (for metal-containing or plastic spirals without hormones):

• Menstruation may become heavier and more painful.
• There may be bloody vaginal discharge between periods.
• Women with sexually transmitted infections (STIs) are at greater risk of developing pelvic inflammatory disease.
• In some cases, expulsion (complete or incomplete loss) of the IUD from the uterus is possible.

When should an IUD not be installed?

Contraindications for installing the IUD are determined by a gynecologist. Only a specialist can determine exactly how safe it is to install a spiral in your case.

An IUD cannot be installed if:

• You think you might be pregnant.
• You have more than one sexual partner.
• Observed acute form inflammatory diseases of the cervix or pelvic organs, including STIs.
• Over the past three months, inflammatory diseases of the pelvic organs have been observed.
• Vaginal bleeding of unknown origin is observed.
• There is a fast-growing one, also if the myomatous node deforms the uterine cavity.
• There is cancer of the genital organs.
• There is a severe form of anemia (hemoglobin<90 г/л).

• There is a high risk of contracting an STI.

How to prepare for installing a spiral?

The procedure for inserting an intrauterine device cannot be performed in the presence of any sexually transmitted infections or other gynecological diseases, therefore, before installing the device, the gynecologist conducts a general gynecological examination, taking smears to determine the degree of cleanliness of the vagina and a smear for oncocytology, in some cases an ultrasound is necessary. research. If any infections or gynecological diseases are detected, the insertion of the IUD is postponed until cured.

Before installing the spiral:

How to behave after inserting the IUD?

Within 7-10 days after installing the spiral, you cannot:

• Have sex;
• Do douching;

After 7-10 days it is necessary to undergo a follow-up examination.

Be sure to see your doctor sooner if:

• Within a few days of having the IUD installed, you have a fever, very heavy vaginal bleeding, abdominal pain, or an unusual vaginal discharge with a foul odor.
• Any time after inserting the IUD, you feel the IUD in your vagina, notice that the IUD has moved or fallen out, or if you notice your period is 3-4 weeks late.

What is the follow-up?

If menstruation does not occur within 4-6 weeks after insertion of the IUD, seek advice. You should contact us for a preventive examination at least once a year, and at any time if you have questions or problems.

What symptoms should you see a doctor for?

Application is necessary if:

• You suspect pregnancy.
• You have heavy vaginal bleeding (heavier or longer than usual).
• You experience severe abdominal pain;
• pain is felt and bleeding occurs during sexual intercourse.
• There are signs of infection, unusual vaginal discharge, chills, and fever.
• You cannot feel the IUD strings or feel that they are shorter or longer than before.

Will there be any changes in how you feel and the nature of your menstruation after the insertion of an IUD?

After installing IUDs without hormones, the following changes are possible:

• Your periods become more painful, slightly longer, and more abundant than before the IUD was installed.
• Spotting bloody discharge from the vagina may be observed, before or after menstruation, sometimes (less often) and in the interval between two menstruation.
• In some cases, due to increased pain during menstruation and irregular bleeding, women are forced to stop using the IUD and remove it before the end of the period.

After installing the IUD with hormones (in particular):

• There may be a significant shortening of menstruation and a decrease in the total amount of bleeding during menstruation.
• Approximately 20% of women using Mirena experience complete disappearance of menstruation (amenorrhea). The restoration of menstruation in this case occurs only after the IUD expires and is removed from the uterus. It is reliably known that the disappearance of menstruation in women using Mirena is not associated with inhibition of the ovaries (as with the use of oral contraceptives), but with the suppression of the development of the uterine mucosa by small doses of hormones.
• Despite the fact that many women are afraid of the disappearance of their periods, there is no reason to consider it dangerous to health. Moreover, this effect of hormonal IUDs can even be beneficial, since it significantly improves a woman’s quality of life and is an effective method of treating anemia, which many women with long and heavy periods have. The Mirena IUD is used to treat severe uterine bleeding.

How is the intrauterine device removed?

Removal is usually done after 5-7 years (depending on the modification of the spiral). But if the woman wishes, this can be done at any time. The reason may be the desire to become pregnant or the occurrence of any complications.

Before removal, the same examination is carried out as before insertion of the spiral. If necessary, vaginal sanitation (improvement) is prescribed.

Removal is done by pulling the spiral tendrils at a certain angle. In some cases, for example, in the case of wearing a spiral beyond the prescribed period, removal must be carried out in a hospital setting, with anesthesia, by curettage of the uterine cavity.

Within 4-5 days after removing the IUD you cannot:

• Have sex;
• Use vaginal tampons (you can use regular pads);
• Do douching;
• Take a bath, visit a sauna or steam bath (you can take a shower);
• Engage in heavy physical labor or intense exercise.

Removing the IUD does not cause changes in the menstrual cycle. The exception is the Mirena IUD, when worn, there is an absence of menstruation or scanty cyclic bleeding. After Mirena removal, the menstrual cycle usually returns in about 3-6 months.

Be sure to consult a doctor if, within a few days after removing the IUD, you have a fever, very strong vaginal bleeding, abdominal pain, or unusual vaginal discharge with an unpleasant odor.

Is it possible to remove the spiral yourself?

Do not under any circumstances try to do this!

The spiral is removed by pulling on the tendrils, which may break before it is removed. After this, the IUD can only be removed instrumentally and only by penetrating the uterine cavity. In addition, the mustache may break as the spiral passes through the cervical canal and it will get stuck there. Take my word for it, it is very painful.

To remove the IUD, be sure to consult a gynecologist.

How often should the coil be changed?

Metal-containing spirals (for example, copper or gold) can be used for 5-7 years without replacement. IUDs with hormones (for example, Mirena) require replacement every 5 years.

Can I get pregnant if I wear an intrauterine device?

Pregnancy in women wearing an intrauterine device is extremely rare. The probability of pregnancy when using copper coils is no more than 8 chances out of 1000 during the year. When using IUDs with hormones, the chance of getting pregnant is reduced to 1 in 1000 within a year.

In this case, the course of pregnancy is no different from the course of a normal pregnancy, the spiral is located behind the membranes, and during childbirth it is born along with the placenta. Many women are afraid that the IUD may grow into the child’s body. These fears are unfounded, since the child’s body is surrounded by and. Pregnant women who have the IUD are observed to be at risk.

The risk of pregnancy increases significantly if the IUD becomes dislodged or falls out of the uterus. This happens especially often after menstruation, when the IUD can be thrown out of the uterine cavity along with the rejected tissue.

In this regard, all women who wear the IUD are recommended to check the presence of the IUD in the uterus at least once a month by feeling the antennae of the IUD deep in the vagina. If you previously felt the antennae of the spiral well, but can no longer find them, contact your gynecologist, as the spiral may have fallen out and you did not notice it.

How do I know if I am pregnant while wearing the IUD?

If While wearing a non-hormonal intrauterine device, your period is delayed by more than 2-3 weeks, you need to take a home pregnancy test and consult a doctor.

Could the IUD interfere with my ability to get pregnant in the future?

The contraceptive effect of intrauterine devices is easily reversible and disappears soon after their removal from the uterine cavity. The probability of pregnancy occurring within 1 year after removal of the IUD reaches 96%.

Planning a pregnancy is possible as early as the next month after removal of the intrauterine device.

Among modern women, many people use an intrauterine device to prevent unwanted pregnancy in their body. But not everyone fully understands principle of operation of the intrauterine device.

The principle of operation of the intrauterine device

An intrauterine device is a gynecological device that mechanically prevents unwanted fertilization of a woman:

The spiral accelerates the movement of the fertilized egg through the fallopian tubes. In such a short period of time, a fertilized egg does not have time to be enriched with all the necessary qualities. These qualities, in turn, during natural conception contribute to the further consolidation of the embryo inside the uterine cavity.

In addition, the intrauterine device mechanically prevents the penetration of the egg into the uterine cavity. The fertilized egg, not finding a cozy place for itself, dies over time and is removed from the female body during menstruation.

The components that make up the intrauterine device reduce the ability of the sperm to perform its functional duties. This significantly enhances the contraceptive effect of this type of female contraception.

Benefits of the intrauterine device

What are the advantages of the IUD:

The first positive point when using an intrauterine device is the high effectiveness of this method of contraception. About 97% guaranteed.

Spirals are very easy to use and do not require preliminary preparations before sexual intercourse.

The presence of a spiral in the uterine cavity does not in any way affect the normal course of a woman’s life.

At the same time, there is a complete absence of discomfort during intimacy and the prevention of unwanted pregnancy.

The intrauterine device does not affect the lactation period in any way and is perfect for women who have recently given birth and who are breastfeeding.

The principle of operation of the intrauterine device does not in any way affect the natural process of reproductive function of the female body. Namely: during ovulation, the egg continues to mature, and the grown layer of the intrauterine epithelium is periodically rejected. The latter is indicated by monthly menstrual bleeding.

After removal of the intrauterine device, a woman can easily become pregnant in the near future.

Disadvantages of the intrauterine device

But this method of contraception has disadvantages:

The spiral is one way or another a foreign body inside the female body. That is, the intrauterine device can be rejected by the tissues adjacent to it. This is evidenced by the occurrence of inflammatory processes in the uterine cavity after the installation of this contraceptive device.

The intrauterine device should not be used by nulliparous women. Due to a possible inflammatory process in the area of ​​the internal genital organs, a woman may remain infertile forever.

May cause more painful menstruation with heavy bleeding.

Does not guarantee 100% absence of unwanted conception and can lead to ectopic pregnancy.

It should be noted that the installation of an intrauterine device should be carried out only by a gynecologist and after a complete medical examination of the woman. Come to our medical center in Moscow, and we are guaranteed to select the optimal method of contraception for you, taking into account all the characteristics of your body. Modern medical equipment and the experience of our clinic’s medical specialists will help identify the presence of diseases of your genital organs even at the earliest stage. This will help preserve your women's health as much as possible and prevent unwanted consequences after installing an intrauterine device.