Intrauterine device - types, pros and cons, reviews. Types of intrauterine devices How the intrauterine device works

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Every woman has a moment when she thinks about becoming a mother. But for many girls, sexual activity begins earlier than they are ready for motherhood, and for family life in general. Especially among modern women, planning a child is postponed until they fully realize themselves in other areas of life.

Well, if a woman has already become a mother, and maybe more than once, then there are very few people who want to repeat this feat a dozen more times and give birth every year. That is why, since ancient times, people have adapted to avoid becoming pregnant without desire. In order to deceive nature, they came up with simple methods of contraception (from the Latin word contraceptio - exception). We started with various essential oils, fruit juices, tampons, lotions, interrupted contact, fabric bags (the predecessor of a condom), and so on.

As you can see, the spiral affects all processes necessary for conception:

• vital activity and speed of sperm movement;
• egg maturation and ovulation;
• attachment of the fertilized egg to the endometrium.

Pros and cons of using intrauterine devices

Benefits of the IUD	Disadvantages of the IUD
Convenient to use, the spiral is installed for a period of 3 to 10 years or more. There is no need for daily procedures, special hygiene care or drinking pills by the hour. In a word, for a long time you can not think about contraception at all and not be afraid of an unwanted pregnancy, but enjoy your sexual relationships.	Not suitable for all women, as it has a number of contraindications. For some women, the IUD does not take root.
Highly effective method: pregnancy occurs only in 2 out of 100 cases. Inert IUDs provide lower efficiency, and when using hormonal intrauterine systems, the risk of pregnancy is reduced to zero.	Yet there is a risk of unplanned pregnancy with a spiral. In addition, the spiral may fall out and the woman may not notice it. But 100% results can only be achieved by removing the appendages or tying the fallopian tubes and completely abstaining from sexual activity.
Preservation of reproductive function immediately after removal of the IUD.	Young and nulliparous women are advised to refrain from using non-hormonal IUDs, since as a side effect, inflammatory changes in the endometrium of the uterus and appendages may develop, reducing the chances of becoming pregnant in the future.
Does not affect the quality of sexual life, that is, on sexual desire, sexual intercourse for both partners and achieving orgasm.	An IUD can cause painful and heavy periods. While hormonal IUDs, on the contrary, solve the problems of painful periods. But progestogen IUDs can lead to absence of menstruation, which also negatively affects women’s health.
Low cost. At first glance, it may seem that some types of spirals are an expensive pleasure. But given the long period of use, this method will be much more economical than those products that require use during each sexual intercourse, daily and monthly.	Possible side effects from the use of spirals, unfortunately, their development is not uncommon.
IUDs can be used after childbirth during lactation when oral hormonal agents are contraindicated.	Increases the risk of developing inflammatory processes genitals, and the spiral does not protect against sexually transmitted diseases.
Additionally for hormonal intrauterine systems: can be used for women of any age; are used not only for contraception, but also in the treatment of certain gynecological diseases (fibroids, endometriosis, painful menstruation, uterine bleeding, etc.).	Increases the risk of developing an ectopic pregnancy. The use of hormonal IUDs significantly reduces the risk of pathological pregnancy.
	The procedure for inserting an IUD requires a visit to a gynecologist and brings discomfort and pain., in nulliparous women, the pain syndrome is especially pronounced, sometimes local anesthesia is required.

Indications for installation of an intrauterine device

1. Temporary or permanent prevention of unwanted pregnancies, especially if the family already has children. Intrauterine devices are ideal for women who have given birth and have one sexual partner, that is, for those whose risk of contracting sexually transmitted diseases is very low.
2. Frequent unwanted pregnancies, ineffectiveness or carelessness of women in using other contraception.
3. Prevention of pregnancy after childbirth, especially cesarean section, after medical abortion or spontaneous miscarriage, when the onset of another pregnancy is temporarily not desirable.
4. The woman has temporary or permanent contraindications to pregnancy.
5. The presence in the family history of genetic pathologies that the woman does not want to pass on by inheritance (hemophilia, cystic fibrosis, Down syndrome and many others),
6. For hormonal intrauterine devices – some gynecological pathologies:

• uterine fibroids, especially if it is accompanied by heavy spotting and uterine bleeding;
• heavy, painful periods;
• estrogen replacement therapy at the beginning of menopause or after removal of the appendages, in order to prevent the growth of the endometrium.

Contraindications

Absolute contraindications to the use of all intrauterine devices

• Presence of pregnancy at any stage, suspicion of possible pregnancy;
• oncological pathologies of the genital organs, as well as breast cancer;
• acute and chronic inflammatory diseases of the female genital organs: adnexitis, colpitis, endometritis, including postpartum, salpingitis and so on, including the presence of sexually transmitted diseases;
• a history of ectopic pregnancies;
• allergic reactions to the materials from which the spiral is made;
• tuberculosis of the reproductive system;

Relative contraindications to the use of non-hormonal IUDs

• if the woman does not have children yet;
• a woman is promiscuous and is at risk for contracting sexually transmitted diseases;
• childhood and adolescence*;
• woman's age over 65 years;
• uterine bleeding and heavy painful periods;
• abnormalities of the uterus (for example, bicornuate uterus);
• hematological diseases (anemia, leukemia, thrombocytopenia and others);
• endometrial growths, endometriosis;
• urethritis, cystitis, pyelonephritis - acute or exacerbation of a chronic course;
• benign tumors of the uterus and appendages (submucosal myoma and uterine fibroids);
• loss of the intrauterine device or the development of side effects after previous use of the device.

* Age restrictions are conditional; gynecologists usually do not offer young nulliparous women the use of intrauterine contraceptives, for fear of harm. But, in principle, the IUD can be successfully installed at any childbearing age, with subsequent successful pregnancy.

Relative contraindications to the use of hormonal intrauterine devices (systems):

• cervical dysplasia;
• abnormalities of the uterus;
• urethritis, cystitis, pyelonephritis - acute or exacerbation of a chronic course;
• uterine fibroids;
• liver diseases, liver failure;
• severe cardiovascular pathologies: malignant arterial hypertension, conditions after a stroke or heart attack, severe heart defects;
• migraine;
• decompensated (uncontrolled) diabetes mellitus;
• thrombophlebitis of the lower extremities;
• woman's age over 65 years.

When can I get an IUD after childbirth, cesarean section, or abortion?

An intrauterine device can be placed already on the 3rd day after an uncomplicated physiological birth. But usually gynecologists recommend waiting until the end of lochia discharge (on average 1-2 months). It will be safer that way. After childbirth, the uterus recovers, so early insertion of the IUD increases the risk of side effects and early rejection of the device. To start using the hormonal intrauterine system, you need to wait 2 months after the baby is born; this is necessary not only for the complete restoration of the uterus, but also for the normalization of hormonal levels.

After a cesarean section, the IUD can be installed in the uterine cavity only after 3-6 months. It takes time for a postoperative scar to form.

After a medical termination of pregnancy (up to 12 weeks), it is better to install an IUD within seven days after the start of the next period after the abortion. But a gynecologist may suggest installing an IUD immediately after an abortion, without getting up from the gynecological chair. This is possible, but in this case the risk of developing side effects of the intrauterine device associated with complications of the abortion itself increases significantly. After a miscarriage, the decision on the feasibility and safety of installing an IUD is made only by a doctor; he assesses the situation individually, analyzes the cause of spontaneous abortion, and weighs the pros and cons. If it is necessary to use a device after a miscarriage, it is installed in the uterine cavity during the next menstruation.

Is an intrauterine device installed after the age of 40?

The IUD can be used for any woman who is ovulating, has maintained her menstrual cycle, and is likely to become pregnant. Hormonal intrauterine systems are also installed in the period after menopause to obtain a therapeutic effect. Therefore, 40 years is not a limitation for using an IUD. According to the instructions, IUDs are not recommended for women over 65 years of age, but this limitation appeared only due to insufficient study of the use of intrauterine devices in older age.

How is an intrauterine device installed?

The intrauterine device is installed only by a gynecologist in a gynecological office. Before inserting an IUD, the doctor assesses the possibility and risk of developing side effects from using this contraceptive, explains to the woman about the possible reactions of the body to the introduction of one or another type of spiral. Before intrauterine contraceptives are installed, a woman must undergo an examination to completely exclude possible pregnancy and contraindications.

Recommended examination before inserting an intrauterine device:

• gynecological examination and palpation (palpation) of the mammary glands;
• vaginal smear, if necessary, culture for microflora;
• cytological examination of smears from the cervix;
• Ultrasound of the pelvic organs;
• in some cases, a pregnancy test or blood test to determine hCG levels;
• Ultrasound of the mammary glands (for women under 40 years of age) or mammography (after 40 years of age).

Preparing for installation

Typically, no special preparation is required to insert the IUD. If inflammatory diseases are detected, you will first need to undergo a course of appropriate therapy.

Immediately before the procedure, you must empty your bladder.

On what day of menstruation is it better to install an intrauterine device?

Intrauterine contraceptives are usually installed during menstruation or towards its end, that is, within 7 days from the start of menstruation. The optimal period is 3-4 days. This is necessary in order not to miss the onset of pregnancy.

An intrauterine device can be installed as emergency contraception, that is, if a woman has had unprotected sexual intercourse and expects an unwanted pregnancy. In this case, the device is inserted in the period after ovulation, this can prevent the attachment of the fertilized egg in 75% of cases.

Technique for inserting an intrauterine device

Any spiral packed in vacuum packaging is sterile. You need to check the expiration date. The coil must be opened immediately before installation, otherwise it loses its sterility and can no longer be used. The IUD is a single-use device; its reuse is strictly prohibited.

In most cases, local anesthesia is not required. Anesthetics in the cervical area can be used in nulliparous women and when installing hormonal intrauterine systems, since they are wider.

The insertion technique for different types of spirals may differ. The installation features of each spiral are described in detail in the device instructions.
1. A gynecological speculum is inserted into the vagina, with the help of which the cervix is ​​fixed.
2. The cervix is ​​treated with disinfectants.
3. Using special forceps, the cervical canal (the canal in the cervix that connects the vagina to the uterus) is straightened, and the cervix is ​​opened.
4. A special probe is inserted through the cervical canal into the uterine cavity to accurately measure the length of the uterus.
5. If necessary, the cervix is ​​anesthetized (for example, lidocaine or novocaine). The insertion of the spiral itself begins after 4-5 minutes, when the anesthetic takes effect.
6. The spiral is inserted using a special guide with a piston. A ring is placed on it on a scale according to the size of the uterus, this is necessary in order not to damage its walls. Then a conductor with a spiral is inserted into the uterus. Having reached the corresponding mark, the doctor slightly pulls the piston towards himself so that the shoulders of the spiral open. After this, the spiral is moved directly to the wall of the uterine fundus. When the gynecologist is sure that the device is installed correctly, the guidewire is slowly and carefully pulled out. When installing some spirals (for example, ring-shaped), the opening of the shoulders is not required, so the spiral is inserted to the wall of the uterine fundus, and then the guide is simply pulled out.
7. The spiral threads are cut into the vagina at a distance of 2-3 cm from the cervix.
8. The procedure is completed, it usually takes 5-10 minutes.

Is inserting an intrauterine device painful?

The procedure itself, of course, is unpleasant and brings some discomfort. But the pain felt is tolerable, it all depends on the woman’s pain threshold. These sensations can be compared to painful menstruation. Abortion and childbirth are more painful.

After installation of the intrauterine device

Ultrasound photo: Intrauterine device in the uterine cavity.

• The uterus completely gets used to the IUD within several months, so during this period some changes in women’s health may be observed; you need to listen to your body.
• In some cases, a course of antibacterial therapy will be required after insertion of the spiral, for example, if chlamydia is suspected, or if there is another chronic infection of the genitourinary system.
• Bloody spotting and nagging pain in the lower abdomen or back may bother you for 1 week after insertion of the IUD. To relieve spasms, you can take No-shpu.
• The hygiene regime is normal; you need to wash yourself with intimate hygiene products twice a day.
• You can have sex only 8-10 days after the installation of the intrauterine device.
• For several months, you should not lift weights, engage in intense physical activity, or overheat (sauna, bathhouse, hot baths).
• It is necessary to periodically probe the spiral threads, control their length, it should not change.
• After 2 weeks, it is better to visit a gynecologist to see if everything is normal.
• Menstruation in the first months after installation of the IUD may be painful and heavy. Over time, menstruation normalizes.
• When using hormonal intrauterine systems, after six months or several years, menstruation may disappear (amenorrhea). After the first loss of a cycle, it is necessary to exclude pregnancy. The menstrual cycle will be restored immediately after the IUD is removed.
• If you have any complaints, you should consult a doctor.
• In the future, examination by a gynecologist is necessary every 6-12 months, as for any healthy woman.

Can an intrauterine device fall out?

If the intrauterine device is not installed correctly or if it does not take root, the intrauterine device may fall out. We need to keep an eye on this. Most often, IUD loss occurs during menstruation or after heavy physical activity. Therefore, it is important to check whether the spiral threads are in place and inspect sanitary pads.

How long does it take to use an intrauterine device?

The period for which intrauterine contraception is installed differs depending on the type of device.

• Inert IUDs are usually installed for 2-3 years.
• Copper spirals – up to 5 years.
• Copper spirals with silver and gold - 7-10 years or more.
• Hormonal intrauterine systems – up to 5 years.

The issue of premature removal of the IUD is decided by the gynecologist.

It is not recommended to use an IUD after the expiration date due to the risk of the IUD growing into the uterine tissue. Hormonal IUDs lose their properties due to depletion of hormonal drug reserves. This reduces the effectiveness of the intrauterine device, which can lead to unplanned pregnancy.

Intrauterine devices (copper, hormonal): installation, operating principle, effectiveness (Pearl index), shelf life. How to check if the spiral is in place - video

Removal and replacement of the intrauterine device

Indications for IUD removal:

• the period of use has expired, and it is possible to replace the intrauterine device;
• a woman is planning a pregnancy;
• there were side effects from the use of an intrauterine device.

The removal procedure, as well as the insertion of an intrauterine device, can only be performed by a gynecologist in a gynecological office. The ideal time to remove the IUD is the first days of menstruation; during this period, the cervix is ​​soft, which makes manipulation easier. In principle, the IUD can be removed at any time during the menstrual cycle.

Removal of the IUD often does not require pain relief; local anesthesia will be required when removing or replacing hormonal IUDs. The doctor fixes the cervix with a gynecological speculum, and then, using a special tool (forceps), grabs the threads of the spiral and carefully pulls out the device, while carefully stretching the cervix.

Usually this procedure goes without difficulty, the woman experiences less pain than when inserting a spiral. But there are situations when the spiral cannot be pulled out so easily, then the doctor widens the cervical canal and makes it easier to remove the IUD. You may also encounter the problem of broken threads, then the doctor inserts a special hook through the cervix, with the help of which the foreign body is removed from the uterine cavity.

But there are situations when the doctor simply does not detect the spiral threads. The question arises: is there a spiral in the uterus at all? If so, where is she? To do this, the woman is offered an ultrasound of the pelvic organs, and, if necessary, radiography. Sometimes there are cases when the spiral is located outside the uterine cavity (due to perforation of its wall), then laparoscopic surgery is urgently needed to remove the foreign body.

Replacing the spiral intrauterine contraception can be performed immediately after removal of the old IUD; the risk of developing any complications does not increase.

Special instructions before removing and replacing the intrauterine device:

• timely replacement of the IUD facilitates the procedure and guarantees continuous contraceptive action;
• It is better to carry out the procedure during menstruation;
• removing the IUD during or before ovulation increases the risk of pregnancy;
• before replacing the IUD, it is necessary to use other methods of contraception (condom, oral contraceptives or spermicides) 7 days in advance to prevent an unwanted pregnancy.

Possible side effects

The intrauterine device is a modern, convenient and effective method of contraception. But this is also a foreign body to which our body can react with undesirable reactions. In most cases, intrauterine contraception is well tolerated, but some women may become intolerant to this method and develop side effects, some of which can have a very negative impact on health and lead to severe pathologies. Reducing the risk of developing these side effects will help by choosing the type of IUD that is suitable for this woman, a detailed assessment of contraindications for its insertion, its timely removal and, of course, sufficient professionalism of the gynecologist who will install this device in the uterine cavity.

Possible side effects and complications when using an intrauterine device

• "Nulliparous cervix";
• irritation of the autonomic nervous system;
• increased emotionality of a woman;
• The size of the intrauterine device does not correspond to the size of the uterus.

Side effect	Reasons for development	How often does it occur?	Treatment of adverse reactions
Pain in the lower abdomen immediately after insertion of the IUD	Often.	Anesthesia of the cervix with local anesthetics; correct selection of spiral sizes.
Loss of the IUD from the uterine cavity or expulsion	Violation of IUD installation technique; incorrect selection of spiral size; Features of a woman - foreign body immunity.	Often.	Adhere to all rules for the technique of inserting and selecting the size of the IUD; After expulsion, it is possible to replace the spiral with another one.
Painful and heavy periods	the first months after insertion of an IUD with copper are a normal reaction; non-infectious inflammation as a reaction to a foreign body; allergic reaction to copper; inflammation of the ovaries - adnexitis.	Up to 15%.	Removing the IUD and replacing the IUD with another type of contraception; replacing the copper IUD with a hormonal intrauterine system, in which heavy menstruation does not occur; prescribing antispasmodics (for example, No-shpa) and non-steroidal anti-inflammatory drugs (ibuprofen, indomethacin, nimesulide, etc.) or antibiotics.
Inflammation of the genital organs (colpitis, endometritis, salpingitis, adnexitis): unusual discharge from the vagina, often with an unpleasant odor; itching and burning in the vaginal area; possible bloody issues in the middle of the menstrual cycle; nagging pain lower abdomen and lumbar region; menstrual irregularities; increased body temperature and general malaise.	The spiral was installed for chronic inflammatory diseases of the genitourinary system; the IUD does not protect against sexually transmitted diseases, but increases the risk of the spread of sexually transmitted diseases from the vagina to the uterus and appendages; non-infectious inflammation, which develops as a reaction to a foreign body, increases the risk of infectious inflammation caused by bacteria and fungi normally contained in the bacterial microflora of the vagina.	Up to 1% of cases	Removing the spiral; prescription of anti-inflammatory and antibacterial therapy, according to the results of laboratory diagnostics.
Severe uterine bleeding	Damage (perforation) of the walls of the uterus by the IUD during its installation or operation; presence of uterine fibroids.	Very rarely	Removing the spiral urgently; emergency medical care.
Anemia: pale skin; changes in blood tests; weakness.	Uterine bleeding; long and heavy periods for more than 6 cycles.	Very rarely.	Individually, it is possible to remove the IUD or replace it with a hormonal IUD; iron supplements (Aktiferrin, Totema and others), vitamins and nutritional correction.
Development of fibroids	Damage to the endometrium during insertion or use of the IUD;	Rarely.	Removal of the IUD or replacement with a hormonal IUD; taking hormonal contraceptives.
Risk of ectopic pregnancy	The inflammatory process, which can be facilitated by the IUD, in some cases leads to obstruction of the fallopian tubes; one of the effects of the spiral is contraction and spasm of the smooth muscles of the fallopian tubes, which can cause a pathological pregnancy.	1:1000	Surgical treatment, removal of the fallopian tube.
Pain during sexual intercourse, difficulty achieving orgasm.	Inflammatory process in the genitourinary system; incorrect position and/or size of the device in the uterus; allergic reaction to the components of the spiral; damage to the walls of the uterus; ovarian cysts.	Up to 2%.	Removal of the IUD or replacement with a hormonal IUD.
Onset of pregnancy	The intrauterine device is not a 100% effective method.	From 2 to 15%.	Individual approach.
Perforation (puncture) of the uterine walls: sharp pain in the lower abdomen; uterine bleeding; deterioration of general condition, up to loss of consciousness.	Damage to the walls of the uterus during insertion, operation and removal of the device. Increase the risk of uterine perforation: early postpartum period; scar on the uterus after cesarean section; abnormalities of the uterus;	Very rarely.	Surgical treatment and emergency medical care.
Ingrowth of the spiral into the wall of the uterus	inflammatory process in the endometrium; using the spiral for more than the recommended period.	Up to 1%.	Removal of the spiral through the cervix using special instruments. Sometimes laparoscopic surgery may be required.
Copper intolerance or Wilson's disease	individual intolerance or allergy to copper.	Rarely.	Replacing with another type of contraception or hormonal intrauterine device.

Additional side effects from the use of a hormonal intrauterine system (related to the hormone progestogen):

• absence of menstruation (amenorrhea), after removal of the device the menstrual cycle is restored;

Also, an allergic reaction may develop to the administration of gestagen, requiring urgent removal of the device from the uterus.

Intrauterine device (IUD): composition, action, indications, possible negative consequences of use - video

Intrauterine device (IUD): mechanism of action, dangerous complications (therapist's opinion) - video

How can pregnancy proceed with an intrauterine device?



As has already become clear, intrauterine contraceptives do not protect 100% from pregnancy. For the majority of these “lucky ones,” the pregnancy proceeds normally, the child can independently push the coil out in the second trimester and even be born with it in his hands; for some children it’s like a toy. But everything is not always so smooth, and if a woman decides to continue such a pregnancy, she should be prepared for various problems.

Basic principles of managing pregnancy with the IUD:

1. Difficulties arise with diagnosing pregnancy; the woman is confident in her contraception. And menstrual irregularities with an IUD are not uncommon; this leads to the fact that pregnancy can be diagnosed late, when abortion is already difficult. Therefore, it is very important to listen to your body and consult a doctor at the slightest deviations, changes or hints of pregnancy.
2. If a woman wishes, a medical abortion can be performed.
3. The IUD is not an indication for medical termination of pregnancy. The choice is up to the woman, because in most cases, pregnancy with the IUD proceeds normally and without complications. But still, the doctor must assess the possible risks of pregnancy and may recommend terminating it.
4. The IUD can be removed during pregnancy. The copper coil is often not removed as it does not affect the development of the fetus. The hormonal IUD will release hormones throughout pregnancy that can lead to fetal developmental abnormalities. The gynecologist can remove the IUD if its threads are preserved and it is removed from the uterus easily and smoothly.
5. Such a pregnancy requires constant monitoring by doctors; regular monitoring of fetal ultrasound is necessary.

Possible risks of pregnancy with an intrauterine device:

• High risk of ectopic pregnancy; ultrasound monitoring is required.
• Such a pregnancy can end in miscarriage at an early stage, which is associated with the effect of the coil on the endometrium, to which the fertilized egg is attached.
• The IUD can cause intrauterine infection of the fetus, as well as intrauterine growth retardation and pregnancy loss.
• High risk of fetal malformations during pregnancy with hormonal IUD.
Be that as it may, if a woman nevertheless becomes pregnant with such a powerful contraceptive as the IUD, then, probably, the child really needs to be born. Every woman can listen to herself and decide whether to give this baby a chance to live or not.

How to choose a good intrauterine device? Which spiral is better?

Your gynecologist should select the type of IUD, its size and manufacturer. Only he can determine the indications and contraindications for the use of a particular intrauterine contraceptive, and the individual characteristics of your body. But if the woman is absolutely healthy, then the doctor can provide a choice of IUDs. Then many questions arise.

“Which IUD should I choose, copper or hormonal?” Here a woman needs to choose between effectiveness and possible adverse reactions. The hormonal IUD has more possible side effects associated with gestagen, but they are temporary and stop after a few months. And the contraceptive effect of using such a device is much higher. If a woman has fibroids, then the hormonal IUD is a method of not only contraception, but also treatment. A copper IUD with silver and, especially, gold has higher efficiency than a conventional copper device, and the risk of side effects is lower; this is a kind of middle ground between a hormonal and a copper IUD.

“How much does an intrauterine device cost?” For many women, the issue of cost-effectiveness is of great importance and determines the choice of a spiral. Copper IUDs are much cheaper than hormonal systems. Also, spirals with silver and gold have a high cost.

“Which coil is used the longest?” Spirals with silver and gold can be used the longest, up to 7-10 years or more. Hormonal IUDs are usually used for no more than 5 years.

“Which IUD will not affect future pregnancies?” Any IUD can lead to problems with future pregnancies, including ectopic pregnancy and infertility due to an inflammatory process. The risk of developing an ectopic pregnancy during IUD use is higher with hormonal IUDs due to the action of progestogen. Copper IUDs pose a greater risk of complications such as inflammation of the uterus and appendages. When an IUD is removed, ectopic pregnancy often occurs after the use of copper IUDs.

“Which coil is painless?” During installation and removal of the coil, the woman experiences some pain. But this should not fundamentally affect the choice of an IUD. When the hormonal system is introduced, these painful sensations are more pronounced, which is why local anesthesia is used. Local anesthesia can be performed by introducing a copper spiral in women who are especially impressionable and emotional.

Review of various modern intrauterine devices: Juno, Mirena, Goldlily, Multiload, Vector extra, spirals with gold and silver

Name

Description

Validity

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. This method of contraception is not used for nulliparous girls.

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 SCM is not a contraindication to taking other medications or performing surgical treatment;
• no additional contraception required;
• variety of models and prices - from budget to expensive.

Despite the 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 IUD interferes with the normal development of the child and increases the risk of complications during childbirth. Often such pregnancies have to be terminated surgically.

Types of intrauterine devices

In 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 devices 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 have a 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 patients after caesarean section.
2. Round or ring – painful sensations may occur during installation. 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 choice of shape, size and type of gynecological device is the prerogative of the doctor. This takes into account the patient’s age, medical history and physique.

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 the fallopian tubes. Minor hormonal disorders, the presence of a foreign object contribute to changes in the peristalsis of the 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. The average cost is 4 thousand rubles.

Jaydess

Coil 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 thickening the mucus in the cervical canal, inhibiting 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. The Jaydess device is not sold in the Russian Federation. The price in Ukraine is 2000 hryvnia.

Multiload

Copper non-hormonal T-shaped coil. Allowed during breastfeeding. There are 2 types of devices on the pharmaceutical market 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 for patients with chronic diseases of the fallopian tubes and 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 a treatment for menstrual disorders and 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 protection is carried out only in a medical institution. The procedure does not require hospitalization.

Preparation

Before installing the IUD, you should undergo a comprehensive examination by a 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 of the reproductive system and exclude possible pregnancy.

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

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 coil.

If side effects occur while using the device, it should be removed from the uterine cavity.

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 removal of the contraceptive and during use of the device;
• unsuccessful attempts to remove the device, ending with surgical curettage of the uterine epithelium;

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 the 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.

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 removing 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.

In women after 25-30 years. This popularity is due, first of all, to ease of use (placed in the uterine cavity).

Modern IUDs are made of inert plastic, wrapped with the finest copper wire, which increases the efficiency and duration of use of the spiral. In addition, the spiral may contain silver, gold, and other additives (for example, propolis). Their purpose is to reduce the risk of developing inflammatory diseases of the uterus when using IUDs, but, according to some data, they also reduce the effectiveness of contraception. Hormone-containing IUDs are a separate item; we will talk about them below.

The contraceptive effect of the IUD is that the spiral makes it difficult for the sperm to move towards the egg and, consequently, its fertilization. In addition, the IUD prevents implantation of the fertilized egg due to its accelerated release from the fallopian tubes and the lack of full secretory transformation of the endometrium.

Pros of use copper-containing IUDs quite significant:

no other contraceptive, with the exception of surgical sterilization, allows you to forget about this problem for so long; the average period of using an IUD is 3-5 years;

one of the cheapest methods of contraception, from $2 to $30 for 3-5 years for copper-containing IUDs;

reliable method, efficiency 97-98%;

Can be used for various therapeutic diseases, excluding diseases of the blood system;

unlike sterilization, the method is reversible; The ability to conceive is normally restored within 3 months after removal of the IUD.

However, this method of contraception also has the largest number of contraindications and side effects, which significantly limits its range of use. Once again the proverb “all that glitters is not gold” is true.

TO side effects include:

Prolonged presence of a foreign body in the uterine cavity contributes to the occurrence of an inflammatory process (endometritis), which, in combination with any STD, results in a very difficult clinical picture. Changes persist for a long time in the inner layer of the uterus after removal of the IUD and can cause miscarriage and infertility.

Dysfunction of the fallopian tubes, stimulated by a foreign body to antiperistaltic contractions. This circumstance is associated with an increase in the number of cases of ectopic pregnancy when using an IUD.

The long-term presence of IUD conductors in the cervical canal promotes the upward spread of vaginal microflora with the development of an infectious process in the mucous membrane of the cervix and the formation of cervical polyps. The combination of an IUD with cervical erosion is especially unfavorable.

With regular sexual activity, women who use IUDs periodically still conceive, followed by spontaneous termination of pregnancy in the first week of its development. Such spontaneous mini-abortions have a blurred clinical picture, which is manifested by heavy, irregular and painful periods. Therefore, this method of contraception is categorically unacceptable for religious people.

The use of an IUD involves surgical manipulation in the uterine cavity during insertion and removal of the IUD. This is associated with rare cases of uterine perforation, which requires abdominal surgery.

Spontaneous loss (expulsion) of the IUD is possible, which is especially common when using this method in women with cervical ruptures.

If pregnancy does occur when using this method, it is not always possible to save it, since the number of spontaneous miscarriages increases.

The listed complications define a wide range of contraindications to using an IUD:

allergy to copper;

various inflammatory diseases of the genital organs;

presence or risk of contracting sexually transmitted diseases;

postpartum injuries, as well as other diseases of the cervix (erosions, dysplasia, polyps);

benign and malignant tumors of the genital organs;

endometriosis, fibroids, hyperplasia, endometrium;

malformations of the uterus;

menstrual irregularities, heavy or painful menstruation;

anemia and blood coagulation disorders.

If we take into account that gynecologists do not recommend the use of IUDs for nulliparous women, then the circle of patients for whom a foreign body can be introduced into the uterine cavity for a long period of time to prevent implantation of the fertilized egg without any particular concerns is very limited.

To summarize: This method of contraception is suitable for absolutely gynecologically healthy women with light, regular, painless periods, who have a child and one sexual partner and who are not guided by conventions associated with religion.

A few words about hormonal IUDs

Available in the pharmacy market hormonal intrauterine system "Mirena". It occupies an intermediate position between the IUD and oral contraceptives. Around the vertical shaft of the IUD there is a cylindrical reservoir containing progestogen, which is released into the uterine cavity in microdoses and enters the inner layer of the uterus and blood. At the same time, a constant concentration of this hormone is maintained in the blood plasma at a level of 1/3 or 2/3 of the level of hormones when using conventional oral contraceptives. Mirena, combining the advantages of the IUD and oral contraceptives, does not have the disadvantages inherent in them individually.

pros	Minuses	Anti- readings
Installation valid for 5 years.	Quite a high price (about $250 for 5 years)	Acute or exacerbation of chronic inflammatory body diseases genitals
Effective rate up to 98%
It is possible to use calling during heavy, painful menstruation, while the system has a therapeutic effect - menstruation becomes scanty and painless - unidentified.	Required Difficulty of manipulation in the uterine cavity	Malignity venous tumors of the uterus or cervix
Does not increase the number of ectopic pregnancies news and inflamed- body diseases	The presence of side effects associated with gestagens (depression, headache, minor body weight change, breast engorgement); Usually these phenomena disappear after 3-6 months from installation of the system	Uterine bleeding discharge from the genital tract unidentified lennoe etiology
Can be used for therapeutic purposes in women with fibroids, endomet- riosis, adenomyosis, premen- strual syndrome.	Some women experience complete cessation reduction of menstruation during the first year of use formation, subsequently the cycle of restoration pours; There are also lubricating non-cyclic logical discharge.	Abnormalities of the uterus that interfere with the insertion of the IUD
Due to the very low concentration of the hormone, it is possible to use the system in women with general pathology, when conventional hormonal contraceptives are contraindicative. cauldrons		Acute hepatitis
Reversible method - the ability to conceive is restored drains within a year after extraction Navy		Acute thrombo- phlebitis or thromboem- pain disorders

How the intrauterine device is inserted and removed.

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.