The intrauterine device is harmful to health. Does the Mirena IUD affect weight?

More than 60 million women in the world prefer such a means of birth control as an intrauterine contraceptive. Which ones are better, for how long are they installed, is this a painful procedure? These questions interest many women.

IUD classification

More than 16% of Russian women use this type of contraception reproductive age. To find out what is good about an intrauterine device and which one best protects against pregnancy, you need to know which devices can be purchased on the domestic market. There are several types of intrauterine contraceptives:

non-medicinal;
first generation medications - “Multiload”, “Nova”, “Junona Bio”;
third generation medications - Mirena.

The first ones are made from synthetic materials with the addition. They come in various shapes: T-shaped or S-shaped. These ineffective doctors report that they are not currently used due to frequent inflammatory complications after their administrations.

The second group is represented by IUDs (intrauterine contraceptives) containing copper, gold, and silver. In this case, it is possible to have one metal or a combination of several: the rod is silver, and the winding is copper. Intrauterine devices with silver and other metals do not corrode and help prevent various inflammations internal genital organs and are placed for quite a long time - for 5 years.

Contraceptives belonging to the third group are similar in form to the previous ones, but contain a container with a synthetic gestagen, which is released in microdoses - up to 20 mcg daily. Such spirals are installed for 7 years. They not only have a contraceptive effect, preventing the attachment of a fertilized egg, but are also used to treat various diseases: endometriosis, dysfunctional uterine bleeding and during hormone replacement therapy with estrogen to prevent endometrial hyperplasia. Such spirals are suitable for women with religious prejudices, since fertilization does not occur due to changes hormonal balance influenced constant allocation progestogens.

Mechanism of action

To decide which intrauterine devices are better, you need to know how they work. This method of contraception leads to the development of specific inflammation as a reaction to a foreign body: leukocyte infiltration of the endometrium, morphofunctional changes that are unusual for the normal menstrual cycle and in which the introduction of a fertilized egg is impossible.

The IUD causes contractions of the uterus, prevents the normal growth of the endometrium for egg implantation, promotes peristalsis and negatively affects sperm with copper, gold and silver ions.

Each theory of contraceptive action should not be considered as prevailing; the mechanism of action consists of several components.

Advantages

To find out which intrauterine device is the best, you need to familiarize yourself with the advantages of all types of IUDs:

efficiency up to 98%;
ease of use;
minimum of adverse reactions;

restoration of the ability to fertilize after removal of the IUD during the first month;
breastfeeding is not affected (not suitable for IUDs with gestagens);
is administered for a long time;
low cost;
There is no need to take pills daily and monitor their use when using oral contraceptives.

Flaws

Among the disadvantages, it should be noted nagging pain in the lower abdomen, especially in the first days, heavy menstruation, a high risk of developing inflammation, constant monitoring of the mustache, restrictions for young women.

Contraindications

Which intrauterine devices are better: “Multiload”, “Junona Bio”, “Nova”? Are there any contraindications for a certain type of IUD? It should be noted that for all types there are relative and absolute contraindications.

TO absolute contraindications include an acute inflammatory process, oncological neoplasms cervix and uterine body, vaginal bleeding of unknown origin, suspected or existing pregnancy. With these symptoms, insertion of the IUD is strictly contraindicated.

Relative contraindications are those symptoms in which the introduction of an IUD is possible after appropriate examination or treatment, or when the contraceptive will not contribute to the progression of the process. This:

Exacerbation of chronic diseases and six months after recovery;
. venereal diseases;
. cervicitis, vaginitis;
. heavy menstruation, intermenstrual bleeding;
. endometrial hyperplasia or polyps;
. uterine fibroids with submucous nodes;
. some forms of endometriosis;
. malformations of the uterus: insufficient development, abnormal structure;
. changes in the cervix that make it impossible to insert an IUD;
. ectopic pregnancy six months before insertion;
. history of IUD expulsion (self-removal);
. infectious and inflammatory complications after abortion during the last three months;
. if there are many sexual partners;
. somatic diseases: chronic inflammation, incl. tuberculosis; anemia or coagulopathy; rheumatic heart disease, valve defects;
. allergy to metal ions;
. Westphal-Wilson-Konovalov disease is a hereditary disease in which copper metabolism is disrupted;
. treatment with immunosuppressants.

In each specific case, after clarification of all unfavorable factors And thorough examination the doctor determines the possibility of using an IUD. Pharmacies sell various intrauterine devices. Photos of the packaging are presented above. Their cost varies from 200 to 10,000 rubles.

Examination before insertion of the IUD

Before using this method of contraception, you must have an individual consultation with your gynecologist and perform the required minimum of examinations:

clinical blood test;
examination;
examination for syphilis, hepatitis B and C, HIV carriage;
extended colposcopy;
Ultrasound of the uterus and appendages.

Time of IUD insertion

According to WHO experts, the IUD can be inserted on any day, but most favorable days days 4-7 of the menstrual cycle are considered. This is explained by the fact that at the specified time the uterine mucosa has been restored after rejection of the endometrium, is slightly open, the presence of menstruation is a reliable sign of the absence of pregnancy, and minimal bleeding that occurs after insertion does not bring discomfort to the woman. After an induced abortion or self-abortion, the IUD can be inserted immediately or within 4 days if there are no signs of bleeding or inflammation.

Complications

Complications are possible immediately and some time after the intrauterine device is installed. Which is better in terms of minimal unpleasant side effects? Often after insertion of the spiral, a pain symptom occurs, which can last for an hour. This is reported in the reviews. Most often, the discomfort goes away after taking analgesics. If the pain is not relieved by taking analgesics and antispasmodics, then it is necessary to perform an ultrasound or hysteroscopy to determine the correct insertion of the IUD and diagnose the presence of a spiral in the uterus or outside it (if the uterus is perforated during insertion).

Expulsion of the IUD is most often observed in young nulliparous women due to increased contractility of the uterus. It occurs mainly in the first days after administration. Moreover, the frequency of this complication depends on the type of IUD: copper-containing devices remove themselves in 6-16% of cases, progestogen-containing devices - in 3-6.5%. With age and an increase in the number of births and abortions, the likelihood of this complication decreases.

Inflammatory diseases are complications that are observed in 3.8-14.5% of cases when the IUD of the second group is inserted. Moreover, if inflammation occurs in the first 3 weeks, then its occurrence can be associated with the introduction of an IUD; if after 3 months, then this is a newly emerging disease. The formation of a purulent tubovarial formation is the most dangerous inflammatory complication. It occurs when long-term use spirals - more than 6-7 years. Bloody discharge is possible in the first days after administration (2.1-3.8% of cases) and can be stopped by prescribing hemostatic agents. If bleeding continues, is accompanied by pain, or occurs between menstruation and does not respond to treatment, then it is necessary to remove the coil.

In 0.5-2% of cases, pregnancy may occur. This occurs with full or partial expulsion of the IUD. Most often, such a pregnancy ends in spontaneous abortion, even if the woman wants to keep it.
And which intrauterine devices are better in terms of complications, a gynecologist will help you decide.

The effectiveness of intrauterine contraceptives

Many types of IUDs pose the following questions to a woman: how to avoid complications, and which intrauterine device is better? Reviews from doctors and patients speak in favor of copper- or silver-containing IUDs.

The addition of copper and silver reduced the incidence of complications by 2-10 times. Moreover, the effectiveness of such IUDs is 93.8%. Inert coils have an efficiency of 91-93%. Currently, copper-containing IUDs are the most acceptable due to the low percentage of complications and high percentage of contraceptive activity.

The Mirena hormonal releasing system is the most effective contraceptive and is considered almost biological sterilization, since it has many actions aimed at preventing fertilization of the egg, attaching it to the endometrium, increasing the viscosity of mucus in the cervical canal to protect against sperm entering the uterus.

We have considered the positive and negative effects, which the intrauterine device has. Which one is better? This issue should be resolved together with a gynecologist. At the same time, the price that the woman expects is determined, and the indications that the doctor identifies after the examination.

Types and features

Currently, there are about 50 variants of IUDs, which differ in shape, size and materials. Therefore, they are usually classified by generation:

The first is inert IUDs. The most popular were spirals made of polymer materials in the shape of the Latin letter S. Today, due to side effects and low efficiency, this type is practically not used, and in some countries it is even prohibited.
The second generation is copper-containing products. The first representatives of this generation were produced with copper wire inserted into the structure. Their main disadvantage was the too rapid release of copper, due to which the coil had to be replaced every 2–3 years. More modern IUDs come with an additional silver rod, which slows the release of copper and makes its use more durable. The most popular of this series are the Nova T intrauterine device, Multiload Cu-250 and Cu-375, as well as Sopper-T.
Third generation - spirals with hormones. The impetus for their creation was the desire to combine the advantages of the IUD and birth control pills. Externally, they are a T-shaped structure, the stem of which is filled with the hormone levonorgestrel or progesterone. How does an intrauterine hormonal device work? Almost the same as hormonal pills. The device is designed in such a way that equal doses of the hormone enter the woman’s body every day. The validity period of such products is 5 years, and the most popular of this generation are Mirena and Levonova.

The types of spirals are very diverse. Usually, women who are thinking about using this means of protection have a logical question: which is better, hormonal or non-hormonal intrauterine device?

Only a gynecologist can solve this problem after examination and receiving test results. Despite the fact that you can purchase any IUD at a pharmacy without a doctor’s prescription, you should not make such a purchase yourself.

Advantages

Of course, the main advantage of modern intrauterine devices is that this product is the most effective of all those currently existing. However, a high percentage of reliability is not their only advantage. Their advantages also include:

Ease of use. The intrauterine device will be valid, depending on the type, from one year to five years and you will not have to take pills every day or think about any other methods of contraception.
Can be used immediately after childbirth and during breastfeeding.
Easy reversibility of the method. After removal of the spiral, the reproductive properties of the body are restored in just a few months.
Even hormonal IUDs do not have such a strong effect on female body, How birth control pills, and, therefore, have much fewer contraindications for use.
Unlike a condom or vaginal ring, they do not cause discomfort and do not reduce sensations.
Taking into account the long validity period, even expensive products are more cost-effective to use than any other means of protection against pregnancy.

Flaws

Unfortunately, there are no ideal methods of contraception, and such a reliable method as the IUD has its drawbacks. The disadvantages of this method include:

Increased risk of developing acute inflammatory diseases.
Not a single contraceptive device protects against sexually transmitted diseases, so this method of protection is more suitable for established, permanent couples.
In the first time after installation, menstruation is usually more painful and occurs more abundantly and takes longer.
The device may spontaneously fall out, for example, during active sports or lifting weights.

Perhaps the most serious disadvantage of using an IUD is the increased risk of developing an ectopic pregnancy due to a violation contractile activity fallopian tubes and the uterus itself.

Rules of Use

Intrauterine device does not apply to simple methods protection against unplanned pregnancy. Its use will require you to comply with several important rules. And the question of whether this method of contraception is suitable for you should be decided only by a gynecologist after examination and tests. The type of spiral that suits you is also selected by your doctor. Typically, experts advise using this type of contraception if:

In a woman increased fertility and unwanted pregnancies happen all too often.
There are diseases for which pregnancy is contraindicated.
The woman or her partner has genetic pathologies that also prevent pregnancy.

How is an IUD installed?

The spiral can be installed regardless of the phase menstrual cycle, but still doctors advise doing this from the fourth to the eighth day, if you count from the first day of your period. Before the procedure, microflora smears must be taken, general analysis blood and urine, an ultrasound examination is performed to exclude pregnancy and determine the size of the uterus.

The procedure itself is quite simple and painless, so it is performed on an outpatient basis and without anesthesia. However, in the first days after installation, you may be bothered by unpleasant sensations in the lower abdomen, aching or cramping pains, which normally go away on their own.

A follow-up examination is required after a week, and during this week it is better for the woman to abstain from:

From intense physical activity.
Hot baths.
Taking laxatives.
Sexual life.
Taking aspirin or medications containing acetylsalicylic acid, as this may cause bleeding.

After each menstruation, you will need to independently check the presence of threads from the spiral, and control examinations, in the absence of complaints, will need to be carried out every six months.

How is an IUD removed?

It is not necessary to wait for the entire duration of the spiral. If you wish, you can ask your gynecologist to remove it at any time. In the absence of complications, removal, as well as installation, is not particularly difficult and is performed on an outpatient basis. The doctor just needs to pull the antennae. However, despite the simplicity of the procedure, you should not carry it out yourself at home.

IN in rare cases, for example, if the tendrils of the spiral break or penetrate the wall of the uterus, its removal can be carried out using a hysteroscope. This device is a tube with special channels for scissors or forceps. In this case, the procedure can be carried out in a hospital.

Before removing the IUD, the gynecologist also mandatory prescribes an ultrasound to clarify its location in the uterine cavity. During removal or immediately after it, pain and bleeding may occur.

Contraindications

The IUD protection method is not suitable for everyone, although it works well in most cases. Like any contraceptive, the intrauterine device has its own contraindications. Conventionally, they can be divided into absolute and relative, when the final decision is made by the doctor after the necessary tests.

The first group includes:

Acute or frequently exacerbating inflammatory diseases of the female sphere.
Suspicions about malignant tumors cervix or uterine body.
Uterine bleeding, the cause of which is not clear.
Suspicion of pregnancy.
Pathological changes in the uterus that may interfere with the correct insertion or placement of the device.
Malformations of the cervix or the uterus itself.

The second group of contraindications includes:

Heavy, painful and prolonged, longer than six days, menstruation or the presence of bleeding in the period between them.
Endometriosis of the cervix and ovaries.
Abnormal configuration of the uterus or too small size.
Myomatous nodes, severely deforming the uterine cavity.
Previous ectopic pregnancy.
Allergies to the components included in the spiral, for example, to polymer substances or copper.
Low hemoglobin levels, bleeding disorders, or other blood disorders.

In some situations with such relative contraindications, such as uterine fibroids, heavy and painful menstruation or endometrial pathologies, the appointment of hormonal IUDs is often, on the contrary, justified.

Side effects

Any intrauterine device is inherently a foreign body, and even a completely healthy body needs time to come to terms with its presence. Therefore, side effects and discomfort usually occur in the first days after installation.

Most often this is:

Aching or cramping pain in the lower abdomen, which, according to statistics, occurs in approximately 5–10% of patients.
Heavier than usual menstrual bleeding, which occurs in 24% of cases. Rarely, such bleeding can lead to the development iron deficiency anemia.
Increased risk of inflammatory diseases in approximately 0.5–4% of cases.
Spontaneous prolapse of the intrauterine device, occurring in 6–15% of cases.

If you have severe pain, unusual discharge, bleeding unrelated to menstruation and a fever, then you need to consult a doctor as soon as possible.

Also, do not delay your visit if your next period is late or if other signs of pregnancy appear, such as morning sickness or pain and swelling of the mammary glands.

If you did not feel the threads of the spiral or, on the contrary, felt its plastic tip, then, most likely, the IUD has moved from its place and no longer performs its main function. In such a situation, you should also consult a doctor.

Intrauterine devices are considered one of the most effective means modern contraception. Their reliability has been recorded in 98% of cases. Modern industry issues various types these means of protection against unwanted pregnancy.

The intrauterine device comes in a variety of structures, levels of rigidity, and principle of operation. In each individual case, the doctor prescribes an individual type. Depending on the anatomical features of the patient and the studies performed.

There are discussions in medical circles regarding the safety, reliability, and justification of using this drug. The effectiveness of using this type of medication largely depends on both the woman’s health and the correctness of determining which IUD spiral the patient needs.

Contraindications for the use of the spiral

Like any other contraceptive, this also has a number of contraindications. Namely:

Any type of neoplasm;
Inflammatory pathologies in the body;
Deviation from the norm in the development of the uterus and its cervix.

And these are just the main, most common reasons why an IUD cannot be prescribed. In addition, it is prescribed only in situations where the girl has one permanent and reliable sexual partner. This feature is due to the fact that the IUD method of contraception for women increases the chances of any type of infection of the uterine cavity.

In addition, doctors note that there is a real risk when the contraceptive may spontaneously fall out. And not always, a woman can determine this on her own. In such situations, the chances of becoming pregnant unintentionally are very high.

But, at the same time, it should be noted that modern, improved models, for example, the Mirena type, have medicinal properties and are even specifically prescribed in therapeutic purposes for a number of gynecological ailments. Photos found on the Internet on request will help you visually familiarize yourself with it - pictures of an intrauterine device.

Positive properties of the IUD

As for positive points application of this method of protection, among them:

Reliability;
Comfort of use;
Duration of effect (up to 5 years);
Indicated for use even during breastfeeding;
Fast recovery period body after extraction.

However, despite all the pros and cons, prescribe this remedy protection against pregnancy can only be done by an experienced gynecologist after an individual examination and a series of tests.

What types of IUDs are there?

This type of contraception is available various types. They are: ring-shaped, spiral, T-shaped. The last type is the most common. To understand what each model looks like individually, it is best to look at the IUD intrauterine device photo.

They may contain hormones and metal alloys, which, along with the main function of protection, can perform a therapeutic function. Most modern models have a T-shaped appearance (see photo). They have an improved design. In addition, this type of contraception is characterized by ease of use.

It’s clear what an intrauterine device looks like. But which type is preferable? Hormonal types, as well as models containing copper, received impeccable recommendations from many doctors.

The first type of spiral is the most reliable. As for the copper types, their popularity is due to the ease of insertion and removal, as well as the ability to produce an anti-inflammatory effect.

Contraceptive suppositories Lady
Lady contraceptive suppositories are a chemical contraceptive drug that is convenient and easy to use, and which has virtually no...

It starts earlier than they are ready for motherhood, and even for family life at all. 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 (precursor to the 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. No daily procedures required, special hygiene care and taking 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.
High 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 are obtained only by removal of the appendages or ligation of the fallopian tubes and complete failure from sexual life.
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 attraction, 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 considering a long period 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 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; used not only for contraception, but also in the treatment of certain gynecological diseases (fibroids, endometriosis, painful menstruation, uterine bleeding And so on).	Increases the risk of developing an ectopic pregnancy. Usage hormonal IUDs significantly reduce 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 pain syndrome particularly pronounced, sometimes requiring local anesthesia.

Indications for installation of an intrauterine device

1. Temporary or constant prevention 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 infection 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 to inheritance (hemophilia, cystic fibrosis, Down syndrome and many others),
6. For hormonal intrauterine devices – some gynecological pathologies:

, especially if it is accompanied by heavy bleeding 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 the mammary gland;
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;
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 (leukemia, thrombocytopenia and others);
endometrial growths, endometriosis;
urethritis, cystitis, acute or exacerbation of 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;
heavy cardiovascular pathologies: malignant arterial hypertension, condition after or, severe heart defects;
migraine;
decompensated (uncontrolled);
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 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 full recovery uterus, but also 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 the onset 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 possible reactions body for 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

Usually special training no spiral is required for insertion. 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. Optimal time is the 3-4th day. This is necessary in order not to miss the onset of pregnancy.

The intrauterine device can be installed as emergency contraception, that is, if a woman 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.

Administration technique for various types spirals may vary. 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 pain threshold women. 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 IUD, for example, if chlamydia is suspected or if there is another chronic 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-shpa.
The hygienic regime is normal, you need to wash yourself with products for intimate hygiene 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, x-rays. 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 it 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 unwanted 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 specifically for this woman, a detailed assessment of contraindications to its insertion, its timely removal and, of course, sufficient professionalism of the gynecologist who will install this device into 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 local anesthetics cervix; 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 for 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 that develops as a reaction to a foreign body increases the risk infectious inflammation caused by bacteria and fungi normally found in bacterial microflora 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; urgent health care.
Anemia: pallor 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 preparations (Aktiferrin, Totema and others), and 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 smooth muscle 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 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 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;
functional ovarian cysts ( benign formations), required hormone therapy estrogen hormones;

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 from 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. This kind of pregnancy requires constant monitoring On the part of 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 may end in early miscarriage, which is due to 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.

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

“Which IUD should I choose, copper or hormonal?” Here a woman needs to choose between efficiency 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. A contraceptive effect from using such a spiral 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 economy is great importance and determines the choice of 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 carried out with the introduction of 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

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Family planning and the ability to independently choose the time of birth of a child have become available thanks to a huge number highly effective contraceptives. What a spiral is, how it works, what its pros and cons should be known to every woman who cares about herself and the health of her children in the future.

What is a spiral, what is its algorithm of action

Before making important decisions, it is worth understanding what this method of protection is and how it works. You will learn about other methods of contraception in the article.

An intrauterine device is a contraceptive device that is inserted into the uterine cavity to prevent unplanned pregnancy. The name “spiral” is not entirely correct; it has been preserved as an established name, because previously such devices looked exactly like this; a modern IUD looks like a T-shaped stick made of flexible inert plastic.

According to the principle of action, spirals are divided into:
copper-containing - a thin copper wire is attached to the upper part;
hormone-containing - contain a container with a substance that enters the uterus during the period of use.

The principle of operation of various types of intrauterine devices

Immediately after insertion, the spiral begins to work in several directions.

Its actions are as follows:
1. Changes in the endometrium and the impossibility of implantation of a fertilized egg into the walls of the uterus. Which is essentially a micro-abortion, so moral aspect often prevents women from using this type of contraception.
2. Progesterone-containing coils have an effect on sperm, reducing them motor activity and interfere with movement in the cervical area.
3. Strengthen the peristalsis of the pipes. This increases the speed of passage of the egg and ensures entry into the uterine cavity without fertilization.
4. Copper-containing coils reduce sperm activity and prevent implantation of the fertilized egg.

Rules for installing and removing the spiral

Do not try to install or remove the coil yourself! This can lead to serious complications and the inability to bear children in the future.

After making a decision about this type of contraception, you need to consult a doctor and ask about all your questions. Let the doctor once again explain in detail how this method works and warn about potential complications.

Next, you should choose the type of spiral and take some tests:
smear from the cervix and vagina;
colposcopy;
blood test for HIV, RW and Australian antigen (Hepatitis C);
UAC and OAM;
analysis for hidden sexually transmitted infections;
Ultrasound.

If the woman is completely healthy and contraindications are excluded, you can begin installing the IUD. This procedure is done on an outpatient basis, in 10-15 minutes in the gynecologist’s office on days 6-8 of the cycle. You may feel discomfort in the lower abdomen for several days.

You should also go to the hospital to remove the IUD. In this case, you do not need to take tests and undergo additional examinations. During a routine appointment, your doctor will apply an anesthetic gel to the cervical area and remove the IUD.

Pros and cons of the intrauterine device

Like any family planning device, the intrauterine device has advantages and disadvantages that must be taken into account when making an important decision.

Advantages of the spiral

Easy to use. After installation, a woman can forget about its existence and no longer worry about contraception.
Long term installation. From 3 to 5 years, depending on the type of spiral.
Efficiency 95-98%.
Use during breastfeeding, which is a significant factor when choosing contraception for young mothers. Hormones in the spiral act only in the area of the uterus and ovaries, without getting into the milk.
Possesses therapeutic effect for certain gynecological diseases (uterine fibroids).
Relieves pain and shortens the duration of menstruation.
Does not have a prolonged effect on the female body. You can plan for a child within 2 cycles after its removal

Disadvantages of the intrauterine device

The procedure is slightly painful.
Complications during unplanned pregnancy. If pregnancy has occurred, the risk of its development in the tube increases significantly - an ectopic pregnancy.
Increased risk of inflammatory diseases. This occurs because after the IUD is installed, the cervix remains slightly open.
Lack of protection against STDs.

Strict contraindications for insertion of an intrauterine device

After assessing the pros and cons, it is worth noting the strict contraindications under which the use of this method is prohibited.

1. For women who have not given birth, IUD installation is not recommended. Their cervix is still tight and can be injured. In this case, problems arise with carrying a pregnancy.
2. Non-regular sexual partner.
3. Inflammatory diseases of the genital organs.
4. Dysplasia and erosion of the cervix. You will learn about erosion in the article
5. Tumor and pre-tumor processes.
6. Injuries and stitches on the cervix during childbirth.
7. History of ectopic pregnancy.
8. Various blood diseases.

Possible complications

When using this method, some quite serious complications may occur:
1. The most severe and life-threatening complication is considered to be perforation of the uterine walls. This is a condition that can occur during installation or removal of the IUD by an inexperienced specialist, which can lead to removal of the uterus.
2. Cervical rupture. A rare complication that can occur if the doctor missed her condition.
3. Bleeding. Perhaps immediately or within a few days after installation.
4. Increased risk of pelvic organ inflammation and attachment bacterial infection. This occurs due to the fact that after installing the IUD, the cervix remains slightly open and bacteria from the vaginal area have access to the uterine cavity.
5. Ingrowth of the spiral into the uterus. Enough dangerous complication, which a woman will not know about until she decides to remove the spiral. When determining this condition, it will be necessary to remove the foreign body by cleaning the uterus under general anesthesia.
6. Increased risk of ectopic pregnancy.
7. Irritation of the walls of the cervix by the antennae of the spiral. This condition occurs due to the increased individual sensitivity of a woman.
8. Loss of the spiral. Probably due to incorrect installation or incorrectly selected size.
9. Pain in the lower abdomen.

What to do when pregnancy occurs?

Complete and categorical protection from pregnancy is provided only by tubal ligation, so the risk of its occurrence is, of course, possible. This situation is described in the topic

It is likely that in such a case the pregnancy will be ectopic and you will have to face all the consequences of treating this condition. This topic will tell you in detail about this condition. The actions of a specialist in such a situation directly depend on the timing of the discovery of the problem. But, with a probability of 80%, a section of pipe will be removed, in more difficult cases the tube will have to be amputated completely.

If after fertilization the egg is correctly placed in the endometrial layer, the pregnancy can be maintained. For its normal development, it is recommended to remove the intrauterine device. Most often, this procedure takes place without irreversible consequences, but of course there is a risk of miscarriage during the procedure.

Such a contraceptive cannot harm the child, because will be pushed to the wall by the growing membranes and will spontaneously come out during labor. But a big risk comes from the fact that the cervix is slightly dilated during the period of gestation. Firstly, the risk of infection and inflammation of the amnion increases many times, which can lead to miscarriage, premature birth and intrauterine death of a child. Secondly, the risk of premature dilation increases, with the same consequences for mother and baby.

If during examination the cervix is closed and the doctor cannot detect the antennae, this position may indicate that it has completely entered the uterine cavity or has grown into the cervix. In this case, the contraceptive should be left in place and the pregnancy should be given a chance to develop independently. This condition increases the risk of miscarriage in the first trimester by up to 50%, and then the course of pregnancy no longer differs from normal.

Before choosing a contraceptive method, you should find out what the IUD is and how this method of protection works. Perhaps this method will be ideal for you!

Author of the publication: Valeria Samoilova

Among all known contraceptives, intrauterine contraceptives are considered the most convenient and do not require total control. If they are installed correctly, taking into account all existing contraindications, you can forget for many years about drawing up schedules, taking pills on a schedule, forget about running to the bathroom at the most inopportune moment. But there is a not entirely substantiated opinion about the adverse effects of intrauterine contraception of this type on a woman’s body.

Consequences of the intrauterine device. All the pros and cons

Just like any of our actions, which have a completely opposite assessment depending on which side you look at, each specific method of contraception has its pros and cons. The benefits and harms of the spiral cannot be assessed unambiguously. It all depends on individual characteristics women. What brings undeniable benefit to one, without causing absolutely any deviations from the norm, will be harmful to another. And the installation of an intrauterine contraceptive device can become a real complication.

Intrauterine contraceptives should be installed exclusively by a doctor and always under appropriate conditions. If no contraindications are found during examination by the attending physician, this method will not cause any complications.

Is the spiral harmful? Contraindications:

This method of contraception will be ideal for women with regular partners, that is, those who have a constant sex life. Is it harmful to use a spiral for promiscuous relationships? Definitely yes! Such contraception is not capable of protecting against sexually transmitted diseases, so its use can be 100% justified only if full confidence purity of relations between partners.

Why is an intrauterine device dangerous in the presence of acute or chronic form diseases of the genital organs? It takes a woman’s body 3 to 8 months to get used to an installed foreign object, and the presence of inflammatory processes significantly complicates the adaptation period. In addition, all existing mildly expressed, “dormant” ailments of the genital organs actively manifest themselves. When the first symptoms appear: burning, itching, pain in the lower back, lower abdomen, general malaise, chills or high body temperature, you should immediately consult a doctor.

Is the IUD dangerous for a woman during pregnancy? Yes! The presence of an IUD during pregnancy can cause a number of complications, including the threat of miscarriage. Regardless of the reason for the pregnancy, it must be removed.

Most likely, there is no need to confirm why the coil is dangerous for uterine bleeding and malignant neoplasms in the genital area.

There are also restrictions on the use of this type of contraception for women with heart disease, inflammation of internal organs, and diabetes mellitus.

Of course, in cases where all possible complications and there are no contraindications for installing an IUD - this best option. Minimum discomfort and fear, plus maximum protection from unwanted pregnancy. Therefore, it makes sense to clarify in each specific case whether the IUD is harmful for a woman? A positive decision with the exception of any complications will give absolute freedom and independence from circumstances in your intimate life.

Is the IUD dangerous for a woman? Possible complications

Now directly about the complications that may arise when using a spiral.

An uncommon but common problem is the loss of an installed contraceptive from the uterine cavity, and complications can be expected in the first time after installation (up to 3 months). It is for this reason that the attending physician suggests an additional examination after this time period.
The very fact of loss does not affect the woman’s well-being in any way and does not cause harm. The only thing is that it is necessary to notice this incident in a timely manner and take action. necessary measures- choose the correct size of the new model.
The introduction of an intrauterine contraceptive can sometimes cause various types of difficulties and uterine bleeding. With such complications, the further verdict - whether the intrauterine device is harmful in a particular case - is made only by the attending physician based on the results of the examination and tests.
Fears such as uterine puncture are a practically unheard-of complication, but theoretically there is a risk. Timely medical assistance completely eliminates this misunderstanding without further consequences.

Regardless of the benefit-risk ratio, its main advantages are undeniable.

Just like any of our actions, which have a completely opposite assessment depending on which side you look at, each specific method of contraception has its pros and cons. The benefits and harms of the spiral cannot be assessed unambiguously. It all depends on the individual characteristics of the woman. What brings undeniable benefit to one, without causing absolutely any deviations from the norm, will be harmful to another. And the installation of an intrauterine contraceptive device can become a real complication.

Is the spiral harmful? Contraindications:

This method of contraception will be ideal for women with regular partners, that is, those who have a constant sex life. Is it harmful to use a spiral for promiscuous relationships? Definitely yes! Such contraception is not capable of protecting against sexually transmitted diseases, so its use can be 100% justified only if there is complete confidence in the purity of the relationship between partners.

Why is an intrauterine device dangerous in the presence of acute or chronic forms of genital diseases? It takes a woman’s body 3 to 8 months to get used to an installed foreign object, and the presence of inflammatory processes significantly complicates the adaptation period. In addition, all existing mildly expressed, “dormant” ailments of the genital organs actively manifest themselves. When the first symptoms appear: burning, itching, pain in the lower back, lower abdomen, general malaise, chills or high body temperature, you should immediately consult a doctor.

Is the IUD dangerous for a woman during pregnancy? Yes! The presence of an IUD during pregnancy can cause a number of complications, including the threat of miscarriage. Regardless of the reason for the pregnancy, it must be removed.

Most likely, there is no need to confirm why the coil is dangerous for uterine bleeding and malignant neoplasms in the genital area.

There are also restrictions on the use of this type of contraception for women with heart disease, inflammation of internal organs, and diabetes mellitus.

Of course, in cases where all possible complications are completely absent and there are no contraindications for installing an IUD, this is the best option. Minimum discomfort and fear, plus maximum protection from unwanted pregnancy. Therefore, it makes sense to clarify in each specific case whether the IUD is harmful for a woman? A positive decision with the exception of any complications will give absolute freedom and independence from circumstances in your intimate life.
Is the IUD dangerous for a woman? Possible complications

Now directly about the complications that may arise when using a spiral.

An uncommon but common problem is the loss of an installed contraceptive from the uterine cavity, and complications can be expected in the first time after installation (up to 3 months). It is for this reason that the attending physician suggests an additional examination after this time period.
The very fact of loss does not affect the woman’s well-being in any way and does not cause harm. The only thing you need to do is notice this incident in a timely manner and take the necessary measures - choose the right size for the new model.
The introduction of an intrauterine contraceptive can sometimes cause various types of difficulties and uterine bleeding. With such complications, the further verdict - whether the intrauterine device is harmful in a particular case - is made only by the attending physician based on the results of the examination and tests.
Fears such as uterine puncture are a practically unheard-of complication, but theoretically there is a risk. Timely medical assistance completely eliminates this misunderstanding without further consequences.

Regardless of the balance of benefit and risk, its main advantages are undeniable:

Almost 100% efficiency;
Long term of use (2 - 5 years);
Lack of influence on the entire body;
Does not affect the ability to become pregnant in the future;
There are no age restrictions;
The installation process is often painless and requires little time.

If you decide to install a spiral, then first consult our experienced gynecologists in order to avoid consequences. You can make an appointment with us by phone, and also leaving a request on the website. When you contact us, we will provide a discount.

An intrauterine device (IUD) is a contraceptive device for women, which is a small device made of plastic with copper that prevents sperm from moving into the uterine cavity, and also reduces the lifespan of the egg and prevents the fertilized egg from attaching to the uterine cavity.
Many IUDs contain copper and silver, which reduce the likelihood of developing inflammatory diseases and suppress the motor function of sperm.

Intrauterine devices (IUDs) are one of the most effective forms of contraception. A foreign body (spiral) is inserted into the uterine cavity and prevents it from closing. In addition, the “leg” of the spiral is braided with copper, which causes a local inflammatory reaction, due to which the sperm loses its ability to fertilize. The contraceptive effect of the IUD lies precisely in this.

The IUD is inserted into the uterine cavity on the 2-3rd day of menstruation for 5 years, after which it must be removed and a new one installed during the next menstruation.
The IUD is a life-saving remedy for many women, because not every female body is able to withstand a normal pregnancy.

However, you should not think that the intrauterine device is completely safe for a woman’s health. There are several points to remember before installing the coil:
1) The intrauterine device does not protect against sexually transmitted infections. Particular attention should be paid to the fact that the uterine cavity is constantly slightly open, and as a result, infections can easily penetrate into it. Even copper or silver wire does not always protect. IUD placement is especially harmful for women who have already suffered from inflammatory diseases (inflammation of the appendages, vagina and uterus), as well as for those who have chlamydia, mycoplasma or viruses;
2) The probability especially increases infectious diseases, if a woman does not have a permanent partner. Therefore, the intrauterine device was popularly called “the contraceptive of faithful wives”;
3) The IUD does not interfere with the movement of sperm to the egg. The spiral has rather abortifacient properties, since the egg is fertilized, but is immediately killed. The uterus contracts and an infectious process develops, as a result of which antibodies are released that do not allow the uterus to give birth to new life;
4) The use of an IUD is characterized by painful sensations during menstruation and during intermenstrual flow. The presence of a foreign body in the uterus leads to intense, prolonged and painful menstruation;
5) The most serious complications of using such a contraceptive are uterine perforation (rupture of the uterine wall) and all kinds of inflammation. As a result, the likelihood of infertility increases, so it is not recommended to use IUDs for women planning to have children in the future. But if doctors have completely forbidden a woman to give birth or bear a child, then wearing an IUD may be necessary;
6) It is known that the likelihood of an ectopic pregnancy in women with an IUD is almost 4 times greater than in other women. During the survey, it turned out that 28 women out of 100 have a miscarriage when using an IUD, and in 8 cases the zygote dies at the stage of ectopic pregnancy, when it should have been performed. surgical intervention specialists.

The intrauterine device can be removed at any time at the woman's request. For the first 3-4 months after removal, you need to protect yourself with various means of contraception (pills, condoms). After all, the uterus must restore its reproductive capacity, which will begin to function normally within a year.

The insertion and removal of the IUD must be carried out under the supervision of a physician. There are cases when the IUD is incorrectly positioned in the uterus and injures the female internal organs. In addition, the gynecologist should examine the patient after 5 days of wearing the IUD, and then carry out regular examinations every six months.
To prevent the ingrowth of the spiral, the woman also needs to undergo an ultrasound.
Finally, in medical practice There have been situations when, due to significant physical exertion, the spiral fell out on its own. This can happen both during sports and during menstruation.

A woman should not forget that the intrauterine device is not a complete contraceptive (it can be called a mini-abortion without surgery). Considering all these factors, it is recommended to consult a gynecologist before installing the IUD.

Veronica asks:

What side effects and consequences can the intrauterine device cause?

Complications and side effects of the IUD

Typically, intrauterine contraception Well tolerated, so side effects are uncommon. In addition, unpleasant symptoms are most pronounced in the first three months of using the spiral, and then most often disappear completely.

Complications when using an IUD are also quite rare; their development is most often associated with the following unfavorable factors::

underestimation of contraindications (use of the IUD by women at risk of developing inflammatory diseases of the pelvic organs, small or deformed uterine cavity, etc.);

the woman’s failure to comply with the doctor’s recommendations;

inexperience of the specialist installing the spiral;

purchasing a low-quality spiral.

The most common complications when using an intrauterine device are pathologies such as (arranged in descending order of frequency of occurrence):

infectious and inflammatory diseases of the pelvic organs;

severe pain syndrome;

spiral rejection;

severe bleeding requiring drug therapy.

Other consequences of using the IUD that are dangerous to a woman’s health are extremely rare. For convenience, all complications associated with the use of IUDs are classified according to the time of occurrence.:

complications related directly to the installation of the spiral;

complications that arise during the use of the spiral;

complications that appear after removal of the coil.

Complications that arise when installing an intrauterine device

Perforation of the uterus

Perforation (perforation) of the uterus is an extremely rare complication and occurs more often in young, non-pregnant and/or nulliparous women, usually when the IUD insertion technique is violated.

Perforation of the uterus can be complete or partial. You can suspect a perforation of the uterus if characteristic symptoms occur: severe pain syndrome occurring against the background of symptoms intra-abdominal bleeding(a fall blood pressure, increased heart rate, pale skin).

In some cases, usually with incomplete perforation of the uterus, the pathology may manifest itself some time after the installation of the coil with severe, unremitting pain in the lower abdomen.

If uterine perforation is suspected, hysteroscopy or ultrasound is prescribed to clarify the diagnosis. In case of incomplete perforation, it is possible to remove the device through the vagina and use conservative therapy.

If there is a complete perforation of the uterine wall, the spiral is removed through abdominal access, and the uterine defect is sutured. In this case, the laparoscopic method is most often used (an optical fiber is inserted through a small hole in the abdominal wall with a video camera that transmits the image to the monitor screen, and the instruments with which the operation is performed).
In extremely severe cases, they resort to amputation of the uterus.

Cervical rupture

Cervical rupture - rare complication, which occurs, as a rule, in nulliparous women when the IUD insertion technique is violated or in case of underestimation of contraindications (cervical stenosis).

Treatment tactics depend on the depth of the rupture (surgical suturing or conservative therapy).

Bleeding that occurred during installation of the IUD

If bleeding develops during installation of the IUD, complications such as uterine perforation or cervical rupture should be excluded. Heavy bleeding is an indication for removal of the IUD; the woman is advised to choose a different method of contraception.

Vasovagal reaction

Not life-threatening, but very unpleasant complication. Occurs most often in nulliparous women with a narrow cervical canal as a heightened reaction vagus nerve on pain and emotional reaction to the procedure. It manifests itself as a sharp pallor of the skin, a drop in blood pressure and a slowing of the heart rate; in severe cases, fainting may develop.

If a vasovagal reaction occurs, it is necessary to pause the insertion of the IUD and reassure the patient. For symptoms of incipient fainting, place on the forehead cold compress, lower the head end and lift the legs up, thus ensuring blood flow to the head.

When fainting, the patient's head is turned to one side to avoid aspiration of stomach contents into the stomach in case of vomiting. Airways. In case of severe pain, analgesics (analgin or ibuprofen) are administered.

Vasovagal reaction does not require drug treatment, but further observation is necessary to exclude the presence of such serious complications as uterine perforation.

To prevent a vasovagal reaction, it is advisable for women at risk to undergo local (paracervical) anesthesia when installing the spiral.

Side effects and complications that may occur when using any type of IUD

Pelvic inflammatory disease (PID)

Infectious and inflammatory diseases of the pelvic organs are one of the most common complications of the use of intrauterine devices and are observed in approximately 4-14% of cases of IUD installation.

As a rule, these complications arise when contraindications to the use of IUDs are underestimated, such as acute and subacute inflammatory processes in the female genital area at the time of installation of the IUD or increased risk development of sexually transmitted diseases due to the presence of several sexual partners.

According to a large-scale study of women with PID that developed due to the use of an intrauterine device, it turned out that in 65% of cases the causative agent of the inflammatory process was sexually transmitted infections, and only in 30% of cases - nonspecific microflora.

PID is dangerous due to severe complications such as: chronic syndrome pelvic pain, ectopic pregnancy (occurs as a result of obstruction of the fallopian tubes), infertility. Therefore, if you suspect the development of infectious and inflammatory processes in the pelvis, you should urgently consult a doctor.

The most common signs of PID are:

nagging pain in the lower abdomen, intensifying during or after menstruation;

fever, nausea, vomiting (in acute process);

dysuria ( frequent urge to urination, pain when urinating);

purulent vaginal discharge with an unpleasant odor.

Therapy for PID consists of prescribing antibacterial drugs taking into account the pathogen that caused the disease.

The development of acute PID is an indication for removal of the IUD, which is carried out against the background of antibiotic therapy.

Expulsion

Expulsion (rejection) of the spiral also refers to relatively frequent complications(5-16% of cases when using copper-containing IUDs and 5-6% of cases when using the Mirena hormonal intrauterine system).

Young people are most susceptible to this complication. nulliparous women. With age, as well as with an increase in the number of pregnancies (including those that ended in abortion), the likelihood of expulsion decreases.

More often this complication develops in the first days or first three months after installation of the spiral. Often, especially in the first days and weeks after installation, expulsion is accompanied by intense cramping pain in the lower abdomen, which is practically not relieved by analgesics and antispasmodics.

In such cases, differential diagnosis is necessary with other complications, such as inflammatory diseases of the pelvic organs, ectopic pregnancy, interrupted physiological pregnancy.

If intense pain that cannot be relieved by analgesics and antispasmodics occurs in the first days after installation of the IUD, then it may indicate incorrect position a spiral, a discrepancy between the IUD and the size of the uterine cavity, or such a serious complication as uterine perforation.

To clarify the causes of pain, ultrasound or hysteroscopy is usually prescribed. In case of IUD expulsion, the woman is advised to choose another method of contraception.

However, the IUD can fall out relatively painlessly, so women using an IUD should regularly (after every period) check for the presence of the IUD tendrils at the cervix.

In cases where the antennae of the spiral cannot be felt, it is necessary to urgently consult a doctor. As a rule, an ultrasound is prescribed to determine the location of the spiral. If the study shows that there is no IUD in the uterus, you should either insert a new IUD or choose another method of contraception.

Sensation of whiskers during intercourse

It is quite rare for a sexual partner to complain about the sensation of antennae during sexual intercourse. At the patient’s request, the doctor can trim the antennae near the cervix; this will not reduce the contraceptive effect of the device, but the woman will lose the opportunity to regularly check the location of the device.

Side effects that occur when using copper-containing IUDs

Prolonged and/or heavy bleeding

According to WHO recommendations, prolonged bleeding can be said when it lasts more than 8 days, and heavy bleeding can be said when it is twice as strong as usual.

Prolonged and/or heavy bleeding when using copper-containing IUDs most often occurs in the first months after installation of the coil. As a rule, they do not require special therapy.

However, with strong and/or heavy bleeding it is necessary to consult a doctor, since it may be a symptom of a pathology, for example, an ectopic pregnancy, uterine perforation or a spontaneously terminated physiological pregnancy.

If more than three to six months have passed since the installation of the IUD, and bleeding continues to be prolonged and/or heavy, so that signs of iron deficiency anemia appear, then it is better to remove the IUD and choose another method of contraception.

If a woman wishes, she can replace the copper-containing IUD. hormonal system, then gestagens entering the uterine cavity will help reduce menstrual blood loss.

Cramping pain in the lower abdomen

Cramping pain in the lower abdomen often bothers women during the first three months after installation of the IUD. This side effect is more common in young, non-pregnant and/or nulliparous women.

If the pain syndrome reaches a high intensity, you should consult a doctor to rule out pathologies such as ectopic pregnancy, spontaneous termination of a physiological pregnancy, IUD rejection, uterine perforation, infectious and inflammatory diseases of the pelvic organs, etc.

However, as shows clinical experience, in most cases, severe pain is an unpleasant side effect of a copper IUD.

If the pain is very severe and/or continues to bother the woman three to four months after the installation of the IUD, then it is better to replace the copper-containing IUD with a hormonal system, or remove the IUD and choose another method of contraception.

Side effects that occur when using a hormonal IUD

Amenorrhea

Amenorrhea is a fairly common side effect of using a hormonal intrauterine system. The absence of menstrual bleeding in such cases is explained by reversible atrophy of the uterine epithelium.

A woman using a hormonal IUD should know that amenorrhea that develops while using the IUD is completely reversible and does not pose a threat to life or reproductive health.

However, immediately after the development of amenorrhea, you should consult a doctor to rule out pregnancy (including ectopic).

Spotting, acyclical menstrual cycle, prolonged and intense bleeding

Spotting or mild bleeding may develop immediately after insertion of the IUD. Typically, these symptoms disappear after a few weeks without treatment.

Acyclicity of the menstrual cycle and the appearance of spotting between menstrual bleeding are quite common side effects hormonal IUD. If such symptoms are observed longer than 3 months after installation of the IUD, it is necessary to exclude gynecological pathology.

Prolonged and intense bleeding during the use of a hormonal IUD is extremely rare, since gestagens entering the uterine cavity help reduce the severity of menstrual bleeding.

In cases where heavy monthly bleeding leads to the development of iron deficiency anemia, it is necessary to remove the IUD and select another type of contraception.

Symptoms of systemic action of gestagens

In the first three months of using a hormonal intrauterine device, symptoms of systemic action of gestagens may appear, such as:

engorgement and tenderness of the mammary glands;