Intrauterine device is harmful to health. Does mirena coil affect weight

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

Navy classification

This type of contraception is used by more than 16% of Russian women in childbirth. reproductive age. To find out how good the intrauterine device is, which one best protects against pregnancy, you need to know which spirals can be purchased on the domestic market. There are several types of intrauterine contraceptives:

non-drug;
medical first generation - "Multiload", "Nova", "Juno Bio";
third-generation medications - Mirena.

The first are made from synthetic materials with the addition. They are various shapes: T-shaped or S-shaped. This ineffective physicians report that they are currently not used due to frequent inflammatory complications after their injections.

The second group is represented by IUDs (intrauterine contraceptives) containing copper, gold, silver. In this case, the presence of one metal or a combination of several is possible: the rod is silver, and the winding is copper. Intrauterine devices with silver and other metals do not corrode, contribute to the prevention 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 progestogen, which is released in microdoses - up to 20 mcg daily. Such spirals are placed 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 a change hormonal balance under the influence permanent allocation progestogens.

Mechanism of action

To decide which intrauterine device is 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 a normal menstrual cycle and in which the introduction of a fertilized egg is impossible.

The IUD causes uterine contractions, prevents the normal growth of the endometrium for egg implantation, promotes peristalsis and negatively affects spermatozoa 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 adverse reactions;

restoration of the ability to fertilize after the removal of the IUD during the first month;
breastfeeding does not suffer (not suitable for IUDs with gestagens);
entered for a long time;
low cost;
there is no need for daily pills and monitoring of use when using oral contraceptives.

Flaws

Among the shortcomings, it should be noted the pulling pains in the lower abdomen, especially in the early days, heavy menstruation, a high risk of developing inflammation, constant monitoring of the antennae, restrictions for young women.

Contraindications

Which intrauterine devices are better: "Multiload", "Juno Bio", "Nova"? Are there contraindications for a certain type of spiral? 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 body of the uterus, bleeding from the vagina of an unclear nature, suspected or existing pregnancy. With these symptoms, the introduction of a spiral is categorically contraindicated.

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

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

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

Examination before the introduction of the spiral

Before using this method of contraception, an individual consultation with your gynecologist is necessary and the necessary minimum examinations must be performed:

clinical blood test;
survey;
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 spiral can be inserted on any day, but most auspicious days 4-7 days of the menstrual cycle are considered. This is due to the fact that at the indicated time, the uterine mucosa was restored after endometrial rejection, ajar, the presence of menstruation is a reliable sign of the absence of pregnancy, and minimal bleeding that occurs after administration does not bring discomfort to the woman. After an induced abortion or self-abortion, the IUD can be inserted immediately or within 4 days in the absence of signs of bleeding and inflammation.

Complications

Complications are possible immediately and after a while after the intrauterine device is installed. What is better in terms of a minimum of unpleasant side effects? Often after the introduction of the spiral, a pain symptom occurs, which can last for an hour. This is reported in the reviews. Most often, discomfort disappears after taking analgesics. If the pain is not relieved by taking analgesics and antispasmodics, then an ultrasound scan or hysteroscopy is necessary to establish the correct insertion of the IUD and diagnose the presence of a spiral in the uterus or outside it (with perforation of the uterus during insertion).

IUD expulsion is most often observed in young nulliparous women due to increased uterine contractility. It occurs mainly in the first days after the introduction. Moreover, the frequency of this complication depends on the type of spiral: copper-containing ones are self-removed in 6-16% of cases, progestogen-containing ones - in 3-6.5%. With age, 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 with the introduction of the IUD of the second group. Moreover, if inflammation occurs in the first 3 weeks, then its occurrence can be associated with the introduction of the IUD; if after 3 months - then this is a newly arisen disease. The formation of a purulent tubovarial formation is the most formidable 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 is stopped by the appointment of hemostatic agents. If bleeding continues, is accompanied by pain, or occurs between periods and is not treatable, then the coil must be removed.

In 0.5-2% of cases, pregnancy is possible. 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, the gynecologist will help decide.

The effectiveness of intrauterine contraceptives

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

The addition of copper and silver made it possible to reduce the frequency of complications by 2-10 times. At the same time, the effectiveness of such IUDs is 93.8%. Inert coils have an efficiency of 91-93%. Currently, copper-containing coils are the most acceptable due to the low rate of complications and the high rate of contraceptive activity.

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

We reviewed the positive and negative effects possessed by the intrauterine device. Which is better to put? This issue should be resolved jointly with the gynecologist. At the same time, the price that the woman expects is determined, and the indications that the doctor reveals after the examination.

Types and features

Currently, there are about 50 variants of the IUD, 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 polymeric materials in the form 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 banned.
The second generation - 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 changed every 2–3 years. More modern IUDs come with an additional silver rod that slows down the release of copper and makes it last longer. The most popular of this series are the intrauterine device Nova T, Multiload Cu-250 and Cu-375, as well as Corre-T.
The third generation is spirals with hormones. The impetus for their creation was the desire to combine the advantages of the IUD and the contraceptive pill. Outwardly, they are a T-shaped structure, the leg of which is filled with the hormone levonorgestrel or progesterone. How does an intrauterine hormonal coil 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 think about using this means of protection have a natural question: hormonal or non-hormonal intrauterine device, which is better?

Only a gynecologist can solve this problem, after examining and receiving test results. Despite the fact that you can buy any IUD at a pharmacy and without a doctor's prescription, you should not make such a purchase on your own.

Advantages

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

Ease of use. The intrauterine device will work, depending on the type, from one year to five years, and you do not have to take daily pills or think about any other methods of contraception.
Can be used immediately after childbirth and during breastfeeding.
Easy reversibility of the method. After removing 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.
Given the long duration of action, even expensive products are more cost-effective to use than any other means to protect 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 spiral protects against sexually transmitted diseases, so this method of protection is more suitable for established, permanent couples.
In the first time after installation, menstruation, as a rule, is more painful and passes more abundantly and takes longer.
Spontaneous loss of the spiral is possible, for example, during active sports or heavy lifting.

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

Application Rules

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

woman increased fertility and unwanted pregnancies happen all too often.
There are diseases in which pregnancy is contraindicated.
The woman or her partner has genetic pathologies in which it is also impossible to become pregnant.

How is the Navy installed?

You can install a spiral 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 menstruation. Before the procedure, smears are taken for microflora, 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 disturbed by discomfort in the lower abdomen, aching or cramping pains, which normally disappear on their own.

A week later, a follow-up examination is mandatory, and during this week it is better for a woman to refrain from:

From intense physical activity.
Hot baths.
Taking laxatives.
Sex life.
Taking aspirin or medicines containing acetylsalicylic acid as it can cause bleeding.

After each menstruation, you will need to independently check the presence of threads from the spiral, and follow-up examinations, in the absence of complaints, will need to take place every six months.

How is the IUD removed?

It is not necessary to wait the entire duration of the spiral. If you wish, you can ask the 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. It is enough for the doctor to simply pull the antennae. However, despite the simplicity of the procedure, it is not worth doing it yourself at home.

AT rare cases, for example, when the antennae of the spiral break or penetrate into 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 spiral, the gynecologist also without fail appoints an ultrasound in order 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. As with 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 often aggravated inflammatory diseases of the female sphere.
Suspicions of malignant tumors cervix or uterus.
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 coil.
Malformations of the cervix or the uterus itself.

The second group of contraindications include:

Abundant, 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.
Myomatous nodes, strongly deforming the uterine cavity.
Ectopic pregnancy in the past.
Allergies to the components that make up the spiral, for example, to polymeric substances or to copper.
Low hemoglobin levels, clotting disorders, or other blood disorders.

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

Side effects

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

Most often it is:

Aching or cramping pain in the lower abdomen, which, according to statistics, occurs in about 5-10% of patients.
More abundant 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 about 0.5-4% of cases.
Spontaneous prolapse of the intrauterine device, which occurs in 6-15% of cases.

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

Also, do not delay the visit in case of a delay in the next menstruation or if other signs of pregnancy appear, for example, 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 was recorded in 98% of cases. modern industry releases various kinds these means of protection against unwanted pregnancy.

The intrauterine device can be of a diverse structure, level of rigidity, and the principle of operation. In each personal case, the doctor prescribes an individual form. Depending on the anatomical features of the patient, the studies performed.

In medical circles, there are discussions regarding the safety, reliability, justification for the use of this tool. The effectiveness of the use of this type of medication depends largely on both the health of the woman and the correctness of determining which IUD spiral is necessary for the patient.

Contraindications for the use of a 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 intrauterine device cannot be prescribed. In addition, she is appointed only in situations where the girl has one permanent and reliable sexual partner. This feature is due to the fact that the methods of contraceptives for women spiral increase the chances of any type of infection of the uterine cavity.

In addition, doctors draw attention to the fact 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, there are very high chances of becoming pregnant unintentionally.

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

Positive properties of the IUD

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

Reliability;
Comfort of use;
Duration of effect (up to 5 years);
Application is shown even at breastfeeding;
Quick recovery period body after extraction.

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

What are the Navy?

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 separately, it is best to look at the IUD spiral intrauterine photo.

Their composition may include hormones, metal alloys, which, together with the main function of protection, can perform a healing function. Most modern models have a T - shaped look (see photo). They have an improved design. In addition, this type of contraceptive is characterized by ease of use.

What an intrauterine device looks like is understandable. But which type is preferable? The impeccable recommendations of many doctors received hormonal types, as well as models with copper content.

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 candles Lady
Contraceptive candles Lady - a chemical contraceptive drug that is convenient and easy to use, and which has virtually no effect on...

It starts earlier than they are ready for motherhood, and even for family life generally. Especially in modern women, the planning of a child is postponed until the full realization of oneself in other areas of life.

Well, if a woman has already become a mother, and maybe more than once, then there are few 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 not getting pregnant without desire. In order to deceive nature, unpretentious methods of contraception were invented (from the Latin word contraceptio - exception). They started with various essential oils, fruit juices, tampons, lotions, broken contact, cloth pouches (precursor to the condom) and so on.

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

vitality and speed of movement of spermatozoa;
egg maturation and ovulation;
attachment of the fetal egg to the endometrium.

Pros and cons of using intrauterine devices

Advantages of the IUD	Disadvantages of the Navy
Convenient to use, the spiral is set for a period of 3 to 10 years or more. No daily procedures required hygiene care and 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 spiral does not take root.
High effective method: pregnancy occurs in only 2 out of 100 cases. Inert spirals give lower efficiency, and when using hormonal intrauterine systems, the risk of getting pregnant 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 only the removal of appendages or ligation of the fallopian tubes gives a 100% result and complete failure from sexual life.
Preservation of childbearing function immediately after removal of the IUD.	From the use of non-hormonal spirals, it is recommended to refrain from young and nulliparous women., 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 getting an orgasm.	An IUD can cause painful and heavy periods. While hormonal spirals, on the contrary, solve the problems of painful periods. But gestogen spirals can lead to the 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 that require application 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, also 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 And so on).	Increases the risk of developing an ectopic pregnancy. Usage hormonal spirals significantly reduce the risk of abnormal pregnancy.
	The procedure for inserting an IUD requires a trip to the gynecologist's appointment, brings discomfort and pain, in nulliparous women pain syndrome especially pronounced, sometimes local anesthesia is required.

Indications for the installation of an intrauterine device

1. temporary or constant prevention unwanted pregnancies, especially if the family already has children. Intrauterine devices are ideal for single-partner women who have given birth, i.e. those who have a very low risk of infection.
2. Frequent unwanted pregnancies, ineffectiveness or inattention of a woman in the use of other contraceptives.
3. Prevention of pregnancy after childbirth, especially caesarean section, after medical abortions or spontaneous miscarriages, when the onset of the next pregnancy is temporarily not desirable.
4. A woman has temporary or permanent contraindications to pregnancy.
5. The presence in the family history of genetic pathologies that a woman does not want to inherit (hemophilia, cystic fibrosis, Down syndrome and many others),
6. For hormonal intrauterine devices - some gynecological pathologies:

, especially if it is accompanied by profuse spotting and uterine bleeding;
heavy painful periods;
estrogen replacement therapy at the onset 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

The presence of pregnancy at any time, suspicion of a 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 coils

if the woman has no children yet;
a woman is sexually promiscuous and belongs to the risk group for contracting sexually transmitted diseases;
childhood and adolescence*;
the woman's age is over 65;
uterine bleeding and heavy painful periods;
anomalies in the development of the uterus (for example, a bicornuate uterus);
hematological diseases (leukemia, thrombocytopenia and others);
growths of the endometrium, endometriosis;
urethritis, cystitis, - acute or exacerbation of a chronic course;
benign tumors of the uterus and appendages (submucosal fibroids and uterine fibroids);
prolapse of the intrauterine device or the development of side effects after the previous use of the device.

* Age restrictions are conditional, gynecologists usually do not offer young nulliparous women the use of intrauterine contraceptives, fearing harm. But, in principle, the spiral can be successfully installed at any childbearing age, followed by a successful pregnancy.

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

cervical dysplasia;
anomalies in the development of the uterus;
urethritis, cystitis, pyelonephritis - acute or exacerbation of a chronic course;
fibromyoma of the uterus;
liver disease, liver failure;
heavy cardiovascular pathologies: malignant arterial hypertension, condition after or, severe heart defects;
migraine;
decompensated (uncontrolled);
lower limbs;
the woman's age is over 65 years.

When can I put a spiral after childbirth, caesarean section, abortion?

The intrauterine device can be placed already on the 3rd day after uncomplicated physiological childbirth. But usually gynecologists recommend waiting until the end of the discharge of lochia (on average 1-2 months). So it will be safer. After childbirth, the uterus recovers, so early insertion of the coil increases the risk of side effects and early rejection of the device. To start using the hormonal intrauterine system, you need to withstand 2 months after the birth of the baby, this is necessary not only for full recovery uterus, but also the normalization of hormonal levels.

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

After a medical termination of pregnancy (up to 12 weeks), it is better to install the IUD within seven days after the start of the next period after the abortion. But the gynecologist may offer to install the spiral immediately after the 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 the complications of the abortion itself increases significantly. After a miscarriage, the decision on the appropriateness and safety of installing a spiral is made only by a doctor, he individually assesses the situation, analyzes the cause of spontaneous abortion, weighs all the pros and cons. If it is necessary to use a spiral after a miscarriage, it is installed in the uterine cavity during the next menstruation.

Is an intrauterine device installed after the age of 40?

An intrauterine device can be used for any woman who is ovulating, has 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 the use of the IUD. According to the instructions, the IUD is not recommended for women over 65 years of age, but this restriction appeared only due to insufficient research on the use of intrauterine devices at an older age.

How is an intrauterine device installed?

The intrauterine device is installed only by a gynecologist in a gynecological office. Before the introduction of the IUD, the doctor assesses the possibility and risk of side effects of using this contraceptive explains to the woman about possible reactions organism to the introduction of one or another type of spiral. Before intrauterine contraceptives are installed, a woman needs to be examined to completely exclude a possible pregnancy and contraindications.

Desirable examination before installing an intrauterine device:

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

Preparing for installation

Usually special training for the introduction of the spiral is not required. If inflammatory diseases are detected, you will first need to undergo a course of appropriate therapy.

Immediately before the procedure, it is necessary to empty the 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 onset of menstruation. Optimal time is 3-4 days. This is necessary in order not to miss the onset of pregnancy.

The intrauterine device can be placed as emergency contraception, that is, if a woman had unprotected intercourse and suggests an unwanted pregnancy. In this case, the device is introduced in the period after ovulation, this can prevent the attachment of the fetal egg in 75% of cases.

Intrauterine device insertion technique

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

In most cases, local anesthesia is not required. Cervical anesthetics can be used in nulliparous women and when placing hormonal intrauterine systems, as they are wider.

Insertion technique for various kinds spirals may vary. The installation features of each spiral are described in detail in the device instructions.
1. A speculum is inserted into the vagina to fix the cervix.
2. The cervix is treated with disinfectants.
3. With the help of special forceps, the cervical canal (the canal in the cervix that connects the vagina with the uterus) is straightened, 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, with lidocaine or novocaine). The introduction of the spiral itself begins after 4-5 minutes, when the anesthetic takes effect.
6. The spiral is introduced using a special conductor with a piston. A ring is set 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 pulls the piston a little towards himself in order to open the shoulders of the spiral. After that, the spiral is moved directly to the wall of the fundus of the uterus. When the gynecologist is satisfied that the device is installed correctly, the guidewire is slowly and gently pulled out. When installing some spirals (for example, annular ones), the opening of the shoulders is not required, so the spiral is inserted to the wall of the uterine fundus, and then the conductor is simply pulled out.
7. The threads of the spiral are cut into the vagina at a distance of 2-3 cm from the cervix.
8. The procedure is over, it usually takes 5-10 minutes.

Does installing an intrauterine device hurt?

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

After insertion of the intrauterine device

Ultrasound photo: Intrauterine device in the uterine cavity.

The uterus completely gets used to the IUD within a few months, so during this period there may be some changes in women's health, you need to listen to your body.
In some cases, a course of antibiotic therapy will be required after the introduction of the spiral, for example, if chlamydia is suspected, if there is another chronic genitourinary system.
Bloody spotting and pulling pains in the lower abdomen or in the back can be disturbing for 1 week after the introduction of the spiral. To relieve spasms, you can take No-shpu.
The hygienic regime is normal, it is necessary to wash with means 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 can not lift weights, engage in intense physical activity, overheat (sauna, bath, hot baths).
It is necessary to periodically probe the threads of the spiral, control their length, it should not change.
After 2 weeks, it is better to visit a gynecologist so that he can see if everything is fine.
Menstruation in the first months after the installation of the spiral can be painful and plentiful. Over time, menstruation normalizes.
When using hormonal intrauterine systems, after six months or several years, the disappearance of menstruation (amenorrhea) is possible. After the first loss of the cycle, pregnancy must be excluded. The menstrual cycle will be restored immediately after the removal of the spiral.
If you have any complaints, you should consult a doctor.
In the future, an 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 inserted correctly or if it does not take root, the intrauterine device may fall out. This must be followed. The most common prolapse of the IUD occurs during menstruation or after heavy physical activity. Therefore, it is important to control whether the spiral threads are in place, to inspect sanitary pads.

How long is the use of an intrauterine device?

The term for which intrauterine contraception is installed differs depending on the type of spiral.

Inert IUDs - 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 spiral is decided by the gynecologist.

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

Intrauterine devices (copper, hormonal): installation, principle of operation, efficiency (Pearl index), expiration date. How to check if the spiral is in place - video

Removal and replacement of the intrauterine device

Indication for IUD removal:

the period of use has expired, while the replacement of the intrauterine device is possible;
a woman is planning a pregnancy;
there were side effects from the use of an intrauterine device.

The removal procedure, as well as the introduction of an intrauterine device, can only be performed by a gynecologist in the condition of a gynecological office. The ideal time to remove the spiral is the first days of menstruation, during this period the cervix is \u200b\u200bsoft, which facilitates manipulation. In principle, the IUD can be removed at any time during the menstrual cycle.

Coil removal often does not require anesthesia, local anesthesia will be required when removing or replacing hormonal coils. The doctor fixes the cervix with a gynecological speculum, and then, using a special tool (forceps), grabs the spiral threads and carefully pulls out the device, while gently stretching the cervix.

Usually this procedure goes without difficulty, the woman experiences less pain than with the introduction of a spiral. But there are situations when the spiral is not so easy to pull out, then the doctor expands the cervical canal and facilitates the removal of the IUD. You can also face the problem of thread breakage, then the doctor inserts a special hook through the cervix, with which he removes the foreign body from the uterine cavity.

But there are situations when the doctor simply does not detect the thread of the spiral. The question arises, is there a spiral in the uterus at all? If yes, where is she? For this, a woman is offered to do an ultrasound of the pelvic organs, if necessary, x-rays. Sometimes there are cases that the spiral is outside the uterine cavity (with perforation of its wall), then a laparoscopic operation is urgently needed to extract foreign body.

Coil replacement intrauterine contraception can be carried out immediately after the removal of the old spiral, 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;
the procedure is best done during menstruation;
removing the coil during or before ovulation increases the risk of pregnancy;
before changing the coil, other methods of contraception (condom, oral contraceptives or spermatocidal preparations) must be used 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 it 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 be intolerant to this method and develop side effects, some of which can have a very negative impact on health and lead to severe pathologies. To reduce the risk of developing these side effects will help the choice of the type of spiral suitable for this woman, a detailed assessment of contraindications to its introduction, 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 match 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 the insertion of the IUD	Often.	Anesthesia local anesthetics cervix; the correct selection of the dimensions of the spiral.
Prolapse of the spiral from the uterine cavity or expulsion	Violation of the IUD installation technique; incorrect selection of the size of the spiral; features of a woman - the immunity of a foreign body.	Often.	Adhere to all the rules of the technique of insertion and selection of the size of the IUD; after expulsion, it is possible to replace the helix with another.
Painful and heavy periods	the first months after the introduction of the IUD with copper - a normal reaction; non-infectious inflammation, as a reaction to a foreign body; allergic reaction on copper; inflammation of the ovaries - adnexitis.	Up to 15%.	Removal of the spiral and replacement of the IUD with another type of contraception; replacement of a copper spiral with a hormonal intrauterine system, in which heavy menstruation does not occur; the appointment of antispasmodics (for example, No-shpy) and non-steroidal anti-inflammatory drugs (ibuprofen, indomethacin, nimesulide, and so on) or antibiotics.
Inflammation of the genital organs (colpitis, endometritis, salpingitis, adnexitis): unusual allocation 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; drawing pains in the lower abdomen and in the lumbar region; violation of the menstrual cycle; fever and general malaise.	The spiral was installed in chronic inflammatory diseases of the genitourinary system; the spiral 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; appointment of anti-inflammatory and antibacterial therapy, according to the results of laboratory diagnostics.
Severe uterine bleeding	Damage (perforation) of the walls of the uterus with a spiral during its installation or operation; the presence of uterine fibroids.	Very rarely	Removal of the spiral as a matter of urgency; urgent health care.
Anemia: pallor skin; changes in the blood test; weakness.	Uterine bleeding; long and heavy periods for more than 6 cycles.	Very rarely.	Individually, it is possible to remove the spiral or replace it with a hormonal IUD; iron preparations (Aktiferrin, Totem and others), and correction.
Fibroids development	Damage to the endometrium during the introduction or operation of the spiral;	Rarely.	Removal of the coil or replacement with a hormonal IUD; taking hormonal contraceptives.
Risk of ectopic pregnancy	The inflammatory process, which the IUD can contribute to, 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 pathological pregnancy.	1:1000	Surgical treatment, removal of the fallopian tube.
Soreness during intercourse, difficulty in achieving orgasm.	Inflammatory process in the genitourinary system; incorrect position and / or size of the spiral 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 coil or replacement with a hormonal IUD.
The onset of pregnancy	The IUD is not 100% effective.	From 2 to 15%.	Individual approach.
Perforation (puncture) of the walls of the uterus: sharp pains in the lower abdomen; uterine bleeding; worsening general condition up to loss of consciousness.	Damage to the walls of the uterus during the introduction, operation and removal of the spiral. *Increase the risk of uterine perforation:* early postpartum period; scar on the uterus after caesarean section; anomalies in the development of the uterus;	Very rarely.	Surgical treatment and emergency medical care.
Ingrown spiral into the wall of the uterus	inflammatory process in the endometrium; use of the spiral beyond the recommended period.	Up to 1%.	Removal of the spiral through the cervix using special tools. Sometimes laparoscopic surgery may be required.
Copper intolerance or Wilson's disease	individual intolerance or copper.	Rarely.	Replacement with another type of contraception or hormonal intrauterine device.

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

absence of menstruation (amenorrhea), after the removal of the spiral, the menstrual cycle is restored;
functional ovarian cysts benign formations), would need hormone therapy estrogen hormones;

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

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

How can a pregnancy proceed with an intrauterine device?

As it has already become clear, intrauterine contraceptives do not protect 100% from pregnancy. Most of these "lucky women" have a normal pregnancy, the child can independently push the spiral out in the second trimester and even be born with it in their hands, for some children it is such a toy. But not everything is always so smooth, and if a woman decides to keep such a pregnancy, she should be ready for various problems.

Basic principles of pregnancy management with a spiral:

1. Difficulties arise from pregnancy, a woman is confident in her contraception. And menstrual irregularities with IUDs are not uncommon, which 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, with the slightest deviations, changes and hints of pregnancy, consult a doctor.
2. At the request of the woman, a medical abortion can be performed.
3. The spiral is not an indication for medical termination of pregnancy. The choice is up to the woman, because in most cases, pregnancy with a spiral proceeds normally and without complications. But still, the doctor must evaluate the possible risks of pregnancy and may recommend terminating it.
4. The IUD may be removed during pregnancy. The copper coil is often not removed as it does not affect fetal development. The hormonal spiral throughout pregnancy will release hormones that can lead to abnormalities in the development of the fetus. The gynecologist can remove the coil if its threads are preserved and it is removed from the uterus easily and without hindrance.
5. Such a pregnancy requires constant surveillance 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 necessary.
Such a pregnancy can end in an early miscarriage, which is associated with the action of the spiral on the endometrium, to which the fetal egg is attached.
The IUD can cause intrauterine infection of the fetus, as well as intrauterine growth retardation and fading of pregnancy.
High risk of fetal malformations during pregnancy with a hormonal spiral.

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

"Which spiral to choose, copper or hormonal?" Here a woman needs to choose between efficiency and possible adverse reactions. The hormonal coil has more possible side effects associated with the progestogen, but they are temporary and stop after a few months. BUT contraceptive effect from the use of such a spiral is much higher. If a woman has fibroids, then the hormonal spiral is a method not only of contraception, but also of treatment. A copper coil with silver and, especially, gold has a higher efficiency than a conventional copper device, and the risk of side effects is lower, this is such a middle ground between a hormonal and a copper coil.

"And how much does an intrauterine device cost?" For many women, the issue of economy is great importance and determines the choice of helix. Copper coils are much cheaper than hormonal systems. Also, spirals with silver and gold have a high cost.

"Which spiral is used longer?" The longest you can use spirals with silver and gold, up to 7-10 years or more. Hormonal spirals are usually used for no more than 5 years.

"Which spiral will not affect the next pregnancy?" Any spiral can lead to problems with future pregnancies, this is an ectopic pregnancy, and infertility due to the inflammatory process. The risk of developing an ectopic pregnancy during the use of the IUD is higher with hormonal coils due to the action of the progestogen. Copper spirals give a greater risk of complications in the form of inflammation of the uterus and appendages. When removing the IUD, ectopic pregnancy often occurs after the use of copper coils.

"Which spiral is painless?" During the installation and removal of the spiral, the woman experiences some pain. But this should not fundamentally affect the choice of the IUD. With the introduction of the hormonal system, 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.

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

Name

Description

Validity

Family planning and the ability to independently choose the time of the appearance of the child became available thanks to a huge number high-efficiency contraceptives. What is a spiral, how does it work, what are its pros and cons, every woman who cares about herself and the health of her children in the future should know.

What is a spiral, what is its algorithm of action

Before making responsible decisions, it is worth understanding what such a method of protection is and how it works. Learn about other methods of contraception in the article.

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

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

The principle of operation of various types of intrauterine devices

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

Her actions are as follows:
1. Changes in the endometrium and the inability to implant a fertilized egg into the walls of the uterus. What is essentially a micro-abortion, therefore moral aspect often prevents women from using this type of contraception.
2. Progesterone-containing coils affect spermatozoa, reduce them motor activity and interfere with cervical movement.
3. Strengthen the peristalsis of the pipes. This increases the rate of passage of the egg and ensures that it enters the uterine cavity without fertilization.
4. Copper-containing coils reduce the activity of spermatozoa and prevent the implantation of the fetal egg.

Rules for installing and removing a spiral

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

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

Next, you should choose the type of spiral and pass some tests:
smear from the cervix and vagina;
colposcopy;
blood test for HIV, RW and Australian antigen (Hepatitis C);
UAC and OAM;
analysis for latent sexual infections;
ultrasound.

If the woman is completely healthy and contraindications are excluded, you can proceed with the installation of the spiral. This procedure is done on an outpatient basis, in 10-15 minutes in the gynecologist's office on the 6-8th day of the cycle. Within a few days, you may feel discomfort in the lower abdomen.

To remove the coil, you should also go to the hospital. There is no need to take tests and pass additional examinations. During a regular appointment, the doctor will apply an anesthetic gel to the cervical area and remove the coil.

Positive and negative sides of the intrauterine device

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

Advantages of the spiral

Easy to use. After installation, a woman can forget about her 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 with certain gynecological diseases (uterine fibroids).
Relieves pain and reduces the duration of menstruation.
Does not have a prolonged effect on the female body. You can plan a child already 2 cycles after its removal

Disadvantages of the intrauterine device

Minor pain during the procedure.
Complications in unplanned pregnancy. If pregnancy occurs, then the risk of its development in the tube increases significantly - an ectopic pregnancy.
Increased risk of inflammatory diseases. It occurs due to the fact that after the installation of the helix, the cervix remains slightly ajar.
Lack of protection against STDs.

Strict contraindications for the introduction of an intrauterine device

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

1. Women who have not given birth are not recommended to install a spiral. They still have a dense cervix and you can injure it. In this case, there are problems with bearing a pregnancy.
2. Non-permanent sexual partner.
3. Inflammatory diseases of the genital organs.
4. Dysplasia and erosion of the cervix. Learn about erosion in the article
5. Tumor and pre-tumor processes.
6. Injuries and stitches on the neck during childbirth.
7. Ectopic pregnancy in history.
8. Various blood diseases.

Possible Complications

When using this method, some rather serious complications may occur:
1. The most severe and life-threatening complication is considered to be perforation of the walls of the uterus. Such a condition that can occur during the installation or removal of the spiral by an inexperienced specialist, which is fraught with the removal of the uterus.
2. Rupture of the cervix. A rare complication that can occur if the doctor missed her condition.
3. Bleeding. Possible immediately or within a few days after installation.
4. Increased risk of pelvic inflammatory disease and appendicitis bacterial infection. It occurs due to the fact that after the installation of the spiral, the cervix remains slightly ajar and bacteria from the vaginal area have access to the uterine cavity.
5. Ingrown 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 with the antennae of the spiral. This condition occurs due to the increased individual sensitivity of a woman.
8. Spiral fall out. Probably due to improper installation or the wrong size.
9. Pain in the lower abdomen.

What to do when pregnancy occurs?

Only tubal ligation provides complete and peremptory protection against pregnancy, so the risk of it, of course, is possible. This situation is described in the topic

It is likely that in such a case the pregnancy will be ectopic and will have to face all the consequences of the treatment of this condition. The topic will tell in detail about this state. The actions of a specialist in such a situation directly depend on the time the problem was discovered. But, with a probability of 80%, there will be a removal of a pipe section, in more than difficult cases the entire tube would have to be amputated.

If, after fertilization, the egg is correctly located in the endometrial layer, the pregnancy can be saved. For its normal development, the intrauterine device is recommended to be removed. 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 a child, because. will be pushed to the wall by growing fetal membranes and will spontaneously come out during childbirth. But the fact of a small opening of the cervix during the period of bearing the baby carries a big risk. Firstly, the risk of infection and inflammation of the amnion increases many times over, which can lead to miscarriage, premature birth and intrauterine death of the child. Secondly, the risk of premature disclosure 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 grown into the cervix. In this case, the contraceptive should be left in place and give the pregnancy a chance for independent full development. This condition increases the risk of miscarriage in the first trimester to 50%, and then the course of pregnancy no longer differs from normal.

Before choosing a method of contraception, you should find out what a spiral is and how this method of protection works. This method might be perfect 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. With their correct installation, taking into account all the existing contraindications, you can forget about scheduling, taking pills on a schedule for many years, forget about running to the bathroom at the most inopportune moment. But, there is a not entirely substantiated opinion about the adverse effects on the body of a woman of intrauterine contraception of this type.

Consequences of the intrauterine device. All for and against

Exactly, 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 features women. The fact that one brings undeniable benefits, without causing absolutely no deviations from the norm, for the other will be harmful. And installing an intrauterine contraceptive can be 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:

Ideal, this method of contraception will be for women who have permanent partners, that is, those who have a constant sex life. Is it harmful to put a spiral in promiscuity? Definitely yes! Such contraception is not able to protect against sexually transmitted diseases, so its use can only be 100% justified if complete confidence purity of relations between partners.

What is dangerous intrauterine device in the presence of acute or chronic form genital diseases? A woman's body gets used to the established foreign object for 3-8 months, and the presence of inflammatory processes significantly complicates the period of adaptation. In addition, all the existing mildly expressed, "sleeping" ailments of the genital organs are actively manifesting themselves. When the first symptoms appear: burning, itching, pain in the lower back, in the lower abdomen, general malaise, chills or high body temperature, you should immediately seek medical advice.

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

Most likely, the fact that the spiral is dangerous for uterine bleeding and malignant neoplasms in the genital area does not need to be confirmed.

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

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

Is the spiral dangerous for a woman? Possible Complications

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

An infrequent, but encountered 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 offers an additional examination after this time period has elapsed.
The very fact of falling out does not affect the well-being of a woman in any way and does not bring harm. The only thing is that it is necessary to notice this incident in a timely manner and take necessary measures- Correctly choose the size of the new model.
The introduction of an intrauterine contraceptive can sometimes cause various complications and uterine bleeding. With such complications, a further verdict - whether the intrauterine device is harmful in a particular case, is set only by the attending physician based on the results of the examination and analysis.
Such fears as a uterine puncture are a practically uncommon complication, but theoretically there is a risk. Timely medical assistance completely eliminates this misunderstanding without further consequences.

Regardless of the ratio of benefits and risks, its main advantages are undeniable.

Exactly, 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. The fact that one brings undeniable benefits, without causing absolutely no deviations from the norm, for the other will be harmful. And installing an intrauterine contraceptive can be a real complication.

Is the spiral harmful? Contraindications:

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

Why is the intrauterine device dangerous in the presence of an acute or chronic form of diseases of the genital organs? A woman's body gets used to the established foreign object for 3-8 months, and the presence of inflammatory processes significantly complicates the period of adaptation. In addition, all the existing mild, “sleeping” ailments of the genital organs are actively manifesting themselves. When the first symptoms appear: burning, itching, pain in the lower back, in the lower abdomen, general malaise, chills or high body temperature, you should immediately seek medical advice.

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

Most likely, the fact that the spiral is dangerous for uterine bleeding and malignant neoplasms in the genital area does not need to be confirmed.

There are also restrictions on the use of contraceptives of this type for women with heart disease, with inflammation of the internal organs, and patients with 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 fears, plus maximum protection against unwanted pregnancy. Therefore, it makes sense to clarify in each case - is the spiral harmful to a woman? A positive decision, with the exception of any complications, will give absolute freedom and independence from circumstances in intimate life.
Is the spiral dangerous for a woman? Possible Complications

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

Infrequently, but a common problem is the loss of the 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 offers an additional examination after this time period has elapsed.
The very fact of falling out does not affect the well-being of a woman in any way and does not bring harm. The only thing you need to notice this incident in a timely manner and take the necessary measures is to choose the right size for the new model.
The introduction of an intrauterine contraceptive can sometimes cause various complications and uterine bleeding. With such complications, a further verdict - whether the intrauterine device is harmful in a particular case, is set only by the attending physician based on the results of the examination and tests.
Fears such as a uterine puncture are an almost uncommon complication, but theoretically there is a risk. Timely medical assistance completely eliminates this misunderstanding without further consequences.

Regardless of the ratio of benefits and risks, its main advantages are undeniable:

Almost 100% efficiency;
Long period of use (2 - 5 years);
Lack of influence on the whole body as a whole;
Does not affect the possibility of becoming pregnant in the future;
No age restrictions;
The installation process is often painless and takes 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, as well as leaving a request on the site. When contacting us, we will provide a discount.

An intrauterine device (IUD) is a contraceptive for women, which is a small plastic device with copper that prevents sperm from moving into the uterine cavity, and also reduces the life 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 inhibit the motor function of spermatozoa.

Intrauterine devices (IUDs) are among the most effective methods 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 spiral is precisely this.

The spiral is introduced into the uterine cavity on the 2nd-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 lifesaver for many women, because not every female body is able to withstand a normal pregnancy.

However, do not think that the intrauterine device is completely safe for a woman's health. There are a few things to keep in mind before installing a coil:
1) The intrauterine device does not save from infectious diseases, sexually transmitted diseases. Especially it is necessary to take into account the fact that the uterine cavity is constantly ajar, and as a result, infections can easily penetrate into it. Even copper or silver wire does not always protect either. Especially harmful is the setting of a spiral for women who have already undergone inflammatory diseases (inflammation of the appendages, vagina and uterus), as well as for those who have chlamydia, mycoplasmas or viruses;
2) Especially the probability 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 prevent the sperm from moving towards the egg. The spiral has rather abortive 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 prevent the uterus from generating new life;
4) The use of the IUD is characterized by pain during menstruation and during intermenstrual discharge. 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 who are going to have children in the future. But if doctors generally forbade a woman to give birth or bear a child, then wearing a spiral is necessary;
6) It is known that the probability of ectopic pregnancy in women with IUDs is almost 4 times greater than in other women. During the survey, it turned out that 28 women out of 100 miscarry when using the IUD, and in 8 cases the zygote dies at the stage of ectopic pregnancy, when it should have been surgical intervention specialists.

You can remove the intrauterine device at any time at the request of the woman. The first 3-4 months after withdrawal, you need to protect yourself with various means of contraception (pills, condoms). After all, the uterus must restore its fertility, which will begin to function normally within a year.

Insertion and removal of the coil should be under the supervision of a physician. There are cases when the IUD is incorrectly located 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 perform a regular examination every six months.
To prevent the ingrowth of the spiral, a woman also needs to undergo an ultrasound.
Finally, in medical practice there were situations when, due to significant physical exertion, the spiral fell out by itself. This can happen both during sports activities and during menstruation.

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

Veronica asks:

What are the side effects and consequences of an intrauterine device?

Complications and side effects of the IUD

Usually intrauterine contraceptives well tolerated, so side effects are rare. In addition, unpleasant symptoms are most pronounced in the first three months of using the spiral, and then most often completely disappear.

Complications when using the IUD are also quite rare, their development is most often associated with the following adverse factors:

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

non-compliance by a woman with the recommendations of a doctor;

inexperience of the specialist installing the spiral;

the acquisition of 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;

coil rejection;

severe bleedingrequiring drug therapy.

Other health-threatening consequences of using a spiral are extremely rare. For convenience, all complications associated with the use of the IUD are classified according to the time of occurrence.:

complications associated directly with the installation of the spiral;

complications arising during the use of the spiral;

complications that appear after the extraction of the spiral.

Complications arising from the installation of 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, as a rule, when the technique of introducing a spiral is violated.

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

In some cases, as a rule, with incomplete perforation of the uterus, the pathology may manifest itself some time after the installation of the spiral with severe persistent 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 extract the spiral through the vagina and conservative therapy.

If there is a complete perforation of the uterine wall, the spiral is removed through the 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 an image to the monitor screen, and the instruments with which the operation is performed).
In extremely severe cases, amputation of the uterus is resorted to.

Rupture of the cervix

Cervical rupture - rare complication, which occurs, as a rule, in nulliparous women in violation of the technique of introducing a spiral or in case of underestimation of contraindications (cervical stenosis).

The tactics of treatment depends on the depth of the gap (surgical suturing or conservative therapy).

Bleeding during coil insertion

In the event of bleeding during the installation of the spiral, the presence of complications such as perforation of the uterus or rupture of the cervix should be excluded. Severe bleeding is an indication for the removal of the coil, the woman is advised to choose another method of contraception.

Vasovagal reaction

Not life-threatening, but very unpleasant complication. Occurs most often in nulliparous women with narrow cervical canal like an overreaction vagus nerve pain and emotional reaction to the procedure. It is manifested by a sharp blanching 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, the insertion of the coil should be suspended and the patient should be reassured. With symptoms of an incipient fainting, put 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 so that in case of vomiting, aspiration of the contents of the stomach into Airways. With a strong pain syndrome, analgesics are administered (analgin or ibuprofen).

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 perform local (paracervical) anesthesia when installing a spiral.

Side effects and complications that may occur during the use of any type of helix

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 insertion.

As a rule, these complications arise when contraindications to the use of the IUD are not taken into account, such as acute and subacute inflammatory processes in the female genital area at the time of the installation of the helix 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 against the background of 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 with severe complications, such as: chronic syndrome pelvic pain, ectopic pregnancy (occurs as a result of impaired patency of the fallopian tubes), infertility. Therefore, if you suspect the development of infectious and inflammatory processes in the pelvis, you must urgently consult a doctor.

The most common symptoms of PID are:

pulling pains in the lower abdomen, aggravated during or after menstruation;

fever, nausea, vomiting (with an acute process);

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

purulent discharge from the vagina with an unpleasant odor.

The treatment for PID is to prescribe antibacterial drugs according to the pathogen that caused the disease.

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

Expulsion

The expulsion (rejection) of the helix also refers to relatively frequent complications(5-16% of cases when using a copper-containing IUD 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 abortions), the likelihood of expulsion decreases.

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

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

If an intense pain syndrome that is not relieved by analgesics and antispasmodics occurs in the first days after the installation of the spiral, then it may indicate wrong position spirals, inconsistency of the IUD with the size of the uterine cavity, or such a formidable complication as uterine perforation.

To clarify the causes of the pain syndrome, as a rule, an ultrasound or hysteroscopy is prescribed. In case of expulsion of the spiral, the woman is advised to choose another method of contraception.

However, the prolapse of the spiral can occur relatively painlessly, so women using the IUD should regularly (after every menstruation) check for the presence of spiral tendrils near the cervix.

In cases where the antennae of the spiral are not palpable, it is urgent to consult a doctor. As a rule, an ultrasound is prescribed to determine the location of the spiral. If the study shows the absence of a spiral in the uterus, you should either put a new spiral or choose another method of contraception.

Sensation of tendrils during intercourse

Rarely enough, there are cases when a sexual partner complains about the feeling of the antennae during intercourse. At the request of the patient, the doctor can cut the antennae at the cervix, the contraceptive effect of the spiral will not decrease, but the woman will lose the opportunity to regularly check the location of the spiral.

Side effects that occur when using a copper-containing IUD

Prolonged and/or heavy bleeding

According to the WHO recommendations, one can speak of prolonged bleeding when it lasts more than 8 days, and heavy bleeding when it is twice as strong as usual.

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

However, with strong and/or profuse bleeding it is necessary to consult a doctor, as it can be a symptom of a pathology, for example, an ectopic pregnancy, uterine perforation, or a spontaneously interrupted physiological pregnancy.

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

At the request of a woman, a copper-containing IUD can be replaced hormonal system, then the gestagens entering the uterine cavity will help reduce menstrual blood loss.

Cramping pains in the lower abdomen

Cramping pains in the lower abdomen often bother women during the first three months after the installation of the spiral. 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 such pathologies as ectopic pregnancy, spontaneous abortion of physiological pregnancy, IUD rejection, uterine perforation, infectious and inflammatory diseases of the pelvic organs, etc.

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

If the pain is very strong and / or continues to bother the woman three to four months after the installation of the spiral, then it is better to replace the copper-containing IUD with a hormonal system, or remove the spiral 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 be aware that the amenorrhea that develops while using the IUD is completely reversible and does not pose a threat to life and reproductive health.

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

Spotting spotting, acyclicity of the menstrual cycle, prolonged and intense bleeding

Smearing spotting or light bleeding may develop immediately after the coil is placed. As a rule, such 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 the installation of the spiral, it is necessary to exclude gynecological pathology.

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

In cases where heavy menstrual bleeding leads to the development of iron deficiency anemia, it is necessary to remove the IUD and choose 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 progestogens may appear, such as:

engorgement and soreness of the mammary glands;