The intrauterine device is the most common and reliable contraceptive method. Therefore, women often go to the doctor about the installation of this device. The spiral, like any other method of contraception, has its own contraindications and features, so there are many questions in this area. This article will provide information that every woman is recommended to read.
What is an intrauterine device
An intrauterine device is a device that is made of medical plastic (synthetic material). The introduction of this contraceptive into the uterine cavity prevents the development of an unwanted pregnancy. Currently, the spirals are small in size, which vary from 24 to 35 mm, in addition to plastic, the device includes metals (gold, silver, copper), notprovoking inflammatory reactions. It may also contain the hormone levonorgestrel.
The development of the spiral began at the beginning of the last century, then Richter suggested using silk and bronze threads as a contraceptive. However, his adaptation did not resonate with women and was not popular. A little later, Grafenburg continued to modernize the intrauterine device, and proposed a ring made of silk threads and silver wire. However, in this case, the invention was doomed to failure. It had a significant drawback - falling out.
In the middle of the last century, Lippes made a serpentine-shaped spiral, which became known as the Lippes loop. Despite the fact that the invention is more of a zigzag shape, it is a prototype of the modern intrauterine device.
Mechanism of action
The introduction of an intrauterine device does not suppress ovulation and does not affect the synthesis of sex hormones. The effect of contraception is achieved as follows:
- Decreased activity and viability of spermatozoa.
- Cervical mucus thickens, making it difficult for sperm to enter the uterine cavity.
- As a result of the provocation of contractions of the muscle layer, the spiral increases the intensity of peristalsis of the fallopian tubes. This leads to the fact that the egg is in the uterine cavity before implantation is possible.
- The introduction of the IUD causes changes in the lining of the body of the uterus. The so-called aseptic inflammation begins, which slightly injures the walls of the reproductive organ, which means conditionsfor egg attachment deteriorate.
This mechanism of action is observed with the introduction of an intrauterine device of any kind, the composition and form does not matter.
Types of spirals
There is no universal spiral that would suit any woman, so the doctor chooses the type of contraceptive, starting from the physiology of the patient and the structural features of the reproductive organ.
Now there are more than 50 types of spirals, which are divided into several generations:
- Inert. This is the first generation of coils that is considered obsolete. Their effectiveness is low, they can fall out and move.
- Copper. This is the second generation of spirals. This type of contraception is a T-shaped device that is wrapped around with copper wire. Copper creates an acidic environment in the uterine cavity, due to which the activity of spermatozoa decreases. The term of use of the spiral is 3-5 years.
- Silver. All metals have the ability to oxidize and break down, so experts began to insert silver into the spiral. As a result, sperm activity is further reduced, and silver ions have an antibacterial and disinfecting effect. This spiral can be used up to 7 years.
- Gold. The advantage of such a spiral is its complete biocompatibility with the female body. The metal is not subject to corrosion and does not cause allergic reactions. In addition, gold has an anti-inflammatory effect, which means that such a spiral remains effective for up to 10 years.
- Hormonal. This is the latest generation of spirals, which are the mostan effective means of contraception. The hormonal drug is evenly released into the uterine cavity in small doses, but it does not enter the bloodstream, exerting only a local effect. You can use such a spiral up to 7 years.
As for the shape of the spirals, they can be as follows:
- T-shaped. This is the most common type and is easy to install and remove.
- Annular. These coils are recommended for post-abortion women.
- Loop-shaped. They are installed for women with a non-standard structure of the uterus.
Overview of the most popular species
When a woman decides to put a spiral, she has a question about which one to use is best. As already mentioned, this issue must be approached individually and only a competent specialist can make the right choice. Most often, doctors install the following types of spirals:
- "Multiload" - T-shaped copper coil, non-hormonal. Shelf life - 4 years. Standard length 35 mm.
- "Copper" is also a copper spiral, but its peculiarity is that it releases more copper into the uterine cavity, therefore, the local reaction will be stronger.
- "Goldlily" - this spiral has gold in its composition, in addition, it is represented by a ruler of sizes, so every woman can choose the one she needs. The term of use is 7 years.
- "Junona Bio-T" - a spiral with silver. Term of use 7 years.
- "Nova-spiral", which contains both copper and silver. Hershould be replaced every 5 years.
- Mirena is a hormonal coil. It is allowed to use 5 years, then the supply of levonorgestrel is exhausted and there is a risk of developing infectious diseases.
Introduction Toolkit
The registration certificate of the intrauterine device insertion kit is the document according to which the product is allowed to be placed on the market. Its presence means that the product is of high quality and safe.
Intrauterine device insertion kit must be sterile. All devices are sterilized in a dry oven or boiled, according to existing rules.
The IUD set should be washed in soapy water and then immersed for 3 days in a 2% chloramine solution. Just before the insertion of the coil, it is immersed in 96% ethyl alcohol for 2 hours.
Every woman should understand that it is important not only to install the IUD correctly, but also to use a high-quality and safe IUD kit. The registration certificate, if the woman wishes, must be provided to her by a he alth worker.
Preparation for the introduction of the spiral
No special training required. Only, before the procedure for introducing an intrauterine device, a woman takes a smear for the presence of infectious and inflammatory diseases. If they are found, it is necessary to undergo a course of treatment.
Setting the spiralIt is carried out during menstruation, 3-4 days are considered optimal. A week before the installation of the spiral, it is recommended to refrain from sexual intercourse. Immediately before the procedure, the woman must empty her bladder.
Spiral introduction
The patient is placed in the gynecological chair, and the doctor disinfects the vagina and cervix. Then local anesthesia is done. After that, the specialist takes a set for the introduction of an intrauterine device, opens the cervix and installs the device in the uterine cavity. The doctor brings the tendrils of the spiral to the outer side of the reproductive organ, in order to then remove the device.
The whole procedure takes 10 minutes. Does it hurt to put a spiral? In some cases, the patient may feel discomfort, which disappears very soon, but in principle, the installation of the spiral is a painless procedure.
Feelings after the procedure
After installing a non-hormonal spiral, more abundant and prolonged periods are possible, as well as spotting before menstruation or in between cycles.
To reduce possible complications, a woman should adhere to the following rules during the week:
- avoid sexual contact;
- avoid strenuous exercise;
- stop using tampons.
A scheduled check-up is scheduled after 10 days, during which an ultrasound can be used to check the locationcontraceptive.
When can I install a coil after childbirth or abortion?
After uncomplicated delivery, the intrauterine device can be placed on the third day. But most often, gynecologists advise doing this after a month or two, in order to prevent unwanted side effects and rejection of the spiral.
After a caesarean section, the spiral is allowed to be installed no earlier than 3-6 months later. It is necessary that the postoperative scar is fully formed.
After an abortion, the coil is installed in a week, however, in some cases, the doctor may recommend its installation immediately after the abortion.
After a miscarriage, only a doctor can say about the possible timing of the installation of the spiral. Since it is necessary to assess the situation in this case on an individual basis.
Pros and cons
Benefits of the intrauterine device:
- Effective contraception, but I must say that the spiral does not provide absolute protection against unwanted pregnancy. Its efficiency is 99%.
- Possibility of use by women who are contraindicated in hormonal contraceptives.
- Ease of use - no need for constant monitoring. It is enough to visit a gynecologist twice a year.
- Long service life.
As for the cons, we can say about side effects, changes in the nature of the menstrual cycle, inflammatory diseases, trauma to the vagina and reproductive organ.
Contraindications and complications
Contraindications for the installation of a spiral can be absolute and relative.
Absolute:
- pregnancy;
- pelvic inflammatory disease;
- oncology of the uterus or its cervix;
- presence of a patient's history of ectopic pregnancy.
Relative:
- bleeding;
- endometrial hyperplasia;
- womb deformity;
- blood diseases;
- submucosal fibroids;
- intolerance to the components of the spiral;
- lack of childbirth.
In terms of side effects and complications, the following may occur after insertion of an intrauterine device:
- Pain in the lower abdomen. They are observed in 4-10% of cases. Allocations after the introduction of the intrauterine device are a sign of the expulsion of the device from the uterine cavity. Persistent pain may be a symptom of uterine perforation, which requires an immediate visit to the doctor.
- Infections. They occur in 5%, are difficult for the patient, often complicated by the destruction of the tissues of the reproductive organ and appendages. Broad-spectrum antibiotics are prescribed for prevention.
- Bleeding. In 24%, abundant menstruation is observed, intermenstrual blood loss is less likely. To prevent this complication, a woman is prescribed a two-month intake of oral contraceptives after the installation of the spiral.
What to do if there is discharge and pain
If pain after installing the spiralstrong and appeared suddenly, we can assume perforation of the uterus. In this case, surgical intervention is necessary.
If pain occurs after a few it after the installation of the spiral, or periodically occurs after sexual intercourse, it is necessary to exclude the displacement of the device. A woman can check the length of the antennae herself. If they become longer or disappear, you should see a doctor.
As for the discharge, in the first few days after the procedure, they are allowed and do not require the intervention of a doctor. But with heavy discharge or incessant periods, a consultation with a doctor is required.
A visit to the doctor is inevitable if there is a purulent discharge, especially if they are accompanied by pain - these are signs of an inflammatory process.
Remove device
Spiral removal is carried out in the following cases:
- expired;
- woman's desire;
- displacement or loss of the spiral;
- pregnancy;
- menopause;
- medical indications.
If the woman did not have any complications while wearing the spiral, the doctor removes the spiral quickly and painlessly. But at the moment of removal, the threads may break, then the spiral will be removed using a special hook.
When a spiral grows into the walls of the uterus, it is simply impossible to remove the spiral, diagnostic curettage or the help of a hysteroscope will be required. The spiral can grow into the walls of the reproductive organ if the terms of operation are missed, and the woman does not come to remove the spiral.
