More than 60 million women in the world use the intrauterine contraceptive as a means of contraception. Which intrauterine devices are better, for how long are they installed, is this procedure painful? These questions are of interest to many women.
Navy classification
This type of contraception is used by more than 16% of Russian women of 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 IUDs:
- non-drug;
- medical first generation - "Multiload", "Nova", "Juno Bio";
- drug third generation - Mirena.
The first are made of synthetic materials with the addition of barium sulfate. They come in various shapes: T-shaped or S-shaped. These are ineffective intrauterine devices. Reviews of doctors reportthat they are not currently 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, help prevent various inflammations of the 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 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 coils are suitable for women with religious prejudices, since fertilization does not occur due to changes in hormonal balance under the influence of constant release of progestogens.
Mechanism of action
To decide which IUDs are best, you need to know how they work. This method of contraception leads to the fact that a specific inflammation develops as a reaction to a foreign body: leukocyteendometrial infiltration, morphological and functional changes that are not typical of the 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 of the fallopian tubes, and negatively affects spermatozoa with copper, gold and silver ions.
One should not consider every theory of contraceptive action as prevailing, the mechanism of action consists of several components.
Benefits
To find out which intrauterine device is the best, you need to familiarize yourself with the benefits of all types of IUDs:
- efficiency up to 98%;
- easy to use;
- minimum adverse reactions;
- recovery of fertility after removal of the IUD during the first month;
- does not suffer from breastfeeding (not suitable for IUDs with gestagens);
- introduced for a long time;
- low cost;
- no need for daily pills and monitoring of use when using oral contraceptives.
Flaws
Among the shortcomings should be noted pulling pains in the lower abdomen, especially in the early days, heavy menstruation, high risk of inflammation, constant control of the antennae, restrictions for young women.
Contraindications
Which IUDs 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.
Absolute contraindications include an acute inflammatory process, oncological neoplasms of the cervix and body of the uterus, bleeding from the vagina of an unclear nature, a suspected or existing pregnancy. With these symptoms, the introduction of a spiral is strictly contraindicated.
Relative contraindications are 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. This is:
• exacerbation of chronic diseases and six months after treatment;
• sexually transmitted diseases;
• cervicitis, vaginitis;
• heavy menstruation, intermenstrual bleeding;
• endometrial hyperplasia or polyps;
• uterine fibroids with submucous nodes;
• some forms of endometriosis;
• malformations of the uterus: underdevelopment, 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 abortion within the last three months;
• if there are many sexual partners;
• somatic diseases: chronicinflammation, 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 disturbed;• treatment with immunosuppressants.
In each case, after finding out all the adverse factors and a 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 insertion of the coil
Before using this method of contraception, an individual consultation with your gynecologist and the necessary minimum examinations are required:
- CBC;
- examination of kidney function;
- examination for syphilis, hepatitis B and C, HIV carriage;
- extended colposcopy;
- Ultrasound of the uterus and appendages.
IUD insertion time
According to WHO experts, the spiral can be inserted on any day, but the most favorable days are 4-7 days of the menstrual cycle. This is due to the fact that at the indicated time, the uterine mucosa is restored after endometrial rejection, the cervical canal is ajar, the presence of menstruation is a reliable sign of the absence of pregnancy, and minimal bleeding that occurs after injection does not bring discomfort to the woman.
After induced abortion or self-abortionAn IUD can be inserted immediately or within 4 days if there is no evidence of bleeding or inflammation.
After childbirth (within 48 hours), it is not recommended to immediately insert the IUD, since there is a high probability of expulsion of the helix. The best time is 6 weeks postpartum.
Complications
Complications are possible immediately and after a while after the intrauterine device is installed. Which one 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 or hysteroscopy is necessary to establish the correct insertion of the IUD and to 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 arisendisease. The formation of a purulent tubovarial formation is the most formidable inflammatory complication. It occurs with prolonged use of the spiral - more than 6-7 years.
Bleeding 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 amenable to treatment, 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.
Effectiveness of intrauterine contraceptives
Many varieties 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 incidence 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%. Copper-containing coils are currently the most accepted due to their low complication rate and high contraceptive activity.
Hormonal releasing system "Mirena" is the most effective contraceptive and is considered almost biologicalsterilization, as 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 examined the positive and negative effects that the intrauterine device has. Which is better to put? This issue should be resolved jointly with the gynecologist. This determines the price that the woman expects, and the indications that the doctor reveals after the examination.
