Protection from unwanted pregnancy, or contraception, helps a woman to maintain her health:
- reduces the frequency of abortions,
- helps plan a pregnancy and prepare for it,
- in many cases it has an additional therapeutic effect.
One type of contraception is intrauterine. It is used most often in China, the Russian Federation and in Scandinavia. In everyday speech, the term "intrauterine device" is often used.
Advantages of intrauterine contraception:
- relatively low cost
- long term use,
- quick recovery of fertility after removing the helix,
- possibility of use during breastfeeding and with concomitant diseases,
- therapeutic effect on the endometrium (when using the hormonal intrauterine system),
- preservation of the physiology of sexual intercourse, lack of preparation, the fullness of sensations during intimacy.
Types of intrauterine devices
Means for intrauterine contraception are of two types:
Inert intrauterine contraceptives (IUDs) are plastic products of various shapes that are inserted into the uterine cavity. It is not recommended to use them since 1989, when the World Health Organization declared their ineffectiveness and danger to the woman’s health.
Currently, only spirals containing metals (copper, silver) or hormones are used. They have a plastic base of different shapes, close to the shape of the inner space of the uterus. Adding metals or hormones can increase the effectiveness of the coils and reduce the number of side effects.
In Russia, the following VCCs gained the greatest popularity:
- Multiload Cu 375 - has the shape of the letter F, covered with a copper winding with an area of 375 mm 2, designed for 5 years,
- Nova-T - in the form of the letter T, has a copper winding with an area of 200 mm 2, designed for 5 years,
- Cooper T 380 A - copper T-shaped, serves up to 8 years,
- hormonal intrauterine system "Mirena" - contains levonorgestrel, which is gradually released into the uterus, providing a therapeutic effect, designed for 5 years.
Less commonly used are IUDs that produce medroxyprogesterone or norethisterone.
Which intrauterine device is better?
This question can only be answered after an individual consultation, taking into account the age of the woman, her health, smoking, the presence of gynecological diseases, future planning of pregnancy and other factors.
Mechanism of action
The principle of action of the intrauterine device is the destruction of spermatozoa and the violation of the process of attachment of the embryo in the uterus. Copper, which is part of many IUDs, has a spermatotoxic effect, that is, it kills spermatozoa that have entered the uterus. In addition, it enhances the capture and processing of sperm cells by special cells - macrophages.
If fertilization does occur, the abortive effect of the contraceptive begins, preventing the implantation of the fertilized egg:
- contractions of the fallopian tube increase, and the fertilized egg too quickly enters the uterus and dies,
- the presence of a foreign body in the uterus leads to aseptic (non-infectious) inflammation and metabolic disorders,
- as a result of the production of prostaglandins in response to a foreign body, the contractility of the walls of the uterus is activated,
- when using the endometrial system of hormonal endometrial atrophy occurs.
The Mirena intrauterine system from a special reservoir constantly releases the hormone levonorgestrel at a dose of 20 micrograms per day. This substance has a gestagenic effect, suppresses the regular proliferation of endometrial cells and causes its atrophy. As a result, menstruation becomes scarce or disappears altogether. Ovulation while not broken, hormones are not changed.
Is it possible to get pregnant if the intrauterine device is worth? The effectiveness of intrauterine contraception reaches 98%. When using copper-containing products, pregnancy in a year occurs in 1-2 women out of a hundred. The effectiveness of the Mirena system is several times higher; only 2-5 out of a thousand women become pregnant for a year.
How to put the intrauterine device
Before you enter the IUD, you need to make sure that there is no pregnancy. The procedure can be carried out regardless of the phase of the menstrual cycle, but it is best for 4-8 day of the cycle (counting from the first day of menstruation). Be sure to analyze smears on the microflora and the degree of purity, as well as ultrasound to determine the size of the uterus.
The procedure takes place on an outpatient basis without anesthesia. This is practically painless manipulation. In the first days after the introduction of the spiral, aching pains in the lower abdomen, caused by contractions of the uterus, can disturb. The first and 2-3 subsequent menstruation can be abundant. At this time, spontaneous expulsion of the spiral is not excluded.
After an artificial abortion, the helix is usually set immediately after the manipulation, after birth - after 2-3 months.
Introduction of IUD after cesarean section is carried out six months later to reduce the risk of infectious complications. Spirals can be used during breastfeeding, which is their biggest advantage.
After the introduction of the IUD during the week the woman is prohibited:
- intense exercise
- hot tubs
- taking laxatives
- sex life.
The next examination is scheduled for 7-10 days, and then, in the absence of complications, after 3 months. A woman should independently after each menstruation check the presence of threads of the IUD in the vagina. Examination by a gynecologist is sufficient to take place once every six months, if there are no complaints.
Removal of the intrauterine device
Removal of the IUD is carried out as desired, with the development of some complications or after the expiration of the period of use. In the latter case, you can enter a new contraceptive immediately after removing the previous one. To extract the IUD, first conduct an ultrasound and specify the location of the spiral. Then, under the control of a hysteroscope, the cervical canal is dilated and the helix is removed, sipping the antennae. If the "antennae" break, the procedure is repeated in the hospital. If the intrauterine device enters the wall of the uterus and does not cause complaints, it is not recommended to remove it unnecessarily, as this can lead to complications.
Complications of intrauterine contraception
Side effects from the intrauterine device:
- lower abdominal pain
- genital infection,
- uterine bleeding.
These symptoms do not develop in all patients and are related to complications.
Lower abdominal pain
Occur in 5-9% of patients. Cramping pains, accompanied by bloody discharge, are a sign of spontaneous expulsion of the IUD from the uterus. To prevent this complication in the period after the administration, nonsteroidal anti-inflammatory drugs are prescribed.
Persistent intense pain occurs if the contraceptive does not fit the uterus in size. In this case, it is replaced.
Sudden sharp pains can be a sign of uterine perforation with the penetration of a part of the helix into the abdominal cavity. The frequency of this complication is 0.5%. Incomplete perforation often goes unnoticed and is diagnosed after unsuccessful attempts to remove the IUD. With full perforation, an emergency laparoscopy or laparotomy is performed.
The frequency of infectious and inflammatory complications (endometritis and others) is from 0.5 to 4%. They are hard to carry, accompanied by severe pain in the lower abdomen, fever, purulent discharge from the genital tract. Such processes are complicated by the destruction of uterine tissue and appendages. For their prevention within a few days after administration of the IUD, broad-spectrum antibiotics are prescribed.
uterine bleeding develops in 24% of cases. Most often it is manifested by abundant menstruation (menorrhagia), less often - intermenstrual blood loss (metrorrhagia). Bleeding leads to the development of chronic iron deficiency anemia, manifested by pallor, weakness, shortness of breath, brittle hair and nails, dystrophic changes in the internal organs. For the prevention of bleeding two months before the installation of the spiral and for 2 months after that it is recommended to take combined oral contraceptives. If menorrhagia causes anemia, the IUD is removed.
Onset of pregnancy
VMC reduces the likelihood of pregnancy. However, if it does occur, the risk of ectopic pregnancy is higher than among other women.
If during the period of use of the spiral comes pregnancy, there are three options for the development of events:
- Artificial interruption, because such a pregnancy increases the risk of infection of the embryo and in half of the cases ends in a spontaneous abortion.
- Removal of the IUD, which can lead to spontaneous abortion.
- The preservation of pregnancy, while the spiral does not harm the child and is released together with the fetal membranes during childbirth. This increases the risk of pregnancy complications.
The ability to conceive and bear a child is restored immediately after the removal of intrauterine contraception, pregnancy occurs within a year in 90% of women who have not used other methods of contraception.
Indications for use
This type of contraception in birthless children can cause serious complications that prevent future pregnancies. Intrauterine device for non-giving women can be used only if it is impossible or unwilling to use other methods. For such patients, mini-coils with a copper content, for example, Flower Cuproom, are intended.
It does not make sense to establish an IUD for a short time, so a woman should not plan a pregnancy for the next year or a longer period.
VMC does not protect against sexually transmitted diseases. It is believed that, by contrast, they increase the risk of developing and worsen the course of such diseases.
Most often VMCs are used in the following situations:
- increased fertility, frequent pregnancies on the background of an active sex life,
- temporary or permanent reluctance to have children
- extragenital diseases in which pregnancy is contraindicated,
- the presence of severe genetic diseases in a woman or her partner.
Contraindications for intrauterine device
- endometritis, adnexitis, colpitis and other inflammatory diseases of the pelvic organs, especially acute or chronic with constant exacerbations,
- cervical or uterine cancer,
- previously transferred ectopic pregnancy.
- uterine bleeding, including heavy menstruation,
- endometrial hyperplasia,
- painful menstruation,
- congenital or acquired uterine deformity,
- blood diseases
- submucous uterine myoma,
- severe inflammatory diseases of internal organs,
- the spontaneous expulsion (expulsion) of the IUD, which happened earlier
- intolerance to the components of the helix (copper, levonorgestrel),
- lack of childbirth.
In these situations, the appointment of an intrauterine hormonal system is often justified. Its use is indicated for uterine myoma, endometrial pathology, heavy bleeding, painful menstruation. Therefore, the gynecologist will be able to choose the right intrauterine device after examining and examining the patient.
What gives the installation of the Navy
The diversity of the Navy allows you to make an individual choice.
Navy made of different materials, have a different shape, but the essence of their use is the same: to prevent the occurrence of unwanted pregnancy.
Operating principle It is based on the obstacle to the fixation of a fertilized ovum, in addition to this there are a number of intrauterine devices that contain a hormonal drug that can change the hormones of a woman.
Under the action of the hormone, the thickness and functional ability of the endometrium is reduced, the viscosity of the cervical mucus increases, which is a protective barrier against spermatozoa.
In some cases, after removing the spiral from the uterus, the fertile function is restored fairly quickly, so this method of contraception does not lose its popularity and remains the safest way to preserve the reproductive health of the woman.
Intrauterine device is installed for a period of 3 to 5 years, then it is necessary to take a break to prevent irreversible consequences. The service life of an IUD depends on the consumable material from which it is made, the supplier and many other things. Monthly immediately after removal of the IUD with the hormonal component should be restored within 12 months.
Of course, a woman is worried about the question: “How effective are intrauterine devices?”
The effectiveness of the mechanism of action of the IUD is close to 100%, and it should be noted that this is a fairly high figure, because using a method of contraception condoms gives 88% of the effectiveness, and when taking oral contraceptives 97%.
Unborn womenBecause of the likelihood of secondary infertility, it is better to choose a different method of contraception.
Side effects of IUD after installation
• Irregularity of the menstrual cycle.
• Increased vaginal discharge, possibly with an unpleasant odor.
• The appearance of intermenstrual bloody discharge. After the introduction of the IUD, there may be discharge, similar to the monthly.
• Pain in the lower abdomen.
• Increased risk of developing ectopic pregnancy.
• The risk of infertility, as after selecting the method of contraception IUD, in some cases, it is difficult to get pregnant.
Pregnancy after removal of the IUD occurs, as a rule, within a year, but some women become pregnant in a 1-2 menstruation cycle immediately after the helix is removed, 30% of women become pregnant after 3 months.
Doctors usually recommend waiting for 3-4 months to restore the endometrium, otherwise the miscarriage could be the outcome of an “early” pregnancy after the helix is removed.
Sex after the introduction or removal of the IUD is possible after 10 days, if there are no inflammatory effects.
With a low qualification of the gynecologist and an improperly selected IUD, the development of infectious complications of the pelvic organs, perforation (through wound of the uterus wall), loss of the IUD is spontaneous.
What to look for before installing
Despite the fact that the IUD is a reliable way to protect against unwanted pregnancy, the spiral does not affect the ability to become infected with a sexually transmitted infection.
This means that in case of casual sexual intercourse it is necessary to use condoms to avoid sexually transmitted diseases, because by itself, the Navy does not make sex safe.
Any independent manipulations with a spiral are inadmissible.
After birth, the IUD is better to install after the resumption of the normal menstrual cycle, 2-5 days after the appearance of blood discharge.
The procedure of introducing the intrauterine device is practically painless, after insertion of the IUD, slight pulling pains in the lower abdomen and bloody bloody discharge from the vagina are allowed.
After the introduction of the intrauterine device for the prevention of the development of infectious diseases, it is necessary to carry out anti-inflammatory treatment. A short course justified the reception of a broad-spectrum antibacterial drug, for example, from the group of levofloxacins.
Minor nagging pain in the lower abdomen after the introduction of the IUD (as during menstruation) will allow to stop a nonsteroidal anti-inflammatory agent - Diklovit candles. The course of treatment is 5 days transrectal.
The installation of the IUD is an intervention in the nature of a woman, which means that vaginal dysbiosis can join, so an antifungal drug is added to preventive therapy, for example, 150 mg of Flucostat once.
What is the reason for treatment to the gynecologist
A woman should be attentive to her health and at the first unfavorable signs consult with a doctor.
What should be alerted:
• Increased temperature reaction, lower abdominal pain.
• Blood smears after insertion of an IUD.
• Vaginal discharge other than normal properties.
• Delayed onset of menstruation for more than 2–3 weeks.
In addition, it is necessary to control the length of the filaments in the vagina, they should always be at about the same level, if you notice otherwise - this may mean that the contraceptive has migrated deep into the uterus, which is a good reason for a gynecologist to examine.
If, after installing the IUD, a stomach ache or abundant bleeding, nausea, spilled pain in the pelvic area, then consult a doctor.
Contraindications to the choice of the Navy as a contraceptive
The intrauterine device does not suit you, if there are such pathological conditions as:
• Pathology of uterus history, congenital or acquired, for example, two-horned uterus.
• Tumor pathology of the endometrium.
• Suspected pregnancy.
• Chronic inflammatory diseases of the female genital organs.
• Diabetes mellitus in the stage of decompensation.
• Uterine bleeding of unexplained genesis.
Women who chose the IUD as a contraceptive have an increased risk of developing pelvic inflammatory diseases and other pathologies. Therefore, it is obligatory to visit the gynecologist 2 times a year and pass tests of urine, blood, smear for cytology, undergo ultrasound of the uterus with appendages.
Complications and side effects of the Navy
As a rule, intrauterine contraceptives are well tolerated, so side effects are rare. In addition, unpleasant symptoms are most pronounced in the first three months of use of the helix, and then most often disappear completely.
Complications when using IUDs are also rarely observed, 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 uterus, etc.),
- non-compliance by the woman of the doctor’s recommendations,
- the inexperience of the healer
- the acquisition of poor-quality spiral.
The most frequent complications when using the intrauterine device are pathologies such as (arranged in decreasing order of frequency of occurrence):
- infectious and inflammatory diseases of the pelvic organs,
- severe pain,
- spiral rejection
- severe bleeding requiring medical therapy.
Other hazards to a woman’s health are extremely rare. For convenience, all complications associated with the use of IUDs are classified according to the time of occurrence.:
- complications associated directly with the installation of the spiral,
- complications arising during the use of the spiral,
- complications manifested after extraction of the helix.
Perforation of the uterus
Perforation (perforation) of the uterus is an extremely rare complication and occurs more often in young non-pregnant and / or fostering women, as a rule, in violation of the technique of introducing a spiral.
Perforation of the uterus may be complete or partial. Suspected perforation of the uterus is possible when the characteristic symptoms: pronounced pain syndrome, occurring against the background of symptoms of intra-abdominal bleeding (drop in blood pressure, increase in heart rate, pallor of the skin).
In some cases, as a rule, in case of incomplete perforation of the uterus, the pathology may appear some time after the installation of the helix with severe persistent pain in the lower abdomen.
If uterine perforation is suspected, hysteroscopy or ultrasound is prescribed to clarify the diagnosis. In the case of incomplete perforation, it is possible to remove the spiral through the vagina and conservative therapy.
If complete perforation of the uterine wall occurs, the helix is removed through the abdominal approach, and the uterine defect is sutured. In this case, the laparoscopic method is most often used (an optical fiber is introduced through a small hole in the abdominal wall with a video camera, which transmits the image to the monitor screen, and with the instruments with which the operation is performed).
In extremely severe cases, resorted to amputation of the uterus.
Rupture of the cervix is a rare complication that occurs, as a rule, in non-giving women with a violation of the technique of introducing a helix or in case of underreporting of contraindications (cervical stenosis).
The treatment tactics depend on the depth of the gap (surgical closure or conservative therapy).
Not life-threatening, but a very unpleasant complication. Occurs most often in nonpartum women with a narrow cervical canal, such as an increased vagus nerve reaction to pain and an emotional reaction to the procedure. It is manifested by a sharp blanching of the skin, a drop in blood pressure and a slower heart rate, in severe cases, the development of fainting is possible.
When a vasovagal reaction occurs, it is necessary to suspend the insertion of the helix and calm the patient. When symptoms begin to faint, a cold compress is placed on the forehead, the head end is lowered, and the legs are raised upwards, thus ensuring blood flow to the head.
When fainting, the patient's head is turned to the side in order to avoid aspiration of the stomach contents into the airways in case of vomiting. With a strong pain syndrome, analgesics are administered (analgin or ibuprofen).
The vasovagal reaction does not require medical treatment, but further monitoring is necessary to rule out such serious complications as uterine perforation.
For the prevention of vasovagal reaction for women at risk, it is advisable to carry out local (paracervical) anesthesia when installing the helix.
Side effects and complications that may arise during the use of a spiral of any type
Inflammatory diseases of the pelvic organs (PID)
Infectious and inflammatory diseases of the pelvic organs are one of the most frequent complications of the use of intrauterine devices and are observed in approximately 4-14% of cases of IUD installation.
As a rule, these complications occur when there are underreporting of contraindications to the use of IUDs, such as acute and subacute inflammatory processes in the female genital area at the time of installation of the helix or an increased risk of developing sexually transmitted diseases due to the presence of several sexual partners.
According to a large-scale study of women with PID, developed on the background of the use of the intrauterine device, it turned out that in 65% of cases sexually transmitted infections became the causative agent of the inflammatory process, and only in 30% of cases - non-specific microflora.
PIDs are dangerous with serious complications such as: chronic pelvic pain syndrome, ectopic pregnancy (caused by impaired tubal patency), infertility. Therefore, if you suspect the development of infectious-inflammatory processes in the pelvis, it is necessary to urgently consult a doctor.
The most common signs of PID are:
- pulling pains in the lower abdomen, worse during or after menstruation,
- fever, nausea, vomiting (in the acute process),
- dysuria (frequent urination, soreness when urinating),
- purulent discharge from the vagina with an unpleasant odor.
PID therapy is the appointment of antibacterial drugs, taking into account the pathogen that caused the disease.
The development of acute PID is an indication for the removal of the helix, which is performed on the background of antibiotic therapy.
Expulsion (rejection) of the helix also applies to relatively frequent complications (5-16% of cases when using copper-containing IUDs and 5-6% of cases when using the Mirena hormonal intrauterine system).
The most susceptible to such complications are young unborn women. With age, and also 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, the expulsion is accompanied by intense cramping lower abdominal pain, which is practically not relieved by analgesics and antispasmodics.
In such cases, differential diagnosis with other complications, such as pelvic inflammatory disease, ectopic pregnancy, interrupted physiological pregnancy, is necessary.
If intense pain painkillers with painkillers and antispasmodics occur in the first days after the helix is installed, then it may indicate a wrong position of the helix, inconsistency of the Navy with the size of the uterus, or such a terrible complication as uterine perforation.
To clarify the causes of pain, as a rule, prescribed ultrasound or hysteroscopy. In the case of an expulsion of a spiral, a woman is recommended to choose another method of contraception.
However, the loss of the spiral can occur relatively painlessly, so women using the IUD should regularly (after each period) check for the antennae of the spiral in the cervix.
In cases where the antennae of the helix are not detectable, it is necessary to urgently consult a doctor. As a rule, ultrasound is prescribed to locate the helix. 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.
Antennal sensation during intercourse
Quite rarely there are cases when the sexual partner complains of the antennae sensation during sexual intercourse. At the request of the patient, the doctor may trim the antennae in the cervix, the contraceptive effect of the helix will not diminish, but the woman will lose the ability to regularly check the location of the helix.
Prolonged and / or heavy bleeding
According to the recommendations of the WHO, prolonged bleeding can be talked about when it lasts more than 8 days, and abundant - when it is twice as strong as usual.
Prolonged and / or heavy bleeding when using a copper-containing IUD is most common in the first months after the installation of the helix. As a rule, they do not require special treatment.
However, in case of severe and / or heavy bleeding, it is necessary to consult a doctor, since it can be a symptom of a pathology, for example, ectopic pregnancy, uterine perforation or spontaneously terminated physiological pregnancy.
If more than three to six months have passed since the installation of the helix, and the bleeding continues to be long and / or heavy, so that signs of iron deficiency anemia appear, then the IUD is best removed and another method of contraception is selected.
At the request of a woman, you can replace the copper-containing Navy with the hormonal system, then the progestogens entering the uterus will help to reduce menstrual blood loss.
Cramping abdominal pain
Colicy pains in the lower abdomen are often disturbed by women during the first three months after the installation of the helix. This side effect is more common in young non-pregnant and / or nerzhavshih women.
If the pain syndrome reaches high intensity, you should consult a doctor to exclude such pathologies as ectopic pregnancy, spontaneous interruption of physiological pregnancy, rejection of the Navy, perforation of the uterus, infectious and inflammatory diseases of the pelvic organs, etc.
However, as clinical experience shows, in most cases a strong pain syndrome is an unpleasant side effect of the copper-containing IUD.
If the pain is very strong and / or continues to bother the woman after three or four months from the moment the helix is installed, it is better to replace the copper-containing IUD with the hormonal system, or remove the helix and choose another method of contraception.
Side effects from using hormonal IUDs
Amenorrhea is a fairly frequent side effect of using the hormonal intrauterine system. The absence of menstrual bleeding in such cases is due to reversible atrophy of the uterine epithelium.
A woman who uses the hormonal IUD should know that amenorrhea, which develops on the background of using a spiral, 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, acyclic menstrual cycle, prolonged and intense bleeding
Smearing bleeding or weak bleeding may develop immediately after the installation of the helix. As a rule, these symptoms disappear after a few weeks without treatment.
The acyclicity of the menstrual cycle and the appearance of spotting between menstrual bleeding are quite frequent side effects of the hormonal IUD. If such symptoms are observed longer than 3 months after the installation of the helix, it is necessary to exclude gynecological pathology.
Prolonged and intense bleeding during the period of use of the hormonal IUD are extremely rare, since the gestagens entering the uterine cavity reduce the severity of menstrual bleeding.
In cases where heavy monthly bleeding leads to the development of iron deficiency anemia, it is necessary to remove the IUD and choose a different type of contraception.
Symptoms of systemic action of progestogens
In the first three months of using a hormonal IUD, symptoms of the systemic action of gestagens may appear, such as:
- breast engorgement and tenderness,
- acne (juvenile acne),
- nausea, vomiting,
- back pain like sciatica
- decrease in sexual desire
- increased nervousness
- worsening of emotional state up to the development of mild depression.
The severity of these symptoms, as a rule, gradually decreases. If, after three months from the moment the helix is installed, unpleasant signs persist, this indicates poor portability of the gestagens. In such cases, it is better to remove the hormonal IUD and choose another method of contraception.
Complications manifested after the removal of the spiral
In most cases, long-term use of the IUD does not harm women’s health, with the exception of cases when, against the background of the use of a spiral, inflammatory diseases of the pelvic organs develop.
Acute infectious processes in the pelvis can lead to the development of tubo-ovarian abscess (purulent fusion of the uterine appendages), peritonitis, or become chronic (chronic adnexitis, etc.).
In such cases, after removal of the IUD, ectopic pregnancies may develop due to a violation of patency in the fallopian tubes. Often infertility or chronic pelvic pain syndrome is a consequence of the transferred inflammatory diseases of the small pelvis.
Spontaneous expulsion of the spiral
Copper-containing helix most often subject to spontaneous expulsion
It must be remembered that the intrauterine device can spontaneously be expelled from the uterus. Most often, this situation occurs in the first year of use when using copper-containing spirals..
In addition, the first three months, especially periods of menstruation, are the most dangerous in terms of the expulsion of the spiral. The frequency of this complication is influenced by many factors: the age of the woman, the presence of births in history, the time of administration and the contraceptive model.
Signs of exile of a spiral are colicy pains in the lower abdomen, bleeding outside of menstruation or during sexual contact, lengthening of the filaments, sensation of a spiral in the vagina.
No contraceptive method gives a 100% guarantee.
None of the existing contraceptives completely exclude the possibility of pregnancy. Uterine pregnancy may occur when not diagnosed displacement or removal of the helix from the uterus. This suggests that after the establishment of the spiral you need to be very attentive to your condition. If any unpleasant sensations in the intimate area, you should consult a doctor. Also, in case of “suspicion” of pregnancy, the right decision is to conduct a test and come to an appointment with a gynecologist.
When the diagnosis of uterine pregnancy is confirmed, the helix is removed. Pregnancy is desirable to interrupt. According to statistics, more than half of the pregnancies that occurred on the background of the helix result in spontaneous miscarriages, premature births, and the risk of infection is also high. Cases of the development of fetal anomalies, various injuries.
However, the choice and decision about the fate of the baby always depends on the woman herself.
The risk of ectopic pregnancy is much higher than with other types of contraception. This is due to the fact that the installation of the spiral somewhat changes the motility of the fallopian tubes. There is also a trend that the longer a woman uses the helix, the higher the likelihood of ectopic pregnancy.
The most common complication when using the helix is ectopic pregnancy. This condition requires emergency surgical care.
Inflammatory diseases of the reproductive organs
Inflammatory diseases are one of the most frequent complications when using the helix. It can be both "fresh" infections and exacerbation of chronic diseases.
When diagnosing such a disease, the helix is usually removed and a specific treatment course is given. Intrauterine contraception can be used again in 6-12 months.
With the use of the helix, menstrual bleeding can become profuse and become massive. This is due to the additional trauma of the endometrium and the characteristics of the woman’s body. Regular heavy bleeding can lead to anemia. Therefore, changes in the nature of menstruation must be reported to your gynecologist. По результатам анализов крови (гемоглобин, гематокрит, количество эритроцитов) принимается решение о пролонгировании такого способа контрацепции.
Длительные и обильные менструации приводят к анемизации организма женщины. Это состояние является показанием для досрочного удаления спирали.
If the pain lasts more than 2-3 months, this is an occasion to see a doctor.
The appearance of pain may be associated with an increase in the tone of the uterus. If the pain appears immediately after the introduction or during the first 2-3 menstruations, then it is enough to take 1-2 aspirin tablets. This drug affects the synthesis of a number of hormones, which leads to a decrease in the contractile activity of the uterus. Longer pain may indicate errors with the introduction of the helix, which requires consultation of the gynecologist.
Intrauterine device: advantages and disadvantages
Intrauterine spiral is a very common method of contraception among women in Russia, Scandinavian countries and Asian countries. Its popularity is won by the following advantages:
- high reliability: out of 100 women using the IUD for one year, only one can have a pregnancy,
- the effect of long-term use is from 5 to 10 years,
- immediate contraceptive effect
- ease of use
- method confidentiality
- low cost of contraceptive,
- when properly positioned in the uterus, not felt by a woman
- is removed at the request of the woman, at any time, as soon as she decides that she no longer wishes to use this type of contraception,
- very rapid fertility recovery,
- possibility of use during breastfeeding, does not harm the health of the child,
- no impact on the body as a whole,
- the use of certain types of IUDs for medical purposes,
- does not require the use of additional methods of contraceptive protection.
Yes, the benefits are not small. But for an objective assessment it is necessary to consider all the arguments for both against the use of the Navy.
Significant disadvantages include:
- the presence of contraindications
- Abundant and long "critical days"
- spotting before and after menstruation,
- lack of protection against sexually transmitted infections
- high incidence of inflammation in the uterus and appendages,
- does not protect against ectopic pregnancy, but rather even provokes it (except for hormone-containing IUDs),
- possible complications of the introduction - perforation or perforation of the uterine wall,
- expulsion is not excluded (spontaneous loss of the IUD from the uterus),
- the spiral cannot be put and removed independently.
So, if you are thinking about installing a contraceptive intrauterine device, the pros and cons of using it listed above will help you decide on the method of contraception.
What is dangerous intrauterine device for women's health?
Consider a situation where the IUD is a contraindication:
The woman is unmarried, has more than two sexual partners and promiscuous sex. Is it dangerous for her to use a spiral?
Sure. Because the spiral does not protect against genital diseases. In addition, its constant presence in the uterus increases the frequency of infection of the pelvic organs.
A woman notes frequent exacerbation of chronic diseases of the uterus and ovaries.
The spiral is definitely not shown to it: the weighting of the inflammatory process can be so severe that it will require surgical treatment.
Long, heavy and painful menstruation.
The Navy will aggravate the situation, lead to an increase in blood loss and the development of iron deficiency anemia.
Benign or malignant tumors of the uterus.
The damage of the helix is obvious.
The spiral can not be applied under the following conditions:
- a definite or suspected pregnancy,
- ectopic pregnancy in the past
- abnormal structure of the uterus,
- copper allergy.
Installation of the Navy to the ageless girls raises many questions and opinions are divided into the opposite. If you have not experienced the joy of motherhood, and the desire to use the spiral is, then a careful gynecologist will not do without a thorough examination of your health.
Side effects and complications of the IUD
Photos: contraceptive side effects
Side effects you need to know about.
- Offset Navy. It is necessary to remove the displaced IUD in the presence of bleeding or pain. Displacement of the IUD, which is not accompanied by any symptoms, can lead to pregnancy.
- Uterine bleeding. They can be from minor to heavy debilitating bleeding during menstruation. The doctor makes a conclusion about the health hazards in such cases! Only a gynecologist will minimize the risk of side effects and complications after the introduction of the IUD and any other contraceptive devices. Do not forget that the IUD is a foreign body in the uterus. The specialist will give you an individual treatment. In the absence of the effect of treatment, the helix is removed.
- Perforation of the uterus spiral. Very rare, but quite a serious complication. If you suspect perforation, they clarify the position of the contraceptive using ultrasound or radiography. With partial perforation, the IUD can be removed under the control of a hysteroscope, and with full perforation, an operation is required. The risk of perforation is reduced if the procedure for inserting an IUD is controlled by ultrasound.
- Expulsion of the IUD is a spontaneous loss of a contraceptive from the uterus. By itself does not harm health. It has a negative impact only if this fact has gone unnoticed by a woman. In such a situation, an unwanted pregnancy occurs.
Most often the prolapse of the spiral occurs during menstruation, when the cervix is in the ajar.
Consequences of using a spiral
So, what could be the consequences after the introduction of the intrauterine device? Be prepared for the following side effects:
- Minor discomfort in the lower abdomen or even aching pains. Usually there are right after installation of the contraceptive. If such problems persist for a long time, then you need to consult a doctor. Perhaps the spiral is wrong or it does not suit you. In any case, the specialist will deal with your problem and suggest either changing the IUD, or completely abandon such a means of contraception.
- Lengthening of menses and blood loss. Most of the spirals have such side effects, in addition to medical,
- IUDs do not protect against genital infections
- Ingrown spiral.
If the lifespan of a contraceptive is not respected, and the woman continues to use it for longer than many years after the expiration date (10.15 and even 25 years), then the helix can tightly grow into the uterine wall. Then it can be difficult to remove.
Long-term wearing of the IUD is an indication for hospitalization in a hospital where, under intravenous anesthesia, you will be removed by a spiral and diagnostic curettage of the uterus.
Does the helix have healing properties?
A spiral with healing properties exists. This is the hormone-containing intrauterine system Mirena, which includes the properties of hormonal and intrauterine contraception: comfortable, long-term, reversible.
The main mechanism of action of Mirena occurs at the level of the inner layer of the uterus (endometrium). The hormone levonorgestrel is packed in a special helix reservoir. Slow release of the hormone from the capsule leads to a thinning of the inner layer of the uterus.
Features of the mechanism of action of this hormonal contraceptive, allow you to use it not only for protection from pregnancy, but also for the treatment of some common female diseases.
Positive non-contraceptive effects of Mirena:
- menstruation becomes shorter, less abundant and long, until their complete cessation - this is a completely normal reaction,
- do not increase the risk of inflammatory diseases of the genital organs, compared with the copper-containing IUD.
Important! Before the advent of the intrauterine system, endometriosis and uterine fibroids served as a contraindication for the helix. The peculiarities of Mirena's action allow it to be widely used in women with endometriosis and uterine myoma. It is reliably proven that myoma nodes in the uterus and foci of endometriosis are significantly reduced.
As you can see, the intrauterine device has its advantages and side effects. But millions of girls and women in the world prefer the IUD as the most appropriate method of contraception. Despite some drawbacks, the helix is a good contraceptive.
It is very important to undergo consultation with a specialist before installing an IUD. The doctor, using his knowledge and experience, will select the best spiral for you. And this is guaranteed to allow you to avoid many of the unpleasant consequences associated with the use of the Navy.
Video with answers from an experienced gynecologist to frequently asked questions.
See what the gynecologist, Ph.D. in Medical Sciences about intrauterine contraceptive coils says. In the first part, you will learn about the risk of ectopic pregnancy and the growth of the IUD into the uterus wall. Having looked at the second part, you will understand whether the risk of infections is increased, whether modern spirals cause bleeding and can they reduce pain during critical days.
Conventionally, they are divided into 4 generations of this device:
- From inert materials
Already irrelevant in our time option. The main disadvantage is the risk of the device falling out of the uterus and an extremely low degree of protection.
- Spirals with copper in the composition
This component "fights" with sperm that have penetrated into the uterus. Copper creates an acidic environment, and as a result of inflammation of the uterine walls, leukocyte levels increase. Installation time - 2-3 years.
Installation period - up to 5 years. Very high level of protection.
The leg of the device is in the form of "T", and it contains hormones. Action: In the uterine cavity, a daily amount of hormones is released, resulting in the suppression of the process of release / maturation of the egg. And by increasing the viscosity of mucus from the cervical canal, the movement of sperm cells slows down or stops. Installation time - 5-7 years.
Forms of the intrauterine device (IUD) - an umbrella, a spiral, a loop or a ring, the letter T. The latter is the most popular.
The most popular types of Navy today
- Navy Mirena
Features: T-shaped with the hormone levonorgestrel in the rod. The drug is "thrown" into the uterus in the mode of 24 mg / day. The most expensive and effective spiral. The price is 7000-10000 rubles. The term of installation is 5 years. IUDs promote treatment for endometriosis or uterine myoma (plus), but it also leads to the formation of ovarian follicular cysts.
Features: the shape of the oval with spikes, protrusions to reduce the risk of precipitation. It is made of plastic with copper wire. The cost is 2000-3000 rubles. Interferes with fertilization (spermatozoa die due to the inflammatory reaction caused by copper) and implantation of the embryo (when it appears) in the uterus. It is considered an abortive contraceptive method (as, indeed, any other IUD). Use permitted for women giving birth. Of the side effects: increased period and painful periods, pain in the lower abdomen, etc. The contraceptive effect can be reduced when taking antidepressants.
Features: form - "T", material - plastic with copper (+ silver tip, barium sulfate, PE and iron oxide), installation period - up to 5 years, average price - about 2000 rubles. For easy removal of the spiral on the tip there is a thread with 2 tails. The effect of the IUD: neutralizing the ability of sperm to fertilize an egg. Cons: does not exclude the appearance of ectopic pregnancy, there are cases of perforation of the uterus when installing a spiral, causes abundant and painful periods.
- Navy T-Copper Cu 380 A
Features: form - "T", installation period - up to 6 years, material - flexible polyethylene with copper, barium sulfate, non-hormonal device, German manufacturer. Action: suppression of sperm activity, prevention of fertilization. Recommended for women giving birth. Special instructions: it is possible to heat the fragments of the helix (and, accordingly, their negative impact on the surrounding tissues) during thermal procedures.
- Navy T de Oro 375 Gold
Features: in the composition - 99/000 gold, Spanish manufacturer, price - about 10,000 rubles, installation period - up to 5 years. Action: protection from pregnancy, reducing the risk of uterine inflammation. The IUD form is a horseshoe, T or U. Of the most frequent side effects, there is an increase in the intensity and duration of menstruation.
Pros and cons of intrauterine devices
Of the advantages of the Navy are the following:
- The long period of validity is up to 5-6 years, during which it is possible (as stated by the manufacturers) not to worry about other methods of contraception and accidental pregnancy.
- The therapeutic effect of some types of IUDs (the bactericidal effect of silver ions, hormonal components).
- Saving on contraceptives. Buy the Navy for 5 years cheaper than constantly spend money on other means of contraception.
- The absence of such side effects, which are after taking hormonal pills - obesity, depression, frequent headaches, etc.
- The ability to continue breastfeeding. Spiral will not affect the composition of milk, unlike tablets.
- Restoration of the ability to conceive from 1 month after removal of the IUD.
Arguments against the use of a spiral - disadvantages of the Navy
- 100% guarantee for protection against pregnancy, no one gives (maximum 98%). As for ectopic pregnancy - the spiral increases its risk by 4 times.
- No IUD guarantees no side effects. In the best case, pain and an increase in the duration of menstruation, abdominal pain, discharge (bloody) in the middle of the cycle, etc. In the worst case, the rejection of the helix or severe health consequences.
- The risk of spontaneous removal of the IUD from the uterus. As a rule, after lifting weights. Usually this is accompanied by cramping abdominal pain and fever (if an infection occurs).
- The Navy is prohibited in the presence of at least one item from the list of contraindications.
- When using the Navy requires regular monitoring of its presence. More precisely, its filaments, the absence of which indicates a shift of the helix, its loss or rejection.
- One of the most significant drawbacks is the risk of premature pregnancy in the future due to endometrial exhaustion in the uterus.
- Pregnancy occurring in the process of using the Navy, experts advise to interrupt. The preservation of the fetus depends on the location in the uterus of the helix itself. It is worth noting that when a pregnancy occurs, the IUD is removed anyway, and the risk of miscarriage increases dramatically.
- The IUD does not protect against sexually transmitted diseases and the penetration of various infections into the body. Moreover, it contributes to their development, because the body of the uterus remains slightly open when using the IUD.
- When installing the IUD there is a risk (0.1% of cases) that the doctor will pierce the uterus.
- The mechanism of action of the spiral is abortive. That is, equated with abortion.
Categorical contraindications for use of the Navy (common, for all types)
- Any pathology of the pelvic organs.
- Diseases of the pelvic organs and genital sphere.
- Tumors of the cervix or the uterus itself, fibroids, polyps.
- Pregnancy and suspicion of her.
- Cervical erosion.
- Infection of internal / external genital organs at any stage.
- Uterus malformations / underdevelopment.
- Tumors of the genital organs (already confirmed or if they are suspected).
- Uterine hemorrhage of unknown origin.
- Allergy to copper (for the Navy with copper in the composition).
- Ectopic pregnancy or suspicion of it.
- Diseases of the cardiovascular system.
- Poor blood clotting.
- Endometriosis (no matter - in the past or in the present).
- The absence of pregnancies in history. That is, for not giving birth to women IUD is not prohibited, but categorically not recommended.
- Violations of the menstrual cycle.
- Little womb.
- Venereal diseases.
- Scars on the uterus.
- The risk of "catching up" a sexually transmitted disease. That is, several partners, a partner with diseases, promiscuous sex, etc.
- Long-term treatment with anticoagulants or anti-inflammatory drugs, which continues at the time of installation of the helix.
- Not uncommon - such a case, as the spiral grows into the uterus. Sometimes women just forget about it, and in the end you have to cut a spiral with the uterus.
Opinions of doctors about the Navy - what experts say
After installing the Navy
- Not a 100 percent contraceptive method, the benefits of which outweigh the side effects and the risk of serious consequences. Definitely not recommended for young girls who did not give birth. The risk of infection and ectopic significantly increases. From the advantages of the spiral: you can safely engage in sports and sex, obesity does not threaten, “antennae” do not interfere even with a partner, and in some cases even a therapeutic effect is observed. True, sometimes it is crossed out by the consequences.
- Studies and observations on the Navy was a lot. Still, there are more positive moments. Of course, no one is immune from the consequences, everything is individual, but to a greater degree spirals today are fairly safe means. Another question is that they do not protect against infections and diseases, and at the risk of developing oncology, their use is strictly prohibited. It should also be said about the use of drugs in combination with the use of hormonal coils. For example, regular aspirin significantly reduces (2 times!) The main effect of the helix (contraception). Поэтому при лечении и приеме лекарств есть смысл использовать дополнительные контрацептивные средства (презервативы, например).
- Что ни говори, а независимо от эластичности ВМС, она – инородное тело. And accordingly, the body will always react to the introduction of a foreign body, according to its characteristics. One of them increases the pain of menstruation, the second has pain in the abdomen, the third has problems with emptying the intestines, etc. If the side effects are severe, or they do not disappear after 3-4 months, then it is better to give up the helix.
- Definitely contraindicated use of the Navy to nulliparous women. Especially in the age of chlamydia. The spiral can easily provoke an inflammatory process, regardless of the presence of silver and gold ions. The decision on the use of the Navy should be taken strictly individually! Together with the doctor and taking into account all the nuances of health. The spiral is a remedy for a woman who has given birth, who has only one stable and healthy partner, good health in the female part and the absence of such an organism, such as an allergy to metals and foreign bodies.
- In fact, it is necessary to take a decision on the Navy - to be or not to be - carefully. It is clear that it is convenient - once set, and for several years you do not care about anything. But there are 1 - consequences, 2 - a wide list of contraindications, 3 - a mass of side effects, 4 - problems with fetus bearing after using a helix, etc. And one more thing: if the work involves lifting weights, then you should not contact the Navy. It’s good if the spiral turns out to be the ideal way out (in any case, it’s better than abortion!), But you should still carefully weigh all possible problems and advantages.
Possible effects of intrauterine devices
According to statistics, most of the refusals of the Navy in our country - for religious reasons. After all, the IUD is actually an abortive method, because the most frequent expulsion of a fertilized egg is at the approaches to the wall of the uterus. The rest refuse the helix due to fear (“an unpleasant and slightly painful installation procedure), due to side effects and possible consequences.
Is it really worth being afraid of the consequences? What can the use of the Navy?
First of all, it is worth noting that complications of a different nature when using the IUD are associated with an illiterate approach to decision making, both by the doctor and the woman: due to underestimation of risks, due to negligence when using the IUD (non-compliance with the recommendations), due to low qualification of the doctor who installs the spiral, etc.
So, the most frequent complications and consequences when using the IUD:
- Infection / inflammation of the pelvic organs (PID) - up to 65% of cases.
- Uterine spiral rejection (expulsion) - up to 16% of cases.
- Spiral ingrowth.
- Very heavy bleeding.
- Severe pain syndrome.
- Miscarriage (in the event of pregnancy and the removal of the spiral).
- Ectopic pregnancy.
- Depletion of the endometrium and, as a consequence, a decrease in the ability of gestation
Possible complications from the use of IUDs containing copper:
- Long and heavy periods - more than 8 days and 2 times stronger. In most cases, they can be the norm, but they can also be a consequence of an ectopic pregnancy, interrupted normal pregnancy or perforation of the uterus, so do not be lazy to go to the doctor once again.
- Cramping abdominal pain. Similarly (see paragraph above) - it is better to be safe and checked by a doctor.
Possible complications from the use of IUDs containing hormones:
- The most common complication is amenorrhea. That is, the absence of menstruation. If the culprit of amenorrhea is not an ectopic pregnancy, namely the IUD, then the cause is reversible atrophy of the uterine epithelium.
- Downed menstrual cycle, the appearance of spotting in the middle of the cycle, etc. When observing such symptoms for more than 3 months, the pathology of a gynecological nature should be excluded.
- Symptoms of gestagen action. That is, acne, migraines, breast tenderness, "radiculitis" pain, vomiting, decreased libido, depression, etc. If symptoms persist for 3 months, one can suspect the intolerance of gestagens.
Possible consequences of violation of the installation of the Navy.
- Perforation of the uterus. Most often observed in nulliparous girls. In the most difficult case, the uterus has to be removed.
- Rupture of the cervix.
- Vasovagal reaction
Possible complications after removal of the IUD.
- Inflammatory processes in the pelvic organs.
- Purulent process in the appendages.
- Ectopic pregnancy.
- Chronic pelvic pain syndrome.