Types of spirals for women. Which is the best intrauterine device photo and reviews

An IUD is a small gynecological device made of plastic or a combination of plastic and metal. The main purpose of introducing the device into the uterine cavity is to prevent the attachment of the fertilized egg. It is installed for a long time and reliably protects against unwanted pregnancy, and some models also have a therapeutic effect.

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Intrauterine device Simurg Juno Bio-T Ag ring-shaped

Material - biologically inert plastic with silver. Produced in 2 sizes: Type 1 – diameter 18 mm; Type 2 – diameter 24 mm. Contraceptive effect: “Type 2” - no more than 5 years. “Type 1” – no more than 3 years. Model - Yunona Bio-T Ag.

Intrauterine device Simurg Juno Bio Multi Ag

The spiral is wrapped in copper wire with the addition of silver. The protection period is at least seven years: due to the noble metal in the composition, the contraceptive will last longer. Recommended for women who have had abortions or childbirth.

Intrauterine device Simurgh Juno Juno Gold

A reliable means of contraception, made using biologically inert materials and noble metal. Features a convenient Nautilus insertion system for maximum comfort.
Validity period - 9 years.

Mechanism of action

This method of contraception is one of the most effective and has been used in medical practice for quite a long time, but not everyone understands how the intrauterine device works.

Standard models are made in the form of a flexible plastic frame around which a thin metal wire is wound. At the end there is a nylon thread designed for ease of placement, position control and removal of the product.

Copper is most often used as a braid, which has a contraceptive effect by suppressing the motor activity of sperm. The action of the intrauterine device shortens the life of the egg and prevents it from attaching to the wall of the uterus. Despite the apparent simplicity of the technique, protection against unplanned conception is about 97%.

In terms of design shape, the most popular types are IUDs in the shape of the letter “T”, as well as F- and ring-shaped. There are other variations - “loop” or “umbrella”, which are not so widely used.

In terms of composition, there are two broad categories:

• Inert or neutral - belong to the first generation and act on the basis of a mechanical obstacle to conception. Today, this type is losing relevance due to the likelihood of complications, as well as poor statistical indicators.
• Medications are divided into two groups. The first - containing the active copper component in its pure form, or with the addition of noble metals (silver, gold, platinum). The second is equipped with a container with progestin hormones. The price of this type of intrauterine device is higher due to the guaranteed effectiveness.

Features of the technique

The installation of an IUD for 5-10 years affects the endometrium of the uterus, resists the attachment of a fertilized egg, damages sperm and rejects the fertilized egg. In this case, the processes proceed painlessly, without disturbing the usual way of life.

Unlike the use of birth control pills, the operating principle of the intrauterine device does not cause weight gain as a result of hormonal changes and does not affect sexual function. IN There is no discomfort during sexual intercourse.

As for the therapeutic effect, many models can lead to the following results:

• elimination of pathological growth of the endometrium;
• reduction in fibroid volumes;
• stabilization of the menstrual cycle;
• reduction of pain in the first days of menstruation.

The administration is carried out exclusively by a doctor and does not require surgical intervention. During the period of use, you will not need to visit the gynecologist more often than usual, and you will not have to constantly worry about timely contraception.

Like any other technique, the intrauterine device has not only pros, but also cons. However, there are not very many of them:

• despite the biologically inert composition, sometimes individual intolerance may occur, which is manifested by rejection of a foreign body;
• during menstruation, increased bleeding is likely, so if significant manifestations occur, this issue should be discussed with a gynecologist;
• in case of unqualified installation, the cervix may be injured or there may be a risk of ectopic pregnancy, so it is important to seek the services of experienced specialists in licensed medical institutions.

Contraindications:

• history of ectopic pregnancy;
• poor blood clotting;
• lack of birth experience if you plan to have children in the future;
• a large number of sexual partners;
• hyperpolymenorrhea;
• chronic anemia;
• the likelihood of endometrial pathology.

How to install

The IUD is indicated for women who have given birth and who do not show signs of the above contraindications, as well as pathologies of the cervix, infections and inflammatory processes in the genital tract.

A preliminary examination, examination, ultrasound and tests are carried out. If satisfactory results are obtained, the insertion of an IUD is prescribed. When an intrauterine device is placed, no anesthesia is required, and in some cases simple local anesthesia is used. The process of insertion into the uterine cavity takes about 10-15 minutes, and the most successful period for its implementation is 3-4 days (sometimes 4-8) from the beginning of the menstrual cycle.

To ensure successful integration of the device, you should not be sexually active for the next eight days after the installation procedure. Even during this period, it is recommended to refrain from playing sports, especially swimming.

Despite the reliability of contraception, the IUD does not protect against sexually transmitted diseases. Therefore, its use is recommended for women who have sex with a regular partner. In other cases, additional methods of counteracting possible infections will be needed.

In the first days after installation, nagging pain may appear in the lower abdomen, as well as due to the restructuring of the uterine mucosa - irregular spotting. At first, during menstruation, bleeding is a little heavier than usual. If such manifestations persist for a long period, you should inform your doctor.

When deciding where to buy an intrauterine device, it is important not to rely solely on the low price. You should purchase high-quality products from specialized manufacturers that will not let you down and will not lead to unpleasant consequences.

In the article we discuss the intrauterine device. We talk about its types, when it is placed, and possible side effects. You will find out whether it is possible to get pregnant with an IUD, whether it is harmful to women’s health, and what the consequences are after using it.

An intrauterine device (IUD for short) is a contraceptive device, which is a device made of synthetic material (medical plastic). It is injected into the uterine cavity, due to which pregnancy does not occur.

The dimensions of modern spirals are 24-35 mm. They contain metals that do not provoke inflammation (copper, silver, gold) or the hormone levonorgestrel.

The action of the intrauterine device

The IUD has the following operating principles:

• Suppression of ovarian function and slowing down ovulation. When using an intrauterine device, the hypothalamic-pituitary system is slightly stimulated. This provokes a slight increase in the secretion of levonorgestrel, while maintaining the production of progesterone and estrogens. At the same time, there is an increase in the amount of estrogen, as well as a shift in their peak in the middle of the cycle by several days.
• Obstruction or failure of implantation. During phase 2, there is a noticeable rise in progesterone, and a decrease in the duration of the second phase. There is a cyclic change in the endometrium, but there is a failure in the synchronization of these transformations. The first phase lengthens, partial maturation of the uterine mucosa occurs, and this prevents the fertilized egg from implanting into the endometrium. The presence of copper in the IUD helps increase the absorption of estrogen, and levonorgestrel activates early maturation of the endometrium with subsequent rejection before the egg has time to securely attach itself to the uterus. This effect of the IUD is abortifacient.
• Aseptic inflammation in the uterine cavity, impaired sperm movement. The presence of an IUD in the uterine cavity irritates its walls, thereby stimulating the secretion of prostaglandins by the uterus. These substances activate partial maturation of the endometrium, as well as aseptic inflammation in the uterine cavity. At the same time, the amount of prostaglandins increases in the cervical mucus, which stops the penetration of sperm into the uterine cavity. Due to aseptic inflammation due to the presence of the IUD, the number of leukocytes, histiocytes, and macrophages increases. All these cells increase sperm phagocytosis, isolating the fertilized egg, preventing it from implanting into the endometrium.
• Changes in the nature of the movement of the egg along the fallopian tube. The released prostaglandins accelerate the peristalsis of the uterine tubes. Because of this, an unfertilized egg enters the uterus (its meeting with a sperm occurs in the tube) or fertilized, but at a time when the endometrium is not ready for implantation.

Pros and cons of the intrauterine device

If you are thinking about whether to install an intrauterine device, we suggest that you familiarize yourself with its main advantages and disadvantages.

Advantages

The most important advantage of using an IUD is the ability to forget about the need to protect yourself from unwanted pregnancy for a period of 3 to 10 years, depending on the type of device. The contraceptive effect occurs immediately after installation of the IUD. Moreover, the degree of protection against unwanted conception is up to 98 percent.

The spiral is easy to install and also easy to remove. You don’t have to wait until its expiration date expires; you can ask your gynecologist and she will get it for you right away. After removal of the IUD, pregnancy usually occurs after several cycles, in some cases during the first menstrual cycle. In this case, restoration of fertility occurs quite quickly.

Contraception using an intrauterine device allows a woman to decide for herself about planning a child. Your spouse or boyfriend may not realize that you are using an IUD, since the man cannot feel it during intercourse. The spiral does not affect the general condition of the body in any way and does not worsen the course of extragenital diseases.

An IUD does not require daily monitoring, which is convenient compared to birth control pills, which must be taken daily at specific times. Taking various medications does not have any effect on the action of the spiral. With an IUD, you can perform various surgical interventions and even breastfeed your baby.

Flaws

The main disadvantage of the IUD is the fact that after its installation the cervix remains open. This is dangerous due to the possibility of penetration of pathogenic microorganisms into it, which provoke inflammatory processes in the pelvis (endometritis and adnexitis). And this happens regardless of the fact that the spiral is made of metal, which has a disinfecting effect.

In the first few months after installation of the IUD, you may experience aching pain in the lower abdomen. This is due to increased sensitivity of the uterus or an incorrectly selected IUD.

The presence of a foreign object in the uterus and regular mechanical damage to the endometrium in the area of ​​contact with the coil provokes increased menstrual flow and the duration of menstruation. In some cases, this later leads to anemia.

Sometimes, while using an IUD, an ectopic pregnancy occurs. It is quite dangerous, as in some cases it is fatal.

The introduction of a spiral into the uterine cavity leads to thinning of the uterine endometrium. In the future, this adversely affects the ability to get pregnant, increasing the risk of miscarriages. Anomalies in the structure of the female genital organs are a prohibition for the installation of an IUD, since in this case there is no guarantee of protection against unwanted pregnancy.

Another disadvantage of the intrauterine device is the possibility of it falling out. As a rule, this happens during menstruation. Since not everyone is able to notice the prolapse of the IUD, this can lead to unwanted conception.

The IUD does not protect against sexually transmitted infections. Therefore, it is better to use it only if you have a regular man, and for protection with casual partners, it is better to use a condom.

The IUD can only be inserted into women who have given birth, which makes this method of birth control inaccessible to those who have not yet experienced the delights of motherhood. It is prohibited to insert or remove the IUD yourself. All manipulations should be carried out by a gynecologist. It should be borne in mind that once every six months you will have to visit a gynecologist to check the IUD.

Sometimes the IUD grows into the uterus. In this case, surgery may be required to remove it.

The intrauterine device brings not only benefits, but also harm. Therefore, it is important to take a responsible approach to its choice, follow all the specialist’s recommendations and remember that an IUD can only be installed after childbirth.

Types of intrauterine device

There is no universal IUD that is suitable for all women. The gynecologist chooses the best option for an intrauterine contraceptive based on the structural features of the uterus and the physiological state of the patient.

Currently, more than 50 contraceptive IUDs can be found on sale.

All types of IUDs are divided into 4 generations:

• inert;
• copper;
• silver, gold;
• hormonal.

Now let's look at each type in more detail.

Inert

They belong to the first generation and are obsolete. They are characterized by low efficiency, often fall out and become dislodged, for this reason their use is prohibited in many countries. Representatives of this group:

• plastic Lipps loop;
• Mauch steel ring with 2 scrolls;
• double helix Saf-T-Coil.

Copper

This type of vaginal device belongs to the 2nd generation. This is a small T-shaped or semi-oval device, its rod is wrapped in copper wire. The device is easy to install and remove.

The presence of copper in the composition of the product allows you to create an acidic environment in the uterine cavity, as a result of which sperm activity is greatly inhibited. Such contraceptives are prescribed for a period of three to five years.

The most famous models of this series:

• Juno Bio;
• Multiload;
• Nova T.

With silver

Any metal can oxidize and collapse. For this reason, to extend the life of the copper IUD, manufacturers began to add silver to its rod. Because of this, the sperm toxic effect is enhanced several times, and silver ions, which have a disinfectant and antibacterial effect, have a beneficial effect on the female body.

The period of use of such a contraceptive is from 5 to 7 years.

Gold

Gold Navy is an alternative to silver and copper products. Its main advantage is complete biological compatibility with the woman’s body, the absence of allergic manifestations, and the metal’s resistance to corrosion damage.

The gold device has anti-inflammatory properties and perfectly protects against unwanted conception. The service life of such a spiral is from 5 to 10 years, and after its removal, reproductive functions remain in normal condition.

Hormonal

The latest generation of IUDs are hormone-containing devices. According to doctors, they are the most effective means of contraception.

Such an IUD is T-shaped; its stem contains a hormonal drug (levonorgestrel and progesterone), which is evenly released in small doses into the uterine cavity.

This contraception has no contraindications, because the hormone does not penetrate into the bloodstream, having only a local effect: it eliminates inflammation, inhibits ovulation, and prevents fertilization of the egg. This product can be used for 5 to 7 years.

Navy uniforms

It is extremely difficult to say exactly which contraceptive device is the best. This product is selected individually, based on the structure of the uterus and personal preferences. Before choosing a contraceptive device, be sure to consult a gynecologist.

Below we will talk about the main forms of the IUD and their distinctive features.

T-shaped

They are the most common. They are easy to use, install and remove. The T-shaped product has the shape of a rod, from which 2 flexible hangers extend.

The hangers help fix the product in the uterine cavity. At the end of the rod there is a special thread with which you can easily remove the contraceptive.

Ring-shaped

The device is easily attached to the uterine cavity and removed. There are no additional threads in it, since they are not necessary.

Loop-shaped

This form of IUD can be in the form of an umbrella. On the outer edges of this product there are spike-like protrusions, thanks to which the spiral is securely fixed in the uterine cavity, thereby reducing the risk of its loss.

A contraceptive product in the form of a loop is used by women who have a non-standard uterine structure. And in this case, they do not have the opportunity to use a T-shaped IUD.

Installation of an intrauterine device

The IUD is installed:

• women who gave birth after an abortion, if it passed without inflammatory complications;
• women over 35 years of age who have already given birth and have contraindications to taking oral contraceptives;
• women who have a low risk of genital tract infections in the absence of cervical pathologies.

Inserting a spiral into the uterine cavity will require some preparation, since this procedure is a medical intervention. Before installing the IUD, it is necessary to undergo an examination and cure all chronic gynecological diseases.

What examinations need to be completed before installing the spiral:

• consultation with a specialist to collect anamnesis;
• gynecological examination to determine the size and position of the uterus;
• Ultrasound of the pelvic organs to detect the presence or absence of inflammation and formations in the uterine cavity and appendages;
• general urine and blood tests;
• bacteriological seeding of vaginal discharge, cervix;
• blood tests for HIV infection;
• submitting a smear for cytology, microflora from three points.

Immediately before inserting the spiral, the specialist probes the uterus, measures the length and distance between the uterine angles. Many women ask what day the IUD is placed on. It is placed on the 3-4th day of menstruation, since during them the cervix is ​​slightly open, and this facilitates the process of introducing a contraceptive. In addition, the blood that is released during menstruation reduces the possibility of injury to the uterus, and also means that there is no pregnancy at the time of installation.

Mild pain in the lower abdomen after insertion of the IUD, as well as spotting, are considered normal, being just a reaction of the uterus to the penetration of a foreign body into it. In the first few days, physical activity is prohibited. You can return to intimate life 7-14 days after installing the contraceptive, depending on how you feel.

After installing the IUD, slight spotting may appear for 2-3 months. When the spiral is installed correctly, neither the woman nor the man feels it.

After the introduction of an intrauterine contraceptive, you need to come for an examination by a gynecologist in a month, then after three months and after that every six months.

Removal of the IUD

Removal of the intrauterine contraceptive device occurs in several stages. If you do not want to get pregnant, then 7 days before removing the IUD, exclude unprotected intimate relations. This is due to the ability of sperm to remain active for 2-3 days, as well as the possibility of ovulation occurring after the IUD is removed. As a result, conception may occur.

It is advisable to remove the IUD on the 3-4th day of your period, in this case the pain from the procedure will be minimized. But at the same time, you can remove the product on any day of the cycle, but only if you feel well.

The procedure begins with an examination in a gynecological chair. The specialist examines the uterus to find the tendrils of the IUD. After this, a dilator is inserted to stabilize the uterus and its cavity is treated with antiseptics.

The patient inhales deeply and slowly, after which the doctor grabs the tendrils of the product with forceps, carefully removing it from the uterine cavity. Now you can easily reach the spiral by hand. During critical days, gliding occurs better.

The total duration of the procedure is several minutes, taking into account preparation. Normal symptoms after IUD removal include muscle spasms, cramping, and minor bleeding. Typically, these signs disappear within a couple of days. If there are no health problems and if desired, a new IUD can be installed immediately after removal of the IUD.

Many women are concerned about whether it hurts to remove the intrauterine device. According to reviews, inserting an IUD is more painful than removing it. Therefore, as a rule, you can do without anesthesia during the procedure.

Which is the best intrauterine device?

Pharmacies offer many remedies for unwanted pregnancy. IUDs are in particular demand among women.

Depending on your financial capabilities and physiological characteristics, the gynecologist will recommend which is best to place an intrauterine device. Below we will talk about the most popular contraceptive intrauterine devices.

Mirena

Mirena is considered the most effective hormonal IUD. It has a T-shape, so it can be used by most women.

The product has a high degree of protection against unwanted pregnancy, suppresses ovulation, reduces the possibility of developing ectopic pregnancy, eliminates inflammation in the reproductive system, and regulates the menstrual cycle.

The service life is from 5 to 7 years. Price - 7-10 thousand rubles.

Nova T

Made in a T-shape. In the budget version it is made of plastic and copper, in the expensive version - from silver.

The product has a detrimental effect on sperm, reduces their motility and the ability to fertilize an egg. The price of the product is from 2 thousand rubles, while the service life is no more than 5 years.

Juno

Belarusian doctors were involved in the development of this spiral. There are many varieties of this spiral on sale, including for women in labor and those who do not yet have children. The price of the product ranges from 250-1000 rubles.

Main types of Juno model:

• Juno Bio Multi - made in F shape with jagged edges. Can be used by women who have given birth and those who have had an abortion.
• Juno Bio Multi Ag - made in a T-shape. The leg of the product is wrapped with copper and silver threads.
• Juno Bio-T is an inexpensive option in the shape of an anchor with a copper thread on the rod.
• Juno Bio-T Super is the same as the previous model, but with an antimicrobial composition.
• Juno Bio-T Au - golden spiral, suitable for women with allergies to metals.

Goldlily

Goldlily (also called Lily) is an effective non-hormonal product that helps prevent unwanted pregnancy. The main metals of the product are gold and copper. These materials release some metal into the uterine cavity, which has an anti-inflammatory effect.

According to the instructions, this intrauterine device can be used for emergency contraception after unprotected or interrupted sexual intercourse during the first days after it. Copper ions have a spermicidal effect.

This spiral is made of polyethylene in a T-shape, wrapped with metal wire. The service life is up to 7 years.

Multiload

This product is made in the shape of an umbrella; there are protrusions of spikes on its sides, which help to securely secure the product in the uterine cavity. The leg of the product is wrapped in copper, which inhibits sperm and neutralizes their ability to fertilize.

The spiral can be used in nulliparous women. The price of the device starts from 3,500 rubles.

Side effects

After installation of an intrauterine device, side effects are extremely rare. Modern technologies for manufacturing IUDs minimize the risk of their formation.

But in some cases, you should not postpone a visit to the gynecologist after inserting the IUD, especially if you have the following symptoms:

• pain in the lower abdomen;
• discomfort during intimacy;
• heavy bleeding;
• there are signs of infection (unpleasant odor, unusual vaginal discharge, burning or itching in the perineum);
• bleeding during sexual intercourse;
• shortening or lengthening the threads from the spiral.

Contraindications

It is prohibited to install or use an IUD in certain cases:

• endometriosis;
• anemia;
• pregnancy;
• diseases of the endocrine system;
• acute inflammatory processes of the genital organ;
• previous history of ectopic pregnancy;
• abnormal uterine structure;
• bleeding in the uterus;
• problems with blood clotting;
• formations in the uterine cavity;
• chronic inflammatory processes of the genital organ;
• cervical dysplasia.

Intrauterine device - photo

Price

Several factors influence the final cost of IUD installation. These include the type of product and the clinic where the installation will take place. This type of contraception is affordable for most women.

In some antenatal clinics, IUDs are installed free of charge. It will not hurt to know that taking oral contraceptives, as a rule, is more expensive than the IUD.

You can buy a spiral at a pharmacy or online store. How much it costs depends on the model, material, manufacturer, and the presence or absence of side effects. The price of an IUD ranges from 300-10,000 rubles.

Prevention from unwanted pregnancy, or contraception, helps a woman maintain her health:

• reduces the frequency of abortions;
• helps plan 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 Scandinavia. In everyday speech, the term “intrauterine device” is often used.

Advantages of intrauterine contraception:

• relatively low cost;
• long period of use;
• rapid restoration of fertility after removal of the IUD;
• Possibility of use during breastfeeding and with concomitant diseases;
• therapeutic effect on the endometrium (using a hormonal intrauterine system);
• preservation of the physiology of sexual intercourse, lack of preparation, fullness of sensations during intimacy.

Types of intrauterine devices

There are two types of intrauterine contraception:

• inert;
• medicinal.

Inert intrauterine contraceptives (IUDs) are plastic products of various shapes that are inserted into the uterine cavity. Their use has been discouraged since 1989, when the World Health Organization declared them ineffective and dangerous to women'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 hormonal agents can increase the effectiveness of the spirals and reduce the number of side effects.

In Russia, the following VMKs have gained the greatest popularity:

• Multiload Cu 375 – has the shape of the letter F, covered with copper winding with an area of ​​375 mm 2, designed for 5 years;
• Nova-T - in the shape of the letter T, has a copper winding with an area of ​​200 mm 2, designed for 5 years;
• Cooper T 380 A – copper-containing T-shaped, lasts up to 8 years;
• hormonal intrauterine system "Mirena" - contains levonorgestrel, which is gradually released into the uterine cavity, providing a therapeutic effect; designed for 5 years.

Less commonly used are IUDs that release medroxyprogesterone or norethisterone.

Which intrauterine device is better?

This question can only be answered after an individual consultation, taking into account the woman’s age, her state of health, smoking, the presence of gynecological diseases, planning a future pregnancy and other factors.

Mechanism of action

The principle of operation of the intrauterine device is the destruction of sperm and disruption of the process of attachment of the embryo in the uterine cavity. Copper, which is part of many IUDs, has a spermatotoxic effect, that is, it kills sperm that enter the uterus. In addition, it enhances the capture and processing of sperm by special cells - macrophages.

If fertilization does occur, the abortive effect of the contraceptive begins, preventing implantation of the fertilized egg:

• contractions of the fallopian tube intensify, while the fertilized egg enters the uterus too quickly and dies;
• the presence of a foreign body in the uterine cavity 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 uterine walls is activated;
• When using an intrauterine hormonal system, endometrial atrophy occurs.

The Mirena intrauterine system constantly releases the hormone levonorgestrel from a special reservoir at a dose of 20 mcg per day. This substance has a gestagenic effect, suppresses the regular proliferation of endometrial cells and causes endometrial atrophy. As a result, menstruation becomes scanty or disappears completely. Ovulation is not disturbed, hormonal levels do not change.

Is it possible to get pregnant if you have an intrauterine device?? The effectiveness of intrauterine contraception reaches 98%. When using copper-containing products, pregnancy occurs in 1-2 women out of a hundred within a year. The effectiveness of the Mirena system is several times higher; pregnancy occurs in only 2-5 women out of a thousand within a year.

How to place an intrauterine device

Before inserting an IUD, you need to make sure there is no pregnancy. The procedure can be carried out regardless of the phase of the menstrual cycle, but it is best on days 4-8 of the cycle (counting from the first day of menstruation). It is necessary to analyze smears for microflora and degree of purity, as well as an ultrasound examination to determine the size of the uterus.

The procedure takes place on an outpatient basis without anesthesia. This is a virtually painless procedure. In the first days after insertion of the IUD, you may experience aching pain in the lower abdomen caused by contractions of the uterus. The first and 2-3 subsequent menstruation may be heavy. At this time, spontaneous expulsion of the spiral is possible.

After an induced abortion, the IUD is usually installed immediately after manipulation, after childbirth - 2-3 months later.

The introduction of an IUD after a cesarean section is carried out six months later to reduce the risk of infectious complications. Spirals can be used during breastfeeding, which is their great advantage.

After insertion of an IUD for a week, a woman is prohibited from:

• intense physical activity;
• hot baths;
• taking laxatives;
• sex life.

The next examination is scheduled for 7-10 days, and then, if there are no complications, after 3 months. After each menstruation, a woman should independently check for the presence of IUD threads in the vagina. It is enough to undergo an examination by a gynecologist once every six months, if there are no complaints.

Removing the intrauterine device

Removal of the IUD is carried out at will, with the development of certain complications or after the expiration of the period of use. In the latter case, a new contraceptive can be introduced immediately after removing the previous one. To remove the IUD, an ultrasound examination is first performed and the location of the spiral is determined. Then, under the control of a hysteroscope, the cervical canal is expanded and the spiral is removed by pulling the “antennae”. If the “antennae” breaks, the procedure is repeated in the hospital. If the intrauterine device penetrates the wall of the uterus and does not cause complaints, it is not recommended to remove it unless necessary, as this can lead to complications.

Complications of intrauterine contraception

Side effects from the intrauterine device:

• pain in the lower abdomen;
• genital infection;
• uterine bleeding.

These symptoms do not develop in all patients and are considered complications.

Pain in the lower abdomen

Occurs in 5-9% of patients. Cramping pain accompanied by bloody discharge is a sign of spontaneous expulsion of the IUD from the uterine cavity. To prevent this complication, non-steroidal anti-inflammatory drugs are prescribed during the post-injection period.

Constant intense pain occurs if the contraceptive does not match the size of the uterus. In this case, it is replaced.

Sudden sharp pain may be a sign of uterine perforation with penetration of part of the spiral into the abdominal cavity. The incidence of this complication is 0.5%. Incomplete perforation often goes undetected and is diagnosed after unsuccessful attempts to remove the IUD. In case of complete perforation, emergency laparoscopy or laparotomy is performed.

Genital infection

The frequency of infectious and inflammatory complications (and others) ranges from 0.5 to 4%. They are difficult to tolerate and are accompanied by severe pain in the lower abdomen, fever, and purulent discharge from the genital tract. Such processes are complicated by the destruction of tissue of the uterus and appendages. To prevent them, broad-spectrum antibiotics are prescribed for several days after insertion of the IUD.

Uterine bleeding

Uterine bleeding develops in 24% of cases. Most often it manifests itself as heavy 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, and degenerative changes in internal organs. To prevent bleeding, it is recommended to take combined oral contraceptives two months before insertion of the IUD and for 2 months after. If menorrhagia leads to anemia, the IUD is removed.

Onset of pregnancy

IUD reduces the likelihood of pregnancy. However, if it does occur, the risk is higher than among other women.

If pregnancy occurs while using the IUD, there are three scenarios:

1. Artificial termination, because such a pregnancy increases the risk of infection of the embryo and in half of the cases ends in spontaneous abortion.
2. Removal of the IUD, which can lead to spontaneous abortion.
3. Preservation of pregnancy, while the device does not harm the baby and is released along with the membranes during childbirth. This increases the risk of pregnancy complications.

The ability to conceive and bear a child is restored immediately after removal of the intrauterine contraception; pregnancy occurs within a year in 90% of women who did not use other methods of contraception.

Indications for use

This type of contraception in nulliparous women can cause serious complications that prevent future pregnancies. The intrauterine device for nulliparous women can be used only if it is impossible or unwilling to use other methods. For such patients, mini-spirals containing copper, for example, Flower Cuprum, are intended.

It makes no sense to install an IUD for a short period of time, so a woman should not plan a pregnancy for the next year or longer.

IUDs do not protect against sexually transmitted diseases. It is believed that, on the contrary, they increase the risk of developing and worsen the course of such diseases.

IUDs are most often used in the following situations:

• increased fertility, frequent pregnancies against the background of an active sexual 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 to the intrauterine device

Absolute contraindications:

• pregnancy;
• endometritis, adnexitis, colpitis and other inflammatory diseases of the pelvic organs, especially acute or chronic with constant exacerbations;
• cancer of the cervix or uterine body;
• previous ectopic pregnancy.

Relative contraindications:

• uterine bleeding, including heavy menstruation;
• endometrial hyperplasia;
• congenital or acquired deformation of the uterus;
• blood diseases;
• severe inflammatory diseases of internal organs;
• previously occurred spontaneous expulsion (expulsion) of the ICH;
• intolerance to the components of the spiral (copper, levonorgestrel);
• absence of childbirth.

In these situations, the use of an intrauterine hormonal system is often justified. Its use is indicated for endometrial pathology, heavy bleeding, painful menstruation. Therefore, the gynecologist will be able to choose the right intrauterine device after examining and examining the patient.

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

IUD classification

This type of contraception is used by more than 16% of Russian women of reproductive age. To find out what is good about an intrauterine device and which one best protects against pregnancy, you need to know which devices can be purchased on the domestic market.

There are several types of intrauterine contraceptives:

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

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

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

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

Mechanism of action

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

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

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

Advantages

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

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

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

Flaws

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

Contraindications

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

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

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

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

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

Examination before insertion of the IUD

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

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

Time of IUD insertion

According to WHO experts, the IUD can be inserted on any day, but the most favorable days are considered to be days 4-7 of the menstrual cycle. This is explained by the fact that at the specified time the uterine mucosa has been restored after rejection of the endometrium, is slightly open, the presence of menstruation is a reliable sign of the absence of pregnancy, and minimal bleeding that occurs after insertion does not bring discomfort to the woman.

After an induced abortion or self-abortion, the IUD can be inserted immediately or within 4 days if there are no signs of bleeding or inflammation.

Complications

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

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

Inflammatory diseases are complications that are observed in 3.8-14.5% of cases when the IUD of the second group is inserted. Moreover, if inflammation occurs in the first 3 weeks, then its occurrence can be associated with the introduction of an IUD; if after 3 months, then this is a newly emerging disease. The formation of a purulent tubovarial formation is the most dangerous inflammatory complication. It occurs with prolonged use of the spiral - more than 6-7 years.

Bloody discharge is possible in the first days after administration (2.1-3.8% of cases) and can be stopped by prescribing hemostatic agents. If bleeding continues, is accompanied by pain, or occurs between menstruation and does not respond to treatment, then it is necessary to remove the coil.

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

The effectiveness of intrauterine contraceptives

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

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

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

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

Anna Mironova

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Is it worth or not to install a spiral? This question is asked by many women who choose a method of protection against unwanted pregnancy. An intrauterine device is a device (usually made of plastic with gold, copper or silver) that serves as a fertilization blocker and (if fusion does occur) as a barrier to the entry of an egg into the uterine cavity or its attachment to the walls of the uterus.

What types of intrauterine device are offered today? , what is better to choose, and what might the installation entail?

Types of intrauterine devices today

Of all the known contraceptives, the spiral is today one of the three most effective and popular. There are more than 50 types of spirals.

They are conventionally divided into 4 generations of this device:

• Made from inert materials

An option that is no longer relevant in our time. The main disadvantage is the risk of the device falling out of the uterus and an extremely low degree of protection.

• Coils containing copper

This component “fights” sperm that has entered the uterine cavity. Copper creates an acidic environment, and due to inflammation of the uterine walls, the level of leukocytes increases. Installation period is 2-3 years.

• Spirals with silver

Installation period – up to 5 years. Very high level of protection.

• Spirals with hormones

The leg of the device is in the shape of a “T”, and it contains hormones. Action: a certain amount of hormones are released into the uterine cavity every day, as a result of which the process of release/maturation of the egg is suppressed. And due to the increase in the viscosity of mucus from the cervical canal, the movement of sperm slows down or stops. Installation period is 5-7 years.

The shapes of the intrauterine device (IUD) are an umbrella, a direct spiral, a loop or a ring, the letter T. The latter is the most popular.

The most popular types of IUDs today

• IUD Mirena

Features: T-shape with levonorgestrel hormone in the shaft. The drug is “thrown out” into the uterus at a dose of 24 mcg/day. The most expensive and effective spiral. Price – 7000-10000 rub. Installation period is 5 years. The IUD helps treat endometriosis or uterine fibroids (plus), but also leads to the formation of follicular ovarian cysts.

• IUD Multiload

Features: oval shape with spikes-protrusions to reduce the risk of falling out. Made from plastic with copper wire. Cost – 2000-3000 rubles. Prevents fertilization (sperm die due to the inflammatory reaction caused by copper) and implantation of the embryo (when it appears) in the uterus. It is considered an abortifacient method of contraception (as, indeed, any other IUD). Use is permitted for women who have given birth. Side effects: increased duration and pain of menstruation, pain in the lower abdomen, etc. The contraceptive effect can be reduced when taking antidepressants.

• Navy Nova T Cu

Features: shape – “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, the tip has a thread with 2 tails. The action of the IUD: neutralizes the ability of sperm to fertilize an egg. Disadvantages: does not exclude the possibility of an ectopic pregnancy; there are known cases of uterine perforation during installation of the IUD; it causes heavy and painful periods.

• Navy T-Copper Cu 380 A

Features: shape – “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 who have given birth. Special instructions: heating of fragments of the spiral (and, accordingly, their negative impact on surrounding tissues) is possible during thermal procedures.

• Navy T de Oro 375 Gold

Features: contains 99/000 gold, Spanish manufacturer, price – about 10,000 rubles, installation period – up to 5 years. Action: protection against pregnancy, reducing the risk of uterine inflammation. The shape of the IUD is a horseshoe, T or U. The most common side effects are increased intensity and duration of menstruation.

The pros and cons of intrauterine devices

The advantages of the IUD include the following:

• A long period of validity - up to 5-6 years, during which you can (as the manufacturers say) not worry about other methods of contraception and accidental pregnancy.
• The therapeutic effect of some types of IUDs (bactericidal effect of silver ions, hormonal components).
• Saving on contraceptives. Buying an IUD is cheaper for 5 years than constantly spending money on other means of contraception.
• The absence of side effects that occur after taking hormonal pills - obesity, depression, frequent headaches, etc.
• The ability to continue breastfeeding. The spiral will not affect the composition of the milk, unlike tablets.
• Restoring the ability to conceive from 1 month after removal of the IUD.

Arguments against the use of the IUD - disadvantages of the IUD

• No one gives a 100% guarantee of protection against pregnancy (maximum 98%). As for ectopic pregnancy, the IUD increases its risk by 4 times.
• No IUD guarantees the absence of side effects. In the best case – pain and increase in the duration of menstruation, abdominal pain, discharge (bloody) in the middle of the cycle, etc. In the worst case – rejection of the device or serious health consequences.
• Risk of spontaneous removal of the IUD from the uterus. Typically after lifting weights. This is usually accompanied by cramping abdominal pain and fever (if there is an infection).
• The IUD is prohibited if at least one item from the list of contraindications is present.
• When using an IUD, regular monitoring of its availability is required. More precisely, its threads, the absence of which indicates a shift in the spiral, its loss or rejection.
• One of the most significant disadvantages is the risk of prematurity in the future due to depletion of the endometrium in the uterus.
• Experts advise terminating a pregnancy that occurs while using an IUD. Preservation of the fetus depends on the location of the IUD itself in the uterus. It is worth noting that when pregnancy occurs, the IUD is removed in any case, and the risk of miscarriage sharply increases.
• The IUD does not protect against sexually transmitted diseases and the penetration of various types of infections into the body. Moreover, it promotes their development, because the body of the uterus remains slightly open when using the IUD.
• When inserting an IUD, there is a risk (0.1% of cases) that the doctor will puncture the uterus.
• The mechanism of action of the spiral is abortifacient. That is, it is equivalent to an abortion.

• Any pathology of the pelvic organs.
• Diseases of the pelvic and reproductive organs.
• Tumors of the cervix or the uterus itself, fibroids, polyps.
• Pregnancy and suspicion of it.
• Cervical erosion.
• Infection of the internal/external genitalia at any stage.
• Defects/underdevelopment of the uterus.
• Tumors of the genital organs (already confirmed or if their presence is suspected).
• Uterine bleeding of unknown origin.
• Allergy to copper (for IUDs containing copper).
• Adolescence.

Relative contraindications:

• Ectopic pregnancy or suspicion of it.
• Diseases of the cardiovascular system.
• Poor blood clotting.
• Endometriosis (whether past or present).
• No history of pregnancy. That is, for nulliparous women, the IUD is not prohibited, but is categorically not recommended.
• Menstrual irregularities.
• Little uterus.
• Venereal diseases.
• Scars on the uterus.
• The risk of catching a sexually transmitted disease. That is, several partners, a partner with diseases, promiscuity, etc.
• Long-term treatment with anticoagulants or anti-inflammatory drugs, which continues at the time of installation of the spiral.
• It is not uncommon for a spiral to grow into the uterus. Sometimes women simply forget about it, and as a result they have to cut out the spiral along with the uterus.

Doctors' opinions about the IUD - what experts say

After installation of the IUD

• Not a 100% contraceptive method, the benefits of which are outweighed by side effects and the risk of serious consequences. Definitely not recommended for young nulliparous girls. The risk of infection and ectopic infection increases significantly. Among the advantages of the spiral: you can safely engage in sports and sex, obesity is not a threat, the “antennae” does not even bother your partner, and in some cases there is even a therapeutic effect. True, sometimes it is crossed out by consequences.
• There have been many studies and observations regarding the IUD. Still, there are more positive aspects. Of course, no one is immune from the consequences, everyone is individual, but for the most part, spirals today are quite safe means. Another question is that they do not protect against infections and diseases, and if there is a risk of developing cancer, their use is strictly prohibited. It is also worth mentioning the use of medications in combination with the use of hormonal IUDs. For example, regular aspirin significantly reduces (by 2 times!) the main effect of the IUD (contraception). Therefore, when treating and taking medications, it makes sense to use additional contraceptives (condoms, for example).
• Whatever you say, regardless of the elasticity of the IUD, it is a foreign body. And accordingly, the body will always react to the introduction of a foreign body according to its characteristics. One has increased pain during menstruation, the second has abdominal pain, the third has problems with bowel movements, etc. If the side effects are severe, or they do not go away after 3-4 months, then it is better to abandon the IUD.
• The use of an IUD is definitely contraindicated for 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 to use an IUD must be made strictly individually! Together with a doctor and taking into account ALL 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 body features as allergies to metals and foreign bodies.
• In fact, making a decision about an IUD - to have it or not to have it - must be done carefully. It’s clear that this is convenient - once you install it, you don’t have to worry about anything for several years. But there are 1 – consequences, 2 – a wide list of contraindications, 3 – a lot of side effects, 4 – problems with bearing a fetus after using the IUD, etc. And one more point: if the work involves lifting heavy objects, you should absolutely not mess with the IUD. It would be good if the IUD turns out to be the ideal solution (in any case, it is better than an abortion!), but you should still carefully weigh all the possible problems and advantages.

Possible consequences of intrauterine devices

According to statistics, most refusals from the IUD in our country are for religious reasons. After all, the IUD is actually an abortifacient method, because most often the fertilized egg is expelled at the approaches to the uterine wall. Others refuse the IUD because of fear (“an unpleasant and slightly painful installation procedure), because of side effects and because of possible consequences.

Is it really worth worrying about the consequences? What can the use of an IUD lead to?

First of all, it is worth noting that complications of various types 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 recommendations), due to low qualification of the doctor who installs the spiral, etc.

So, the most common complications and consequences when using an IUD:

• Infection/inflammation of the pelvic organs (PID) – up to 65% of cases.
• Rejection of the IUD by the uterus (expulsion) – up to 16% of cases.
• Spiral ingrowth.
• Very heavy bleeding.
• Severe pain syndrome.
• Miscarriage (if pregnancy occurs and the IUD is removed).
• Ectopic pregnancy.
• Depletion of the endometrium and, as a result, a decrease in the ability to bear a fetus.

Possible complications from using copper-containing IUDs:

• Long and heavy menstruation - more than 8 days and 2 times stronger. In most cases, they can be normal, but they can also be a consequence of an ectopic pregnancy, an interrupted normal pregnancy, or perforation of the uterus, so don’t be lazy about going to the doctor again.
• Cramping pain in the lower abdomen. Similarly (see point above) - it’s better to play it safe and get checked by a doctor.

Possible complications from using an IUD containing hormones:

• The most common complication is amenorrhea. That is, the absence of menstruation. If the culprit of amenorrhea is not an ectopic pregnancy, but an IUD, then the reason is reversible atrophy of the uterine epithelium.
• A disrupted menstrual cycle, the appearance of spotting in the middle of the cycle, etc. If such symptoms are observed for more than 3 months, a gynecological pathology should be excluded.
• Symptoms of the action of gestagens. That is, acne, migraines, breast tenderness, “radiculitis” pain, vomiting, decreased libido, depression, etc. If symptoms persist for 3 months, gestagen intolerance can be suspected.

Possible consequences of violating the IUD installation technique.

• Perforation of the uterus. Most often observed in nulliparous girls. In the most difficult cases, the uterus has to be removed.
• Cervical rupture.
• Bleeding.
• Vasovagal reaction

Possible complications after removal of the IUD.

• Inflammatory processes in the pelvic organs.
• Purulent process in the appendages.
• Ectopic pregnancies.
• Chronic pelvic pain syndrome.
• Infertility.