Spiral gynecological. Everything you need to know about the contraceptive spiral. Indications for use

The intrauterine device is a contraceptive that is installed in the uterine cavity. Suitable only for women with a normal menstrual cycle and no signs of hormonal disorders. For nulliparous girls, this method of contraception is not used.

The intrauterine device is a proven method of contraception

Pros and cons of the Navy

If the spiral is installed in accordance with the requirements of medical protocols, then the woman does not feel this contraceptive.

Navy Advantages:

• efficiency - from 80 to 99% depending on the type of device;
• long-term effect - the service life is from 3 to 5 years;
• reversibility - after removal, fertility is restored within 1-2 cycles;
• is not felt by either the woman or the partner;
• the presence of VSM is not a contraindication to taking other medicines, surgical treatment;
• no additional contraception required;
• a variety of models and prices - from budget to expensive.

Despite the large number of advantages, this method of protection has several disadvantages.

Cons of the Navy:

• the body of the uterus remains ajar, which contributes to the penetration of pathogenic flora;
• foreign device in the uterus;
• lengthening of menstruation, an increase in the volume of released blood;
• the risk of ectopic pregnancy increases by 4 times;
• expulsion - independent loss of the device;
• the likelihood of perforation of the uterine wall;
• does not protect against STDs;
• completed pregnancy - the spiral interferes with the normal development of the child, increases the risk of complications in childbirth. Often such a pregnancy has to be terminated surgically.

Types of intrauterine devices

In appearance - in the photo - this is a small-sized device made of plastic and metal of a T-shaped or annular shape, as well as in the form of a loop or umbrella. The classification of intrauterine concepts depends on the metal from which it is made, the content of drugs, its shape.

plastic intrauterine device

As contraceptives improved, 3 generations of IUDs were identified:

1. Plastic, acted on the principle of blocking the implantation of the fetal egg. The effectiveness is low, therefore it is currently prohibited for use.
2. Metal-containing devices. Allocate devices with copper wire, with silver and gold. The latter are more effective and their validity period is up to 10 years.
3. Hormonal devices. The efficiency is 100%. In addition, they have a therapeutic effect and are one form of treatment for endometriosis.

What does the Navy look like?

1. Semi-oval or umbrella-shaped - equipped with corrugation or spikes, which allows the spiral to be securely held in the uterine cavity. The introduction of this form is painless, since it is installed in a folded state, and then it is located inside in an unfolded form. Suitable for women giving birth and patients after caesarean section.
2. Round or ring - during installation, pain is possible. Not recommended for women after caesarean section, with a history of 1 birth.
3. In the shape of the letter "T" - has a gold, silver or copper base and plastic hangers. It is convenient for installation, does not cause discomfort to a woman. But the risk of spontaneous loss is higher than other varieties. Recommended for patients after caesarean section or with 1 birth in history.

The principle of operation of intrauterine devices

All vaginal devices have a complex mechanism of action. This improves the efficiency of the IUD.

The device blocks the passage of sperm into the uterine cavity, damages them, reduces the life of the egg and prevents the fertilized egg from attaching to the uterine wall.

The mechanism of action of the spiral on the body:

1. Inhibition of ovulatory processes. Against the background of the use of the device, there is a slight increase in the production of LH. But the amount of estrogen and progesterone does not change. This inhibits the production and maturation of eggs.
2. Implant warning. When using a spiral, the cyclical formation of the endometrium is disrupted. The first phase of the cycle is lengthened, so the mucosa is not ready for the attachment of the embryo.
3. Obstruction of the movement of spermatozoa. After the installation of the IUD, aseptic inflammation develops. The level of leukocytes, the production of phage cells increases. They actively destroy the trapped spermatozoa and isolate the egg.
4. Changes in the nature of the movement of germ cells in the fallopian tubes. Minor hormonal disorders, the presence of a foreign object contribute to a change in the peristalsis of the fallopian tubes. As a result, the egg either does not enter the uterus or enters the period of the immature endometrium.

The principle of operation of the intrauterine device

Overview of the best Navy

It is better to put the device that the gynecologist selected based on the patient's history. Popular brands of contraceptive medical devices:

Nova T

Non-hormonal spiral T-shaped. Production material - copper and silver. The use of 2 types of wire allows you to increase the duration of the IUD up to 5 years.

Nova T - non-hormonal spiral

It is intended for women with a history of 1-2 births, as well as episodes of adnexitis and other inflammatory diseases of the reproductive organs. The average cost is 4 thousand rubles.

Jaydes

Spiral with levonorgestrel and silver ring. The manufacturer is Bayer. The device is valid for 3 years. The mechanism of action is based on the thickening of mucus in the cervical canal, inhibition of sperm activity. Not applicable to nulliparous women.

Packing Navy Jaydes

The probability of falling within 3 years is 1%. The most significant side effect is the cessation of menstruation. On the territory of the Russian Federation, the Jaydes device is not for sale. The price in Ukraine is 2000 hryvnia.

Multiload

Copper non-hormonal T-shaped spiral. Allowed during breastfeeding. On the pharmaceutical market, there are 2 types of devices with different surface area of ​​copper wire - 250 mm and 375 mm. The service life of the first type is 5 years, the second - up to 8 years. The main side effect is an increase in menstrual flow.

Multiload - Copper T-Spiral

After installing the equipment, it is not advisable to use tetracycline antibiotics, drugs of the NSAID group. This reduces the effectiveness of the contraceptive. The cost of the device is 3800 rubles.

Juno

This brand has several varieties of contraceptive. Horseshoe and T-shaped products are produced with copper, silver and gold wire, containing propolis as an anti-inflammatory agent. Approved for use for patients with chronic diseases of the fallopian tubes, endometritis.

Navy Juno packaging

The cost of the device depends on the material from which it is made. Copper and silver - an average of 550 rubles, gold - up to 4 thousand rubles. rubles.

Mirena

Hormonal T-shaped coil with levonorgestrel. The drug inhibits the development of the endometrium. This product is positioned as a remedy for menstrual disorders, endometriosis.

Hormonal T-coil Mirena

Assign women over 40 years. Smoking reduces the effectiveness of the device. The spiral works 5 years. The cost of the device is 14 thousand rubles. rubles.

How is the spiral placed?

The installation of a gynecological device from pregnancy is carried out only in a medical institution. The procedure does not require hospitalization.

Preparation

Before installing the spiral, you should undergo a comprehensive examination by a gynecologist. This will eliminate inflammatory processes and contraindications to device implantation.

Preparation consists of the following steps:

• examination by a doctor with a vaginal discharge for examination;
• PCR analysis - to exclude STDs - is carried out only if the patient has complaints;
• blood and urine tests;
• Ultrasound and colpicoscopy - to assess the state of the reproductive system, to exclude a possible pregnancy.

Before the procedure, sexual intercourse is prohibited for 2 days and the use of local antibacterial drugs.

Before installing the spiral, a colpicoscopy is performed

Installation

The introduction of an intrauterine contraceptive is carried out on the 4-5th day of menstruation. During this period, the uterus is ajar, which facilitates the installation of the device. The duration of the procedure is 5 minutes.

Sequence of operations:

1. The patient is placed on an examination chair.
2. Mirrors are inserted into the vagina, the cervix is ​​treated with an antiseptic solution.
3. The doctor uses a probe to measure the length of the uterus.
4. A plastic conductor is introduced, which is included with the device. The IUD is pushed into the uterine cavity with the help of a piston.
5. The device is removed. The threads are brought out into the vagina. They are cut to the desired length. The patient needs them to control the presence of the spiral in the reproductive organs.

On the card, the doctor will mark the date of installation of the equipment. After 10 days, a follow-up examination of the patient is shown.

Sexual life is allowed to begin 14 days after the installation of the spiral. It is undesirable to use hygienic tampons in this cycle.

Side effects

Side effects can develop immediately after implantation of the device, but also against the background of prolonged use of the spiral.

Possible complaints after the introduction of the IUD:

• pain during menstruation, during sexual intercourse, outside of menstruation;
• uterine and ectopic pregnancy;
• anemia;
• individual reactions to the hormonal components of the device;
• allergic reactions to the metal components of the coil.

After the insertion of the IUD, there may be pain during menstruation

Contraindications to the installation of a contraceptive

Contraindications to the use of this method of contraception are divided into absolute and relative.

It is forbidden to install spirals against pregnancy in the following cases:

• cancer of the reproductive organs;
• pregnancy;
• suspicion of pregnancy;
• inflammatory processes in the acute stage;
• uterine bleeding of unknown origin;
• the presence of several partners, promiscuity in sexual relations.

You can not install a spiral with inflammation in the uterus

Relative contraindications to IUD insertion:

• chronic inflammatory processes of the reproductive system in history;
• the presence of an ectopic pregnancy in history;
• violation of the menstrual cycle, heavy menstruation;
• malformations of the uterus;
• endometriosis;
• inflammatory processes in other organs;
• spontaneous loss of a contraceptive in the past;
• narrowing of the cervical canal;
• fibroids;
• diseases of the cardiovascular system, blood.

Possible consequences

Possible consequences and complications after the installation of a female contraceptive:

• injuries during the equipment installation procedure, development of bleeding;
• spiral fallout;
• violation of the menstrual cycle;
• a pregnancy that ends, as a rule, with a surgical abortion;
• the development of chronic inflammatory processes after the removal of the contraceptive and against the background of the use of the device;
• unsuccessful attempts to remove the device, ending with surgical curettage of the uterine epithelium;

The procedure is carried out only in a medical institution during menstruation.

Removal of the spiral is carried out only in a medical institution

Possible options for removing the spiral:

• outpatient - the control threads are captured by the instrument and the IUD is removed from the uterus;
• using a hysteroscope under anesthesia;
• laparoscopically through the abdominal cavity - if it is impossible to remove medical equipment through the cervical canal.

You should not remove the equipment yourself, even if you clearly feel the control threads - this is fraught with injuries to the epithelium and the body of the uterus, the cervical canal.

In women after 25-30 years. This popularity is due, first of all, to ease of use (placed in the uterine cavity).

Modern IUDs are made of inert plastic wrapped with the finest copper wire, which increases the efficiency and duration of the coil. In addition, the spiral may contain silver, gold, other additives (for example, propolis). Their purpose is to reduce the risk of developing inflammatory diseases of the uterus when using the IUD, but, according to some reports, they also reduce the effectiveness of contraception. Hormone-containing spirals are a separate item, we will talk about them a little lower.

The contraceptive effect of the IUD is that the spiral makes it difficult for the sperm to move towards the egg and, consequently, its fertilization. In addition, the IUD prevents the implantation of the fetal egg due to its accelerated flow from the fallopian tubes and the lack of a full-fledged secretory transformation of the endometrium.

Pros of using copper containing IUDs quite significant:

However, this method of contraception also has the largest number of contraindications and side effects, which significantly limits the range of its application. Once again, the proverb "not all that glitters is gold" is justified.

TO side effects include:

These complications define a wide range of contraindications to the use of the IUD:

If we take into account that gynecologists do not recommend the use of IUDs for nulliparous women, then the circle of patients who, without any particular fear, can be introduced into the uterine cavity for a long time to prevent implantation of the ovum, is very limited.

Let's summarize: this method of contraception is suitable for absolutely gynecologically healthy women with light, regular, painless periods, having a child and one sexual partner and not guided by the conventions associated with religion.

A few words about hormonal IUDs

Available on the pharmacy market hormonal intrauterine system "Mirena". It occupies an intermediate position between the IUD and oral contraceptives. Around the vertical rod of the IUD is a cylindrical reservoir containing gestogen, which is released into the uterine cavity in microdoses and enters the inner layer of the uterus and blood. At the same time, a constant concentration of this hormone is maintained in the blood plasma at a level of 1/3 or 2/3 of the level of hormones when using conventional oral contraceptives. Mirena, combining the advantages of the IUD and oral contraceptives, does not have the disadvantages inherent in them separately.

How is the introduction and removal of the intrauterine device.

(Navy) by a gynecologist in the uterine cavity. At the end of the spiral, a special thread is fixed, which goes through the uterine canal and then out into the vagina. It serves to make it convenient for the doctor to remove the spiral if necessary.

Types of Navy

There are two types of intrauterine devices that are most common:
- hormonal coils (containing a special hormone levonorgestrel), such coils act for 5 years, while also performing a therapeutic function;
- copper-coated coils are very IUDs that can stay in the uterine cavity for up to 10 years.

The principle of operation of the Navy

All types of spirals have the ability to mechanically prevent the implantation of a fertilized egg in the uterine wall, as well as damage spermatozoa. Hormonal coils change the consistency of the mucus in the cervical canal, making it more viscous. Due to this, the penetration of spermatozoa into the uterus is almost impossible. In addition, hormonal spirals help to reduce the amount of discharge during menstruation and reduce their intensity.

Copper-coated coils cause damage to spermatozoa by exposure to copper ions, as well as the release of prostaglandins, enzymes and leukocytes into the uterine cavity, which have the ability to block the activity of sperm.

Why put the Navy

For the prevention of unwanted pregnancy, the intrauterine device is the most effective means. It can also be used within 5 days of unprotected intercourse. The effectiveness is much higher than that of tablets for emergency prevention of pregnancy.

The spiral is removed at the moment when the woman is ready to become pregnant. It is also necessary to remove and replace with a new coil, after a certain number of years after its installation, this time ranges from 3 to 10 years, depending on the type of coil and recommendations of its manufacturer.

IUD contraception is considered the most appropriate for most women, including nulliparous women and adolescents. You can install a spiral immediately after childbirth, 10 minutes after the placenta has passed, and also after a spontaneous or conscious abortion.

Contraindications for the installation of the IUD are: pregnancy, any anatomical changes in the uterine cavity, unexplained bleeding and pelvic infections. In the presence of these contraindications, complications are possible after the installation of the IUD.

Instruction

The contraceptive spiral is placed in the woman's uterus, after installation it is not felt in the body. This system is small in size (three and a half centimeters in length), and weighs very little. The coil contains the hormone levonorgestrel, the system releases a small dose of it daily. Since the hormone immediately reaches its destination, the body lacks a really meager amount. This hormone in a daily dose is seven and a half times less than in conventional contraceptives.

The intrauterine hormonal coil acts in three directions at once. Under the influence of levonorgestrel, the mucus in the cervix thickens significantly, which prevents the penetration of infections. In addition, its thickening interferes with the movement of spermatozoa. In addition, the hormone creates an uncomfortable environment for the spermatozoa in which they lose their mobility, so even if one of them managed to overcome the cervical mucus, he has very little chance of reaching the egg. In addition, under the action of levonorgestrel, the inner layer of the uterus thins, to which a fertilized egg must attach. After installing the spiral, the uterus cleanses itself from the inside, which has a beneficial effect on its health, moreover, even if a tenacious spermatozoon has managed to fertilize the egg, it simply has nowhere to attach itself. It should be noted that the moment of attachment of the fetal egg to the wall of the uterus is considered to be the moment, since this does not happen, it is impossible to consider the hormonal coil as an abortive method.

The hormonal spiral is established by the doctor for a period of three years. Please note that in the first months there will be an adaptation period, which can cause a number of inconveniences. First of all, this is due to the thinning of the endometrium (the inner layer of the uterus) and its removal to the outside, which affects menstrual flow. Within two to three months between periods, there may be a large amount of additional discharge. Do not be afraid, this is a normal process. After the end of the adaptation period, they most often decrease, become less abundant and painful.

If you first put yourself such a spiral, it is advisable to check with a doctor during the adaptation period. It is best to do this ten days later, in order to see with the help of ultrasound how well the spiral “got up”, and then three months after the end of adaptation, in order to check the condition of the body. After that, you need to visit the gynecologist every six months for the prevention and control of health.

Are you tired of keeping track of dangerous days and looking for options? How it works, what are the pros and cons of using an intrauterine device and who is suitable for the IUD, read the article.

The intrauterine device is an intrauterine contraceptive, a miniature T-shaped device made of plastic and copper, which prevents the fertilized egg from attaching to the uterine wall, slows down the progress of spermatozoa into the uterine cavity and reduces the life of the egg. Reviews prove that this is one of the most reliable.

The IUD releases the hormone progestogen into the uterus. This delays the development of the uterine mucosa, where the fertilized egg is introduced. Progestogen also thins the uterine lining, which prevents a fertilized egg from attaching to it. Some women may stop ovulating after the placement of a hormonal coil.

The IUD works for 5 years, or for 3 years, depending on the type. So you don't have to think about contraception every day or every time you have sex. The use of the IUD does not depend on whether you have children or not.

Intrauterine device: pros and cons

• The effectiveness of the intrauterine device is more than 99%. Pregnancy occurred in less than 1 case in 100 when using the Mirena IUD for 5 years. The Jaydess brand has similar statistics (the spiral is valid for 3 years).
• You can remove the spiral at any time with the help of a doctor, and fertility will quickly return to normal.

An IUD can make or stop periods, so it may help women who have painful periods.

Jaydess is less likely to stop menstruation than Mirena.

• The hormonal coil can be used by women who are not suitable for oral contraceptives due to migraines, for example.
• Some women may experience mood swings, skin problems, or breast tenderness after a coil is placed.
• It should also be remembered that there is a small risk of infection during the installation of the spiral.
• The process of inserting the coil can be uncomfortable, but painkillers can make it easier.

• The IUD does not protect against sexually transmitted infections (STIs). To protect yourself from STIs, you should use condoms.

How does an intrauterine device work

The hormonal IUD releases the hormone progestogen, which is similar to the natural hormone progesterone produced in a woman's ovaries.

Progestogen delays the development of the lining of the uterus, which prevents the passage of the sperm and its reaching the egg. It also thins the lining of the uterus, which prevents a fertilized egg from attaching to it.

The coil may also stop ovulation in some women, but in most cases, ovulation will continue as before.

Intrauterine spiral: how to put

The coil can be inserted at any time of the monthly menstrual cycle, as long as you are definitely not pregnant. Ideally, it should be installed within seven days of the start of your period because it will immediately protect you from pregnancy.

You will need to use condoms for the first seven days if an IUD is inserted at any other time of your cycle.

Before the coil is placed, you will have a complete examination to determine the size and position of the uterus. You may also be tested for existing infections, such as STIs. It is best to do this before an IUD is inserted so that infections can be treated. You may also be offered antibiotics during an IUD insertion.

The whole installation process takes about 15-20 minutes:

• the vagina is held open, as during a cervical smear
• The IUD is inserted through the cervix and into the uterine cavity

The adjustment process can be uncomfortable or painful for some women, and can be marked by cramps afterwards.

You may be asked to use a local anesthetic or pain medication prior to insertion. Discuss this with your healthcare provider ahead of time. The anesthetic injection itself can be more painful, which is why many women go through the procedure without it. Once the IUD is in place, you will need to check with your doctor 3-6 weeks later to make sure everything is okay.

Be sure to tell your doctor if you or your partner have been exposed to an STI, as this can lead to a pelvic infection.

Seek medical attention in such cases if, after insertion of an IUD,

• pain in the lower abdomen
• heat
• profuse discharge with an unpleasant odor

This may mean that there is an infection in the body.

How to determine if the spiral is in place

The IUD has two thin threads that hang down from the top of the vagina. The doctor who inserts the IUD will teach you how to feel for these threads and check if the coil is in place.

Check your IUD several times during the first month and then after each period at regular intervals. It is highly unlikely that the coil will come out, but if you don't feel for the threads or if you think the IUD has moved, you are not protected from pregnancy.

In this case, contact your doctor immediately and use additional contraception such as condoms until your IUD has been checked. If you have had sexual intercourse recently, you may need to resort to remedies.

Your partner should not feel your coil during sex. If he feels the threads, see a doctor to check the position of the helix .

Doctors will also be able to shorten the threads a little. If you experience pain during intercourse, see your doctor immediately.

Removal of the intrauterine device

The spiral can be removed at any time. If you do not intend to have the IUD inserted again, but do not plan to become pregnant, you will need to use another method of contraception (such as condoms) for seven days before the IUD is removed.

Sperm can stay in a woman's body for up to seven days and can fertilize an egg after the IUD is removed. As soon as the coil is removed from the body, your fertility returns.

If the coil is in a woman who is over 45 years old, the IUD can be left until the onset of menopause or until the period when contraception is no longer needed.

Intrauterine device: when and to whom you can put

Most women can use an IUD, including women who have never been pregnant and women who are HIV positive. Your healthcare provider will take your medical history to see if the hormonal coil is right for you as a contraceptive.

Intrauterine device: contraindications

• breast cancer, or have had the disease within the past five years
• cervical cancer
• liver disease
• unexplained vaginal bleeding between periods or after intercourse
• arterial disease or a history of serious heart disease or stroke
• untreated STI or pelvic infection
• problems with the uterus or cervix

Intrauterine device after childbirth

The coil can be installed as early as 4-6 weeks after childbirth (vaginal delivery and caesarean section). From 21 days after giving birth, that is, three weeks later, you will need to use alternative methods of contraception until the coil is installed. In some cases, an IUD may be inserted within 48 hours of delivery. It is safe for breastfeeding and does not affect the volume and flow of milk.

Intrauterine device after miscarriage or abortion

An IUD can be inserted by a doctor immediately after an abortion or miscarriage, if the gestational age has not exceeded 24 weeks. If you have been pregnant for more than 24 weeks, you may have to wait a few weeks before the coil is inserted.