An intrauterine device is the most common and reliable contraceptive. Therefore, women often consult a doctor about installing this device. The spiral, like any other method of contraception, has its contraindications and features, so there are many questions in this area. This article will provide information that every woman is encouraged to familiarize themselves with.
What is an intrauterine device?
An intrauterine device is a device that is made of medical plastic (synthetic material). The introduction of this contraceptive into the uterine cavity prevents the development of an unwanted pregnancy. Currently, spirals are small in size, which vary from 24 to 35 mm, in addition to plastic, the device includes metals (gold, silver, copper) that do not provoke inflammatory reactions. It may also contain the hormone levonorgestrel.
The development of the spiral began at the beginning of the last century, when Richter proposed using silk and bronze threads as a contraceptive. However, his adaptation did not find a response in women and was not popular. A little later, Grafenburg continued the modernization of the intrauterine device, and proposed a ring of silk threads and silver wire. However, in this case, the invention was doomed to failure. It had a significant drawback - loss.
In the middle of the last century, Lippes made a serpentine spiral, which was called the Lippes loop. Despite the fact that the invention is more zigzag in shape, it is a prototype of the modern intrauterine device.
Mechanism of action
The introduction of an intrauterine device does not have an overwhelming effect on ovulation and does not affect the synthesis of sex hormones. The effect of contraception is achieved as follows:
- Sperm activity and viability are reduced.
- Cervical mucus thickens, and it becomes difficult for sperm to enter the uterine cavity.
- As a result of the provocation of contractions of the muscle layer, the spiral increases the intensity of the peristalsis of the fallopian tubes. This leads to the fact that the egg is in the uterine cavity earlier than implantation is possible.
- The introduction of an IUD causes changes in the mucous membrane of the uterus. The so-called aseptic inflammation begins, which slightly injures the walls of the genital organ, which means that the conditions for the attachment of the egg deteriorate.
Such a mechanism of action is observed with the introduction of an intrauterine device of any kind, the composition and shape does not matter.
Types of spirals
A universal spiral that would suit any woman does not exist, so the doctor chooses the type of contraceptive, starting from the physiology of the patient and the structural features of the genital organ.
Now there are more than 50 types of spirals that are divided into several generations:
- Inert. This is the first generation of spirals that is considered obsolete. Their effectiveness is low, they can fall out and shift.
- Copper. This is the second generation of spirals. This type of contraception is a T-shaped device, which is entwined with copper wire. Copper creates an acidic environment in the uterine cavity, due to which sperm activity decreases. The term of use of the spiral is 3-5 years.
- Silver. All metals have the ability to oxidize and decompose, so experts began to insert silver into the spiral. As a result, sperm activity is further reduced, and silver ions have an antibacterial and disinfecting effect. Such a spiral can be used up to 7 years.
- Gold. The advantage of such a spiral is its complete biocompatibility with the female body. The metal is not subject to corrosion and does not cause allergic reactions. In addition, gold has an anti-inflammatory effect, which means that such a spiral remains effective for up to 10 years.
- Hormonal This is the latest generation of spirals, which are the most effective contraceptive. The hormonal drug in small doses is evenly excreted in the uterine cavity, but it does not enter the bloodstream, providing only local effects. Use this spiral can be up to 7 years.
As for the shape of the spirals, they can be as follows:
- T-shaped. This is the most common type that is easy to install and remove.
- Ring-shaped. These spirals are recommended for women after abortion.
- Looped. Are established for women with a non-standard structure of the uterus.
Overview of the most popular species
When a woman decides to put a spiral in her, the question arises as to which one is best used. As already mentioned, this issue needs to be approached individually and only a competent specialist can make the right choice. Most often, doctors establish the following types of spirals:
- "Multiload" - a T-shaped copper spiral that is not hormonal. Shelf life is 4 years. Standard length is 35 mm.
- “Copper” is also a copper spiral, but its feature is that it releases more copper into the uterine cavity, therefore, the local reaction will be stronger.
- “Goldlili” - this spiral contains gold, in addition, it is represented by a ruler of sizes, so every woman can choose the one she needs. The term of use is 7 years.
- Juno Bio-T - a spiral with silver. The term of use is 7 years.
- The Nova Spiral, which contains both copper and silver. It should be changed every 5 years.
- "Mirena" is a hormonal spiral. It is allowed to use for 5 years, then the supply of levonorgestrel is exhausted and there is a risk of developing infectious diseases.
Toolkit for Introduction
The registration certificate of the kit for the introduction of the intrauterine device is a document according to which the products are allowed for release on the market. Its presence means that the product is of high quality and safe.
The intrauterine device insertion kit must be sterile. All devices are sterilized in a dry oven or boiled, according to existing rules.
The kit for the introduction of an intrauterine device should be washed in soapy water, and then immersed for 3 days in a 2% solution of chloramine. Immediately before the introduction of the spiral, it is immersed for 2 hours in 96% ethanol.
Every woman should understand that it is important not only to install the spiral correctly, but also to use a high-quality and safe kit for introducing an intrauterine device. The registration certificate at the request of the woman must be provided to her by a medical professional.
Preparing for the introduction of a spiral
Some special training is not required. Only, before the procedure for introducing an intrauterine device, a woman takes a smear for the presence of infectious and inflammatory diseases. If they are found, it is necessary to undergo a course of treatment.
The installation of the spiral is carried out during menstruation, 3-4 days are considered optimal. A week before installing the spiral, it is recommended to refrain from sexual contact. Immediately before the procedure, a woman should empty her bladder.
Spiral introduction
The patient is placed in a gynecological chair, and the doctor performs a disinfectant treatment of the vagina and cervix. Then local anesthesia is done. After that, the specialist takes a kit for the introduction of an intrauterine device, opens the cervix and installs the device into the uterine cavity. The doctor displays the antennae of the spiral on the outside of the genital organ, then to remove the device.
The whole procedure takes 10 minutes. Does it hurt to put a spiral? In some cases, the patient may feel unpleasant sensations, which pass very soon, but in principle, the installation of a spiral is a painless procedure.
Sensations after the procedure
After the installation of a non-hormonal spiral, more plentiful and prolonged menstruation is possible, as well as spotting before menstruation or in between cycles.
To reduce possible complications, a woman should adhere to the following rules during the week:
- exclude sexual intercourse;
- avoid strong physical exertion;
- refuse to use tampons.
After 10 days, a scheduled examination is prescribed, during which an ultrasound can be used to monitor the location of the contraceptive.
When can I install the spiral after childbirth or abortion?
After uncomplicated labor, the intrauterine device can be placed on the third day. But most often, gynecologists advise doing this in a month or two, in order to prevent unwanted side effects and spiral rejection.
After cesarean section, the spiral is allowed to be installed no earlier than after 3-6 months. It is necessary that the postoperative scar is fully formed.
After the abortion, the helix is established in a week, however, in some cases, the doctor may recommend its installation immediately after the abortion.
After a miscarriage, only a doctor can tell about the possible timing of the installation of the spiral. Since it is necessary to assess the situation in this case individually.
Advantages and disadvantages
Advantages of the intrauterine device:
- Effective contraception, but I must say that the spiral does not provide absolute protection against unwanted pregnancy. Its effectiveness is 99%.
- The possibility of use by women who are contraindicated in hormonal contraceptives.
- Ease of use - no need for constant monitoring. It is enough to visit a gynecologist twice a year.
- Long service life.
As for the minuses, we can say about side effects, changes in the nature of the menstrual cycle, inflammatory diseases, trauma to the vagina and genital organ.
Contraindications and complications
Contraindications for the installation of the spiral can be absolute and relative.
Absolute:
- pregnancy;
- inflammatory diseases of the pelvic organs;
- oncology of the uterus or its neck;
- the patient’s history of an ectopic pregnancy.
Relative:
- bleeding
- endometrial hyperplasia;
- uterine deformity;
- blood diseases;
- submucous myoma;
- intolerance to the components of the spiral;
- lack of childbirth.
With regard to side effects and complications, the following may be observed after the introduction of an intrauterine device:
- Pain in the lower abdomen. Observed in 4-10% of cases. Discharge after the introduction of the intrauterine device is a sign of the expulsion of the device from the uterine cavity. Constant pain may be a symptom of uterine perforation, which requires an immediate visit to the doctor.
- Infections Occur in 5%, the patient is difficult to tolerate, often complicated by the destruction of the tissues of the genital organ and appendages. For prevention, antibiotics of broad action are prescribed.
- Bleeding. Heavy periods are observed in 24%, intermenstrual blood loss is less likely. To prevent this complication, a woman after the installation of the spiral is prescribed a two-month oral contraceptive intake.
What to do if there are discharge and pain
If the pains after installing the helix are severe and appear suddenly, we can assume uterine perforation. In this case, surgery is necessary.
If the pain arose a few times after installing the spiral, or periodically occurs after sexual intercourse, it is necessary to exclude the displacement of the device. A woman can check the length of the antennae herself. If they become longer or have disappeared, it is necessary to consult a doctor.
As for the discharge, in the first few days after the procedure, they are allowed and do not require the intervention of a doctor. But with heavy discharge or continuous periods, consultation with a doctor is required.
A visit to the doctor is inevitable if purulent discharge appears, especially if they are accompanied by pain - these are signs of an inflammatory process.
Removing a device
The removal of the spiral is carried out in the following cases:
- expired;
- woman's desire;
- displacement or loss of a spiral;
- pregnancy onset;
- menopause;
- medical indications.
If a woman did not experience any complications while wearing a spiral, then the doctor removes the spiral quickly and painlessly. But at the time of removal, a breakage of threads may occur, then the spiral will be removed using a special hook.
When the spiral grows into the walls of the uterus, it is simply impossible to remove the spiral; diagnostic curettage or the help of a hysteroscope will be required. The spiral can grow into the walls of the genital organ if the service life is missed, and the woman does not come to remove the spiral.