More than 60 million women in the world prefer an intrauterine contraceptive device to prevent pregnancy. Which intrauterine devices are better, for how long they are installed, is it a painful procedure? These questions are of interest to 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, which one best protects against pregnancy, you need to know which spirals can be purchased on the domestic market.
There are several varieties of intrauterine contraceptives:
- non-drug;
- first-generation medications - Multiload, Nova, Juno Bio;
- third-generation medication - Mirena.
The first are made from synthetic materials with the addition of barium sulfate. They come in various shapes: T-shaped or S-shaped. These are ineffective intrauterine devices. Reviews of doctors report that they are not currently used due to frequent inflammatory complications after their administration.
The second group is represented by the IUD (intrauterine contraceptives) containing copper, gold, silver. In this case, the presence of one metal or a combination of several is possible: the rod is silver, and the winding is copper. Intrauterine devices with silver and other metals do not corrode, contribute to the prevention of various inflammations of the internal genital organs and last for a rather long time - 5 years.
Contraceptives belonging to the third group are similar in form to the previous ones, but contain a container with synthetic gestagen, which is released in microdoses - up to 20 mcg daily. Such spirals are set 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 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 constant release of progestogens.
Mechanism of action
To decide which intrauterine device is better, you need to know how it works. 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 not characteristic of 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 of the fallopian tubes, and negatively affects sperm with copper, gold and silver ions.
It is not necessary to consider each theory of contraceptive action as prevailing, the mechanism of action consists of several components.
Benefits
To find out which intrauterine device is the best, you need to familiarize yourself with the benefits of all types of IUDs:
- efficiency up to 98%;
- ease of use;
- minimum adverse reactions;
- restoration of fertility after removal of the IUD during the first month;
- breastfeeding does not suffer (not suitable for IUDs with progestogens);
- introduced for a long time;
- low cost;
- there is no need for daily pills and control over the use of oral contraceptives.
disadvantages
Among the shortcomings should be noted pulling pains in the lower abdomen, especially in the early days, heavy menstruation, a high risk of inflammation, constant monitoring of the antennae, restrictions for young women.
Contraindications
Which intrauterine devices are better: Multiload, Juno Bio, Nova? Are there any contraindications for a certain type of spiral? 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, vaginal bleeding of an unclear nature, presumed or existing pregnancy. With these symptoms, the introduction of a spiral is strictly contraindicated.
Relative contraindications are those symptoms in which the introduction of an IUD is possible after appropriate examination or treatment or when a contraceptive will not contribute to the progression of the process. It:
• exacerbation of chronic diseases and six months after treatment;
• venereal diseases;
• cervicitis, vaginitis;
• heavy menstruation, intermenstrual bleeding;
• hyperplasia or polyps of the endometrium;
• uterine fibroids with a submucous arrangement of nodes;
• some forms of endometriosis;
• malformations of the uterus: insufficient development, abnormal structure;
• changes in the cervix, in which the introduction of the IUD is impossible;
• ectopic pregnancy six months before the introduction;
• history of expulsion (self-extraction) of the IUD;
• infectious and inflammatory complications after abortion in the last three months;
• if there are many sexual partners;
• somatic diseases: chronic inflammation, incl. tuberculosis; anemia or coagulopathy; rheumatic heart disease, valvular defects;
• allergy to metal ions;
• Westphal-Wilson-Konovalov disease - a hereditary ailment in which copper metabolism is impaired;
• treatment with immunosuppressants.
In each case, after clarification of all adverse factors and a thorough examination, the doctor determines the possibility of using an IUD. In pharmacies, various intrauterine devices are sold. Photos of packages are presented above. Their cost varies from 200 to 10,000 rubles.
Examination before the introduction of the spiral
Before using this method of contraception, an individual consultation with your gynecologist is necessary and the required minimum of examinations is performed:
- clinical blood test;
- examination of kidney function ;
- screening for syphilis, hepatitis B and C, HIV-carriage;
- advanced colposcopy;
- Ultrasound of the uterus and appendages.
The time of introduction of the IUD
According to WHO experts, the spiral can be entered on any day, but 4-7 days of the menstrual cycle are considered the most favorable days. This is due to the fact that at the indicated time, the uterine mucosa is restored after endometrial rejection, the cervical canal is ajar, the presence of menstruation is a reliable sign of the absence of pregnancy, and the minimal spotting that occurs after administration does not bring a woman any discomfort.
After an artificial abortion or self-abortion, an IUD can be administered immediately or within 4 days in the absence of signs of bleeding and inflammation.
After childbirth (within 48 hours) it is not recommended to immediately introduce an IUD, since there is a high probability of spiral expulsion. The best time is at 6 weeks after delivery.
Complications
Complications are possible immediately and after a time after the intrauterine device is installed. Which is best in terms of minimizing unpleasant side effects? Often after the introduction of the spiral, a pain symptom occurs, which can last for an hour. This was reported in the reviews. Most often, discomfort passes after taking analgesics. If the pain does not stop with the use of analgesics and antispasmodics, then it is necessary to conduct an ultrasound or hysteroscopy to establish the correctness of the introduction of the IUD and to diagnose the presence of a spiral in the uterus or outside it (with perforation of the uterus during administration).
Expulsion of the IUD is most often observed in young nulliparous women due to increased uterine contractility. It occurs mainly in the first days after administration. Moreover, the frequency of this complication depends on the type of spiral: copper-containing self-removing in 6-16% of cases, progestogen-containing - in 3-6.5%. With age, an increase in the number of births and abortions, the likelihood of this complication decreases.
Inflammatory diseases are complications that are observed in 3.8-14.5% of cases with the introduction of the IUD of the second group. Moreover, if inflammation occurred in the first 3 weeks, then its occurrence can be associated with the introduction of IUD; if after 3 months - then this is a re-emerging disease. The formation of a purulent tubovarian formation is the most formidable 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 is stopped by the appointment of hemostatic agents. If bleeding continues, is accompanied by pain or occurs between menstruation and is not amenable to treatment, then the spiral must be removed.
In 0.5-2% of cases, pregnancy is possible. This occurs with full or partial expulsion of the IUD. Most often, such a pregnancy ends in a miscarriage, even if the woman wants to keep it.
And which intrauterine device is better in terms of complications, the gynecologist will help.
The effectiveness of intrauterine contraceptives
Many varieties of IUDs pose such questions to a woman: how to avoid complications, and which intrauterine device is better? Reviews of doctors and patients speak in favor of copper- or silver-containing IUDs.
The addition of copper and silver allowed to reduce the frequency of complications by 2-10 times. Moreover, the effectiveness of such IUDs is 93.8%. Inert spirals have an efficiency of 91-93%. Currently, copper-containing spirals are most acceptable due to the low percentage of complications and the high percentage of contraceptive activity.
The Mirena hormonal releasing system is the most effective contraceptive and is considered almost biological sterilization, as it has many actions aimed at preventing fertilization of the egg, attaching it to the endometrium, increasing the viscosity of mucus in the cervical canal to protect sperm from entering the uterus.
We examined the positive and negative effects that the intrauterine device has. Which is better to set? This issue should be addressed in conjunction with a gynecologist. In this case, the price that the woman is counting on is determined and the indications that the doctor reveals after the examination.