Over the past 40 years intrauterine device (IUD) has become the most popular long-term contraceptive method in the world. About 160 million women use it. But at the same time, there is very little knowledge about this method of protecting against unwanted pregnancy. Therefore, one part of the patients believes that choosing and putting up a “spiral” is nothing easier, and even almost independently, and the other is mortally fearful, reinforcing their fears with many nightmarish myths. We offer to understand.
What is the spiral intrauterine
This system is installed in the uterine cavity, protecting against accidental conception or making it impossible to carry a pregnancy. It affects the endothelium lining the uterus from the inside, interfering with its preparation for implantation of a fertilized egg. Or, a special hormone is added to the system, which prevents the sperm from meeting the egg and its fertilization.
Hence the myth number 1 that all spirals cause abortion in the early period is incorrect. Opponents of abortion can safely use hormonal intrauterine systems, thanks to which conception does not occur at all.
Various types of intrauterine devices
As seen in the photo, the appearance of modern models is far from the name that corresponded to the first spiral, invented in 1909 by Polish doctor Richard Richter. It took 4 decades for his truly revolutionary invention to appreciate and start using the medical community. True, it was no longer a ring of flexible soft suture material, but a large and rather traumatic “fish”. It was called the Dalkon system and did not catch on due to frequent complications such as inflammation or even perforation of the uterine wall.
This is where the second myth about the danger of spirals came from. Compared with old models, new ones are made of non-traumatic soft material and several times smaller. Therefore, fears are in vain. To minimize the risk of suppurative inflammation, the intrauterine systems are impregnated with copper, less often with gold or silver. And before installing into the uterine cavity, a woman should be examined and a vaginal smear should be taken. And if it is inflammatory, it is first necessary to be treated (sanitized) with drugs prescribed by a doctor.
Important: contraindicated for at least 3 months after recovery, the introduction of the IUD with purulent secretions, with cervicitis, with gonorrhea or exacerbation of chlamydial infection.
What are the spirals intrauterine
The first generation of intrauterine contraceptives (IUD) is a neutral IUD. They do not allow a fertilized egg to implant in the uterus due to the irritant effect on the endometrium. From here it is not difficult to guess that they are the largest in size and the most traumatic. Therefore, one should almost always expect painful menstruation, pain in the abdomen during the first weeks after installation and an increased risk of ectopic pregnancy. The only plus is cheapness. But for such a dubious advantage, 3 out of 100 women pay for the occurrence of an unwanted pregnancy during the first year after the introduction of the helix. Today, such VMCs are used less and less.
The second generation – drug Navy. That is, the spiral is impregnated with copper, less often with silver or gold. These metals have a toxic effect on sperm cells, reducing their mobility, and accelerate the wavy contractions of the fallopian tubes, which prevent the progress of the egg through them. As a result, the probability of conception, compared with the first-generation contraceptives, is reduced by 10 times. In addition, metal ions have a detrimental effect on pathogenic microbes, minimizing the risk of pyo-inflammatory complications. Today it is the most common group of the VMC. Its representatives are: Nova T, Multiload, Sorrer-T 200, C-380-Slimilin and T C-380Ag.
The third, newest generation of the IUD is represented by hormonal intrauterine systems. That is, there is a long groove in the body of the helix, filled with a special hormone gradually released into the cavity of the cervix and body of the uterus. Thanks to him, cervical mucus becomes very thick and does not miss sperm. They die without encountering an egg cell. These are the most reliable contraceptives: only one woman out of a thousand becomes pregnant. The advantage of such systems is their therapeutic effect on the endometrium with its hyperplasia, with endometriosis, with the initial stage of adenomyoma and with severe premenstrual syndrome.
Important: One word “hormonal” should set up a mandatory consultation with a doctor to clarify the possibility of installing such a helix.
Myth number 3: spirals can be chosen for any woman.
There is a list of diseases in which the IUD is temporarily or for life contraindicated:
1. The patient had sepsis after giving birth or after an abortion. There is a very high risk of perforation of the thinned wall of the uterus with the development of peritonitis.
2. Regularly occurring uterine bleeding, the cause of which has not yet been clarified.
3. Malignant tumors of the female genital sphere.
4. A purulent-inflammatory or infectious disease in the pelvis, including tuberculosis.
5. Anatomical anomaly of the cervix or body of the uterus, deforming the fibromyoma nodes, due to which it is technically impossible to introduce a spiral into the uterus, or there is a risk of perforation of the wall.
6. Allergy to any component of the Navy, and for copper-containing – Wilson-Konovalov disease.
Myth number 4: from spirals a lot of complications.
What women take for complications is actually just a manifestation of the reaction of the uterus to a foreign body. The gynecologist should warn:
- the first 3 months of menstruation may be longer, more abundant and painful;
- possible spotting on any day of the cycle;
- from hormonal IUDs to 3 months from the moment of injection, acne can appear and swell the chest. Nausea, weight gain, irritability and depressive mood are frequent.
Complications are registered very little:
- perforation of the uterine wall due to the traumatic introduction of the IUD;
- loss of spiral (expulsion);
- ectopic pregnancy.
Important: purulent inflammation can be easily avoided if you have sex protected by a condom with one partner and are regularly preventively examined by a gynecologist.
Myth number 5: the spiral must be changed every 5 years.
There are proven recommendations based on the mechanism of action of the contraceptive. They indicate that the neutral Navy really is better to replace after 5-7 years, copper-containing protect for 10 years. And the service life of hormonal coils directly depends on their ability to secrete a drug. If the package says LNG 20 µg24 hours, the contraceptive effect lasts 5 years, if 14 µg24 hours is indicated. – then 3 years. But this imported product or domestic – there is no difference.
Myth number 6: women after 40 years of age and who have not given birth to a spiral can not be put.
It is better to refuse neutral Navy. Non-traumatic models of the 2nd generation are not contraindicated, since they do not increase the risk of ectopic pregnancy, purulent-inflammatory diseases and infertility. The hormonal IUDs are also allowed, but with the proviso: it is necessary to plan the conception a year after the extraction of such an IUD.
When can I put and remove the spiral
If pregnancy does not occur – on any day of the cycle. But for 4-8 days it is easier and less painful to do it, since the cervical canal is slightly ajar.
After birth, there are two options:
- In the first hour after birth. It is possible and later, but due to the strong contractions of the uterus, the risk of expulsion is high.
- After 2-6 months, when the gynecologist confirms that the uterus is sufficiently reduced, and there are no postpartum complications.
After induced abortion or miscarriage, the IUD is installed immediately if the gestation period does not exceed 12 weeks. If the uterus is large, especially if an infection is suspected, it is better to delay this procedure until the end of treatment.
Removal – on any day: both for medical reasons, and simply at the request of the woman.
Myth number 7: for the production of a spiral, you must pass a long examination.
If the woman is healthy, not pregnant, leads an orderly sex life and is regularly examined by a preventive gynecologist, the procedure can be performed on the day of treatment or tomorrow, when the result of a bacteriological smear is ready. Even a blood test can not be done, as modern contraceptives do not make anemia heavier.
If a previous visit to the doctor was several years ago, then you really need to be prepared for the doctor to examine the mammary glands, do a colposcopy, take cytology, send for x-rays, general blood tests and sexually transmitted infections. If a woman often changes her sexual partners, it is in her interest to have an HIV test, since a positive result is a contraindication for the introduction of the IUD.
Myth number 8: after the introduction of the helix, it is necessary to drink antibiotics so that inflammation does not develop.
If the probability of inflammation is high, it is better not to risk it at all and to be treated in advance by a doctor’s prescription. And if the smear is clean, the antibiotic can provoke thrush. Candida colpitis will bring a lot of discomfort, take a lot of money and time.
What to do if conception occurred amid the Navy
Remove the helix in any gestational age. This is especially important in the case when a woman decided to give birth. The faster the contraceptive is removed from the uterus, the less will be the risk of miscarriage or premature birth.
Until now, there is an opinion that hormonal drugs increase the risk of developing some defects in the fetus. In such a situation, it is better to discuss the issue of preserving pregnancy with a geneticist after careful ultrasound and, if offered, amniocentesis.
Recommendations after the introduction of the spiral
Refrain from lifting loads heavier than 5 kg, from sports activities with jumping and vibration, for example, from riding a horse.
Sexual contact is allowed after 7-10 days.
To control the presence and height of the helix standing, probing its antennae. If they are not felt, or the IUD body is felt, contact a gynecologist to exclude expulsion. Urgent inspection is required:
- if there is pain during sexual intercourse;
- if there is purulent discharge, accompanied by fever, poor health;
- if bleeding has arisen or intensified;
- if suddenly there was severe unexplained pain in the lower abdomen.
For the first few days, with pulling pain in the stomach, you can put a candle with indomethacin or take a pill of no-shpa.
If a woman feels good, an examination by a doctor is required only after the end of the next menstruation, that is, 3-5 weeks after the placement of the IUD.