How to install a spiral into the uterus. Intrauterine device: types, indications and contraindications. Pregnancy and intrauterine contraceptive

The IUD is an effective means of contraception; there are about 36 types. Each in its own way interferes with the implantation process. A product unique in structure and function helps millions of women around the world protect themselves. Many are worried about their future offspring and do not use IUDs, which prevent implantation from occurring, but use advanced DVRs, which prevent the egg from being fertilized. Mirena is one of these. This effective IUD helps combat the abortifacient method of contraception, preventing the sperm from fertilizing the egg. But because of these wonderful properties, the cost of this small device is quite high.

Recently, many women have realized that if they want a high-quality and safe intrauterine device, the price will not be decisive for them, since the IUD is installed for more than one year and subsequent costs are not expected.

What determines the cost of an intrauterine device?

What determines the price of this type of intrauterine device? Of course, first of all, this is the quality of materials and the type to which the product belongs. The manufacturer and distributor company is also of no small importance. Below we will consider the types and composition of the IUD.

The main type of IUD used is the “anchor” or “T-shaped” type. The device has a widened upper base that blocks the exit of the fallopian tubes, and a tapered end with an attached thread for easy removal of the device. Each IUD consists of different materials, some are made of copper and silver, others release hormonal substances, and others are neutral. Each type has its own advantages and disadvantages.

Spiral IUDs have a semicircular base with small spike-like protrusions at the ends, thanks to which the device is attached inside the uterus. A rod with threads runs from the base for easy removal of the device. Ring-shaped IUDs have a ring inside of which a metal wire is inserted, with threads at the end for removal of the IUD after the expiration of its service life.

For a hormonal intrauterine device, the price varies from 5 to 15 thousand rubles. The price for a T-shaped intrauterine device varies from 2 thousand and above. Popular manufacturers of VMCs are: Russia, Germany, the Netherlands, Finland, Ireland, Belarus.

Gynecologists recommend purchasing products called: Juno, NovaTCu200, Multiload Cu375, Mirena, Goldily Exlusive, since these products have proven themselves well and are the latest developments in this area. In order to understand how prices for this contraceptive were established, a table is presented at the end of the article: “Intrauterine devices prices.”

How much do intrauterine devices cost?

Before installing an IUD, all women are concerned about the question: “How much does a contraceptive device cost?” Manufacturers are trying to produce them in an affordable price category. Prices for an IUD spiral range from 200 rubles to several thousand. Before purchasing, you can look at online pharmacies and see a photo of the intrauterine device and its price. Basic models consisting of neutral materials are cheaper. Hormonal and non-medicinal models with metal (silver, copper, gold) are more expensive due to the better effect and additional capabilities of the device.

IUD spirals price

So, the price of an IUD is based on:

• quality of the product material,
• product shapes,
• manufacturer,
• size.

Each manufacturer independently determines the cost of goods based on the costs of production and delivery of goods. Next, the distributor, as a link between the manufacturer and the pharmacy, adds his own premium to the cost of the product. The pharmacy, in turn, invests a small percentage in the cost of the medicine to make a profit. The total amount comes from these values.

WHO experts believe that the IUD can be inserted on absolutely any day of the menstrual cycle, if there is one hundred percent certainty that there is no pregnancy. Nevertheless, many women torment themselves with the question: “When is it better to install an intrauterine device?”

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When the IUD is inserted: does the cycle affect the day the IUD is inserted?

Most often, the installation of an IUD, regardless of the type of device and the age of the woman, is carried out either on the first day of menstruation or immediately after the end of menstruation. In this case, there is complete confidence that the woman is not pregnant. In addition, the cervical external pharynx, through which the anti-pregnancy device will be inserted, is in a slightly open state, which greatly facilitates the procedure for inserting the IUD and reduces unpleasant or painful sensations.

This is especially important if the IUD is installed in a young nulliparous woman. Because the main difference between the cervix in women who have given birth and women who have not given birth is the shape of the external pharynx. Before childbirth, it has a dotted appearance, and after childbirth, it has a slit-like shape. Typically, inserting the IUD into the uterus in women who have given birth does not encounter any difficulties, which is facilitated by the structure of the cervical canal. But for nulliparous women, it is necessary that the external opening of the cervix be slightly open. This occurs on any day of menstruation.

The IUD is allowed to be inserted immediately or within 3-5 days after a medical abortion or spontaneous miscarriage, but only if there is no bleeding or signs of inflammation. If the IUD is not installed within the specified period, then it is necessary to reschedule the procedure for the next period.

An intrauterine device is usually installed after 6-8 weeks, and after a cesarean section - after 6 months.

The insertion of an IUD is possible on any day of the cycle, but the following conditions must be met:

• absence of pregnancy;
• absence of inflammatory diseases and bleeding at the time of IUD installation.

Healthy women with no history of gynecological diseases can have an IUD containing copper, silver or gold. The shape of the spiral does not matter. Women suffering from endometriosis or having uterine fibroids should give preference to the Mirena hormonal system.

Up to what age can IUD be inserted?

There are no age restrictions for using an IUD. An intrauterine device can be installed in a woman of reproductive age from 18 to 49 years old or before the onset of menopause. Although experts have different opinions about the age at which an intrauterine device should be placed.

It is believed that nulliparous women and women over 40 are not recommended to use the IUD for pregnancy. For those who have never given birth - due to complications (ectopic pregnancy, inflammation of the genital organs and, as a result, infertility in the future), and for those who are “age-related” - allegedly because of the risk of cancer.

The installation of an IUD in itself in women over 45 years of age does not increase the risk of developing cancer. It’s just that in this age category, the likelihood of developing various kinds of pathologies already increases due to lifestyle, habits, and careless attitude towards one’s health, but these problems do not arise because of the IUD.

You are 45 years of age or older. You can safely use an IUD if:

• You have regular periods;
• you have a permanent and only sexual partner;
• Your doctor does not find any contraindications to inserting an IUD.

You are a young girl of 18 years old or a young nulliparous woman. There are restrictions on your use of this method of contraception. But there are situations when another type of protection against unwanted pregnancy is not suitable or is contraindicated. Consult your doctor - there are always exceptions to every rule. A specialist will select a spiral that is less “harmful” for you.

How to install a spiral and where it should be done

In order to place an intrauterine device, you must first undergo a medical examination, pass the necessary tests, and identify possible contraindications. All this is done in the conditions of any antenatal clinic.

You should discuss with your doctor which type of IUD is right for you and ask all your questions about the pros and cons of intrauterine contraception.

The main scope of examinations is standard:

• taking an anamnesis (conversation with the doctor, identifying gynecological and concomitant diseases);
• mandatory examination in a gynecological chair (in order to identify pathology of the cervix, the size and shape of the uterus, to exclude pregnancy);
• taking smears from the outside of the cervix for atypical cells (oncocytology) and to determine the vaginal microflora. In case of inflammation in the vagina, insertion of an IUD is permitted only after its sanitation!
• in some cases, it may be necessary to examine the cervix using a colposcope;
• routine blood and urine tests. It is important to know the level of hemoglobin in the blood, since the IUD can contribute to longer and heavier periods, in which case it should be discarded.
• tests for HIV infection, syphilis;
• Ultrasound of the pelvis to exclude an abnormal structure of the uterus.

At first glance, it may seem that the scope of the examination is large. But believe me, there is nothing superfluous in it. It would be wiser to carry it out than to risk your health and subsequently be disappointed in this method of contraception.

Attention! The intrauterine device is installed only in a medical institution and only by a trained specialist! Installing an intrauterine contraceptive device at home is not possible. The IUD should be placed deep into the uterine cavity. Under no circumstances will you be able to install an IUD on your own without causing injury to yourself.

Where to buy a spiral? Installation cost.

An anti-pregnancy device can be purchased at a pharmacy (if you know exactly which IUD you need) or purchased from a doctor.

The cost of installation depends on the region of your residence and the type of medical institution. In a public clinic, if there is a compulsory health insurance policy, the service may be completely free or cost a small “symbolic amount.” In a private clinic, the cost of inserting an IUD can range from 3,000-5,000 to 25,000 rubles. It all depends on your wallet.

For what period of time is an IUD installed?

The IUD is a long-term method of contraception. As they say, once you put it on, you can forget about pregnancy protection for several years. On average, an IUD is installed for a period of 5 to 7 years. The time interval depends on the individual tolerance of the foreign body in the uterus, the type of IUD, and also on how long the need for contraception is.

How to place an IUD for pregnancy, video

Insertion of an intrauterine device is a very common method of contraception. The reliability of this method of birth control is very high, ranging from 95 to 99%. This effectiveness is determined by the fact that the selection and installation of an IUD is prescribed by a doctor in accordance with the individual characteristics of the body.

Installation of an IUD with ultrasound control without the cost of a spiral

The intrauterine device is one of the most effective and safe methods of contraception. A silver, gold or copper rod with flexible nylon tendrils is inserted into the uterine cavity. This design is securely fixed in the reproductive system. The presence of a foreign body in the uterus and the special properties of metals prevent conception. The rod does not affect the hormonal balance, as well as the regularity of the menstrual cycle. An additional advantage of this method is the duration of action. If you install an IUD (the price depends on the type of material), protection against unwanted pregnancy will last for several years.

There are a number of contraindications to installing an IUD:

• infections and inflammatory processes of the genitourinary organs,
• history of ectopic pregnancies,
• blood clotting disorders,
• oncological diseases.

A woman must undergo a comprehensive examination before having the IUD inserted. Please check with the administrator when registering for prices for diagnostic tests.

How much does it cost to install an IUD in a clinic?? In our clinic you can install a coil under ultrasound guidance. This ensures correct placement of the contraceptive in the body of the uterus and the absence of complications.

A woman can remove the IUD at any time. To do this, you also need to visit the clinic.

This method of contraception does not affect ovulation, so reproductive function is restored in a short time.

We offer placement of gold, silver and copper coils under ultrasound guidance.( prices from 2640 rubles per spiral). A gynecologist will help you choose a suitable contraceptive. You can make an appointment with a specialist by calling 8 495 133 03 03

Which intrauterine device is better to place?

IUD spirals are made from high-quality polyethylene with a small addition of barium sulfate. Some areas of the spiral are coated with copper or silver. Most IUDs are T-shaped. An important element of any spiral is the thin antennae, which, when installed, are located in the canals of the cervix.

An important advantage of IUD coils is that a woman does not feel their use in any way, either during sex or during active physical activity.

There are three main types of IUDs:

1. Intrauterine device with copper coating. Operating principle: copper coating has a destructive effect on sperm, provokes a local inflammatory process on the uterine wall and fertilization becomes impossible. This type of IUD spirals is inserted for a period of 3 to 5 years.
2. Progesterone releasing system (PRS). This type of IUD is a hormonal device that makes the mucus in the cervix more viscous, thereby preventing sperm from moving towards the egg. This type of spirals is introduced for a period of no more than 12 months.
3. Levonorgestrel releasing system (LRS). This type of IUD is an improvement on the intrauterine progesterone-releasing system. The main difference is a longer period of use, from 5 to 7 years.

You can choose the most suitable type and insert an intrauterine device only at an appointment with a gynecologist. Before placing an intrauterine device, the doctor is obliged to check the woman’s health to make sure there are no contraindications.

The main contraindications to the use of IUD coils are chronic diseases, inflammatory processes in the body and diseases of the genitourinary system.

ADVANTAGES OF THE INTRAUTERINE DEVICE

• High efficiency, comparable to the effectiveness of hormonal contraceptives. To some extent, IUDs are more reliable than hormonal pills because there is no danger of missing pills. When using the IUD, absolutely no action is required on the part of the woman to maintain the contraceptive effect, and, therefore, any possibility of error or accident is eliminated.
• Provides protection from pregnancy for a long time (from 5 to 7 years depending on the type of IUD).
• Use is not associated with sexual intercourse.
• Compared to all other contraceptive methods, the intrauterine device is the cheapest contraceptive method. Despite the fact that the cost of one IUD is many times higher than the cost of one package of birth control pills or one regular package of condoms, recalculating its cost over 5 years (the usual period of wearing one IUD) shows its undeniable superiority in economic terms.
• Unlike birth control pills, metal or plastic IUDs, which do not contain hormones, have absolutely no overall “hormonal” effect on the body, which many women (in some cases justifiably) fear. For this reason, IUDs, which do not contain hormones, are recommended as the primary method of birth control for women over 35 years of age, with active smoking, or with other conditions that make the use of birth control pills impossible, but require a very high level of protection against unwanted pregnancy.
• The spiral is not felt at all during sexual intercourse and does not interfere with partners.

WHEN IS AN IUD NOT INSTALLED?

Contraindications for installing the IUD are determined by a gynecologist. Only a specialist can determine exactly how safe it is to install a spiral in your case.

An IUD cannot be installed if:

• You think you might be pregnant.
• You have more than one sexual partner.
• There is an acute form of inflammatory diseases of the cervix or pelvic organs, including STIs.
• Over the past three months, inflammatory diseases of the pelvic organs have been observed.
• Vaginal bleeding of unknown origin is observed.
• There is a rapidly growing uterine fibroid, also if the myomatous node deforms the uterine cavity.
• There is cancer of the genital organs.
• There is a severe form of anemia (hemoglobin

BEFORE INSTALLING THE SPIRAL

1. Discuss all questions with a gynecologist you trust; Avoid sexual intercourse 1-2 days before installing the IUD;
2. A few days before installing the IUD, do not douche and refuse to use any intimate hygiene products;
3. A few days before installing the IUD, stop using any medications in the form of vaginal suppositories, tablets or sprays unless their use has been previously agreed with your doctor before installing the IUD.

HOW TO BEHAVIOR AFTER THE INTRODUCTION OF THE IUD?

• Within 7-10 days after installing the spiral, you cannot:
• Have sex;
• Do douching;

After 7-10 days it is necessary to undergo a follow-up examination.

BE SURE TO CONSULT YOUR DOCTOR IF:

• Within a few days of having the IUD installed, you have a fever, very heavy vaginal bleeding, abdominal pain, or an unusual vaginal discharge with a foul odor.
• Any time after inserting the IUD, you feel the IUD in your vagina, notice that the IUD has moved or fallen out, or if you notice your period is 3-4 weeks late.
• Contact is necessary if: You suspect pregnancy.
• You have heavy vaginal bleeding (heavier or longer than usual).
• You experience severe abdominal pain;
• pain is felt and bleeding occurs during sexual intercourse.
• There are signs of infection, unusual vaginal discharge, chills, and fever.
• You cannot feel the IUD strings or feel that they are shorter or longer than before.

HOW TO REMOVAL THE SPIRAL

Removal is usually done after 5-7 years (depending on the modification of the spiral). But if the woman wishes, this can be done at any time. The reason may be the desire to become pregnant or the occurrence of any complications.

Before removal, the same examination is carried out as before insertion of the spiral. If necessary, vaginal sanitation (improvement) is prescribed.

Removal is done by pulling the spiral tendrils at a certain angle. In some cases, for example, in the case of wearing a spiral beyond the prescribed period, removal must be carried out in a hospital setting, with anesthesia, by curettage of the uterine cavity.

Within 4-5 days after removing the IUD you cannot:

• Have sex;
• Use vaginal tampons (you can use regular pads);
• Do douching;
• Take a bath, visit a sauna or steam bath (you can take a shower);
• Engage in heavy physical labor or intense exercise.

Removing the IUD does not cause changes in the menstrual cycle. The exception is the Mirena IUD, when worn, there is an absence of menstruation or scanty cyclic bleeding. After Mirena removal, the menstrual cycle usually returns in about 3-6 months.

Be sure to consult a doctor if, within a few days after removing the IUD, you have a fever, very strong vaginal bleeding, abdominal pain, or unusual vaginal discharge with an unpleasant odor.

Under no circumstances attempt to REMOVE THE SPIRAL BY YOURSELF!

The spiral is removed by pulling on the tendrils, which may break before it is removed. After this, the IUD can only be removed instrumentally and only by penetrating the uterine cavity. In addition, the mustache may break as the spiral passes through the cervical canal and it will get stuck there. Take my word for it, it is very painful. To remove the IUD, be sure to consult a gynecologist.

Despite the many worries after the birth of a child, sooner or later the question of preventing an unplanned pregnancy still arises.

It is clear that other intravaginal devices are excluded; condoms are not suitable for everyone.

What remains is the IUD, which is one of the best means of preventing pregnancy.

Is it possible to install an IUD after childbirth? This is a common dilemma that a nursing mother must decide for herself.

According to statistics, 95% of women resume sexual activity after childbirth in approximately two months. This is necessary for the final restoration of the female body and the cessation of all discharge.

The intrauterine device is the most common contraceptive device. It is located in the uterine cavity and creates a barrier to the implantation of the fertilized egg. If used correctly, the effectiveness of intrauterine contraception approaches 100%. In this way, the use of the spiral is comparable to the effect of oral contraceptives.

Like any medical device and method, the spiral has its advantages and disadvantages.

IUD after childbirth - is it possible to use it?

Is it possible to install an IUD after childbirth? This question often arises during pregnancy.

Inserting the IUD into nulliparous women is very difficult due to the tightly closed cervix of the uterus and the narrow cervical canal. The IUD after childbirth, as stated above, is the most effective existing method of contraception.

The advantages of using the IUD after childbirth include:

1. High, almost 100% effectiveness of this method, comparable to the result from the use of oral contraceptives. There is no need for additional effort: taking tablet medications requires constant monitoring; even one missed tablet can lead to pregnancy.

2. A regular IUD does not change hormonal levels, as happens when taking tablet contraceptives, and, therefore, does not change ovulation. Therefore, after removing the IUD, there are no problems with a planned pregnancy in the near future. True, there are hormone-containing IUDs, after the use of which the restoration of fertility occurs in approximately the same time as when taking tableted hormonal contraceptives.

3. Does not interfere with lactation.

4. The IUD maintains contraceptive functions continuously, including the period of menstruation.

5. Duration of contraception from 5 to 10 years.

6. Does not cause discomfort to any of the sexual partners.

7. Affordability and ease of installation.

These advantages of the IUD over other methods of contraception answer the doubts of some women about whether the IUD can be inserted after childbirth.

8. It is possible and even convenient, since modern spirals contain silver and gold components, the presence of which suggests an anti-inflammatory effect.

9. The IUD is a good alternative for many women after childbirth with existing contraindications to taking tablet contraceptives.

10. In addition, which is very important for a woman after childbirth, intrauterine contraception does not cause metabolic disorders, unlike oral contraceptives. This is another weighty argument and answer to the question: “Is it possible to insert an IUD after childbirth?”

11. The economic aspect is also important. One package of contraceptives costs less than the IUD. But an oral contraceptive will have to be purchased monthly, unlike an intrauterine device, which will be used for many years (at least up to five).

Spiral after childbirth - disadvantages of the method and contraindications

There are also some disadvantages of using a spiral that you need to know about:

1. Does not prevent the penetration of pathogenic microbes that cause sexually transmitted diseases.

2. It is an abortifacient.

3. It should be installed only by a specialist to avoid complications. These include painful spasms, heavy and long menstrual and intermenstrual bleeding, and various inflammations.

4. Under certain conditions, if a woman ignores the specialist’s recommendations, the IUD can leave the uterine cavity on its own. The incidence of coil loss (expulsion) is low, but it is important to be aware of this possibility. Only a specialist can insert and remove an existing intrauterine device. Every woman can control it, following the advice of a doctor.

Despite the positive aspects of the intrauterine device, there are contraindications to its installation. The doctor will warn you about them during the examination and when deciding on the choice of contraceptives. Such contraindications are:

1. Uterine fibroids.

2. Pathological structure of the uterus, in which it is impossible to place a spiral in its cavity.

3. Frequent inflammation of the genitourinary organs.

4. Painful, heavy and prolonged menstruation.

5. With a history of uterine bleeding.

IUD after childbirth - when can I use it?

The IUD after childbirth - when it can be placed - is usually decided by doctors. In each case, this issue is resolved individually, just as the selection of the spiral itself takes place, taking into account the woman’s condition, the characteristics of the body and the existing concomitant pathology.

Since there is a variety of intrauterine devices, they are made with the inclusion of various materials, you need to understand that after childbirth it is not recommended to install a copper device, because it will not only not relieve the inflammatory process, but will become its source. Therefore, after childbirth, the most suitable option is copper-silver, which does not contain hormones.

The Mirena intrauterine device, which in addition to contraceptive properties, has therapeutic: reduces local inflammation, restores hormonal levels, reduces menstrual bleeding, can be used exclusively after cessation of lactation.

IUD after childbirth - when to install: If there are no contraindications, this can be done in the maternity hospital. The presence of an intrauterine device will not affect the “cleansing” of the uterus from all postpartum secretions (blood, mucus, etc.).

If the IUD was not installed in the maternity hospital, then it can be installed later during the first menstruation. With active breastfeeding, menstruation appears after a maximum of six months, since the hormones prolactin and progesterone, produced during breastfeeding, suppress ovulation. The IUD is placed during the first menstruation that occurs after childbirth. Or two months after childbirth, so that the internal genital organs recover after childbirth. Postpartum discharge lasts the same amount of time. For women who have had a caesarean section, the IUD is inserted after six months.

If the questions - whether it is possible to place an IUD after childbirth and when to place an IUD after childbirth - have been resolved by a woman, the choice has been made, you need to know a few more important aspects: each IUD has a certain duration of action. It is necessary to know exactly its expiration date and remove the spiral before it expires.

If this contraceptive does not work, the specialist will remove the IUD at any time.

If the spiral changes its position or falls out twice, it needs to be changed.

If you have an intrauterine device, you need to take into account that after its insertion, the uterus will react to the device with muscle contractions. This may manifest itself:

Nagging pain or discomfort in the lower abdomen,

More abundant menstruation than before the installation of the IUD,

Your periods may become longer

During the intermenstrual period, spotting may occur that was not there before.

Therefore, it is important to control the appearance and smell of the discharge so as not to miss inflammation.

Need to know, that in the presence of a normally installed spiral, neither a man nor a woman should experience any discomfort during sexual intercourse. If unpleasant or painful sensations still occur, you need to check the placement of the IUD with a gynecologist to prevent it from falling out or its correct placement.

And one more important question that concerns any woman is the effect of the spiral on libido or sensations during sexual intercourse. The spiral does not change either sensitivity or libido.

Only a gynecologist can insert and remove the IUD. If you have a spiral, you must visit a doctor once every six months for monitoring, since the spiral may become dislodged.

Not every woman wants to get pregnant again soon after giving birth. Therefore, the issue of contraception when there is a baby in your arms is very relevant. Look around, you will see a lot of mothers with children of the same age. Many of them will tell you that their plans did not include such a rapid addition to the family. But this is what happened: despite breastfeeding, the use of oral contraceptives, strict calculations.

We do not mean to say that birth control pills are not effective, condoms are weak, and breastfeeding does not protect against pregnancy. It’s just that every rule has exceptions, and any woman can make a mistake in the calculations while taking care of the house and baby.

So, let's talk about the most reliable of the modern methods of contraception - the intrauterine device, about when you can install the device after childbirth, what are its advantages, disadvantages, what you should pay attention to.

IUD: what is it, what are the advantages and disadvantages?

The IUD or Intrauterine Device is a mechanical means of protection against unplanned pregnancy. It is installed directly into the uterine cavity and allows a woman, without any additional means of contraception, to quietly engage in sexual activity without becoming pregnant. This is in simple terms.

What are the advantages of this method of contraception? One of the main and most convenient is constant protection. That is, with an IUD installed, you do not need to keep a calendar, take pills strictly on schedule and, thus, there is simply nothing to forget.

Another plus is that the spiral is installed for a long time, or more precisely, for several years. It is during this period that you can absolutely not worry about safety (provided that the IUD is installed correctly).
The advantage of this method is its relative cost-effectiveness. At first glance, it may seem that this little thing is quite expensive. However, its price is approximately equal to the cost of an annual set of hormonal pills. Annual! While it is established for a period of up to 5 years.

Responsibility of contraception after childbirth

If you insert an IUD after childbirth, it does not affect the quality and taste of breast milk, and has no effect on the baby’s body if breastfeeding.

And the spiral will come in handy if for some reason hormonal oral contraceptives are contraindicated for you or, say, you have varicose veins, which is quite common today.

The IUD is removed when you need it and the ability to get pregnant after it is restored quite quickly.

The guarantee of not getting pregnant in this case is 99.9%.

Disadvantages, disadvantages, contraindications for installing an IUD

You should not install an intrauterine device if you had inflammatory diseases of the genital organs before or after childbirth. Here you should wait for complete recovery and tissue regeneration.
The IUD is inserted and removed only by a doctor. This is the only way you can provide yourself with the desired guarantees of safety and avoid complications later.

The spiral tendrils can sometimes cause some discomfort (often microtrauma) to your sexual partner. Therefore, when installing, you can ask the doctor to make them a little shorter.

After each menstruation, you should check the presence of the antennae, making sure that the spiral remains in place.

Since your body will perceive the IMF as a foreign body, the uterus will try to “expel” it, contracting and giving you unpleasant sensations in the lower abdomen. This can also cause heavier and more painful periods.

If you decide to have an IUD after childbirth, you should be aware that there are certain contraindications.

These include neoplasms (both malignant and benign), pathologies of the uterus, cervix, pregnancy, inflammatory processes, ischemia, uterine bleeding, etc.

There are special contraindications for coils that contain copper: an allergy to this metal. Women suffering from coronary heart disease, migraines, thrombosis, and cirrhosis of the liver are not advised to install a hormonal IUD.

A little about stitches after childbirth and how to heal stitches on the perineum faster

What types of IUDs are there, and why are they placed?

Spirals come in regular and medicated forms.

Conventional ones are made from silver, platinum, gold and polyethylene and are installed solely for the purpose of preventing pregnancy.

Medicines are often given to women, among other things, for therapeutic effects, for example, to treat or control uterine fibroids. They contain copper or the hormone progesterone.

It should be noted that the IUD itself is not a barrier to fertilization of the egg. It is quite possible. However, the IUD thus affects the inner layer of the uterus; the fertilized egg cannot attach to it.

Regular coils need to be removed after a year. IUDs containing copper - after 3-5 years at the discretion of the doctor, and hormonal (with progesterone) - after 5 years (unless, of course, you want to get pregnant earlier).

Is it painful to insert the IUD?

In principle, inserting a spiral does not hurt. It is least painful to install it during menstruation - from 1 to 7 days. However, you may still experience discomfort, as with any gynecological examination. Some women feel nothing at all, while others may experience a slight tugging in the lower abdomen (as during menstruation). As a rule, this goes away within a few hours. Sometimes faster, sometimes a little longer.

The gynecologist will advise you to abstain from sexual activity for the first few days. And before the onset of your period, still use a barrier method of contraception (in other words, a condom).

Immediately after your period, you should come for a follow-up examination and check whether the IUD in the uterus is working properly. If the doctor said that everything is “OK”, you no longer need to use additional means of protection.

When can IUD be inserted after the baby is born?

There are different opinions on this matter. Some gynecologists place the IUD after childbirth right in the maternity hospital. This is only possible if the woman does not experience any inflammatory processes before and after the birth of the child.

Sex after childbirth: options and rules

Is this advisable or not? Probably, the body still needs rest. After giving birth, you will still be advised to abstain from sexual activity for a while to avoid unnecessary risks of infection. Therefore, if you are very worried and are afraid of becoming a mother again too soon, you can give your internal organs a certain time to recover and have an IUD placed after giving birth in a month and a half.

If the lactation process proceeds without problems, then you can wait six months to install the IUD. However, before inserting the IUD, you should still use a condom during sexual intercourse, since there is still a risk of getting pregnant.

Is it possible to remove the spiral yourself?

We will definitely answer no to this question. The risk of complications (bleeding, infectious diseases, etc.) is too high. Therefore, be wise: do not consider it difficult to see a doctor.

The intrauterine device, as you can see from the video, looks like a T-shape. It is placed in the cervix, as seen in the photo, and only by a gynecologist. At the end of the spiral there is a thread necessary for its further removal.

Types of spirals

The video shows that uterine devices can be of two types: containing hormones and coated with copper. The photo shows the Mirena hormonal device. It contains a synthetic progesterone substitute - levonorgestrel, which is constantly released into the uterine cavity in small quantities. A hormonal-type intrauterine device is effective for 5 years, its installation is more reliable compared to copper.

The video shows that in some cases women are fitted with a hormonal IUD for medicinal purposes. The cost of a hormonal IUD is higher than a copper one, but copper ones, in turn, are more common. The copper IUD has a plastic body with wire wound around it.

Copper coils are very effective in protecting against pregnancy; they can remain in the uterine cavity for up to ten years.

The principle of operation of the spiral

The video shows how both types of coils damage sperm, preventing the mechanical attachment of a fertilized egg in the uterine cavity. The hormonal type of the spiral makes the mucus in the cervical canal more viscous, providing protection against the penetration of sperm. A hormonal-type intrauterine device prevents egg implantation and thickening of the endometrium.

Installing a device in the uterine cavity reduces the volume of menstrual flow and reduces pain during menstruation. Copper coils damage sperm by exposing them to copper ions and releasing enzymes, white blood cells and prostaglandins into the uterine cavity, which also block sperm activity.

Indications for installing a spiral

The form states that this type of contraception is suitable for many women, including teenagers and nulliparous women. Installation of the spiral into the uterine cavity can be carried out immediately after childbirth (ten minutes after the delivery of the placenta), four weeks after birth (postpartum delayed installation), after an abortion (conscious or spontaneous).

The intrauterine device is suitable for girls with the following features:

• Previous surgery on the pelvis.
• An ectopic pregnancy has occurred.
• Migraine.
• Deep vein thrombosis disease.
• Presence of arterial hypertension.
• Diabetes.
• Anemia.
• Endometriosis.
• Smoking.

Installation of a device in the uterine cavity is unacceptable for the following phenomena:

• Serious anatomical changes in the uterine cavity.
• Pregnancy.
• Vaginal bleeding without an accurate diagnosis.
• Infectious diseases of the pelvis.
• Gestational trophoblastic disease with persistently elevated beta hCG levels.

Depending on the type of use of the IUD in the uterus, there may be some contraindications. For example, the video recommends not using a copper IUD if you have Wilson's disease, and hormonal IUDs should not be inserted into the uterus of women with liver tumors and breast cancer.

Complications after installing the spiral

The intrauterine device, as can be seen from the video, very rarely causes complications, the most common of which is its spontaneous expulsion from the uterine cavity. This happens in 2-10% of all moments. Patients are advised to frequently check for the presence of the IUD in the uterus by checking for the presence of threads emerging from the cervical canal. A more rare complication, as seen in the video, is the failure of the technique - pregnancy occurs, despite the presence of the IUD.

When using a hormonal IUD, the failure rate of the method is 0.2% in the first year of its use. When using a copper IUD, the probability of pregnancy in the first year of appearance is 0.8%. When using an intrauterine device, ectopic pregnancy most often occurs.

If pregnancy develops in the uterus, the IUD must be removed. If this is not done, there is a high probability of miscarriage. In rare cases, there may be a complication such as perforation of the uterine wall. It appears in 0.1% of cases.

When manipulating during installation of the IUD, vasovagal reflux may develop, which may be accompanied by vomiting and loss of consciousness.

What you need when installing a spiral

The video says that before installing this type of spiral, it is recommended to consult a gynecologist. The examination is carried out on a chair, inflammatory diseases in the pelvis, diseases transmitted during sex must be excluded, colposcopy and Pap test, regular and transvaginal ultrasound of the uterus and appendages, ultrasound of the liver (if a hormonal device is installed) and ultrasound of the mammary glands are performed. This is required to assess possible contraindications to the installation of the IUD. You must first do a pregnancy test.

Spiral installation process

As shown in the photo, installation of the spiral does not require much time or anesthesia. When installing the IUD into the uterine cavity, unpleasant sensations may occur, which should subside after a few hours.

The most noticeable discomfort may appear in women who have not given birth before, and in those for whom a long time has passed since the end of their last menstruation. In general, this procedure for installing a spiral is safe and painless. To confirm the correct installation of the IUD, it is recommended to perform a repeat ultrasound after its installation.

When should you visit a doctor?

After about four weeks since the intrauterine device was installed, the woman needs to visit the gynecologist again. During your visit to the doctor, any possible concerns that may arise after the IUD is inserted into the uterus are discussed. The position of the IUD in the uterine cavity must be monitored.

When is the best time to install a spiral?

You can install an intrauterine device on any day of the menstrual cycle, but the first seven days after the start of menstruation are considered the best period. This is due to the fact that at this time there is no possibility that an intrauterine device could be placed during pregnancy. There are also frequent cases of spontaneous exit of the IUD from the uterine cavity if its installation was carried out in the second phase of the cycle.

When to remove the coil

The IUD can be removed at any time when the desire to conceive a child arises. Also, the spiral must be removed after a certain number of years of its presence in the uterine cavity, replacing it with a new one. The number of years during which the device can remain in the uterus ranges from three to ten, depending on the manufacturers' recommendations and the type of intrauterine device.

The intrauterine device is an effective remedy for unwanted pregnancy. Depending on your preferences, you can choose a copper or hormonal IUD. Under no circumstances try to install the IUD yourself; only a gynecologist should do this!

What is an IUD?

An intrauterine device (IUD) is a small plastic device inserted into the uterus to prevent pregnancy. Modern models are made of plastic and contain metal or a drug (copper, silver, gold or progestin).

What types of intrauterine devices are there?

Modern intrauterine devices are small plastic or plastic-metal devices. Their dimensions reach approximately 3x4 cm. Typically, copper, silver or gold are used to make spirals.

The appearance of most spirals resembles the shape of the letter “T”. The T-shaped shape of the spirals is the most physiological, as it corresponds to the shape of the uterine cavity.

1-27 — variants of spiral shapes. One thing in common is that they all act as a “foreign body”.

28 - Lipps loop. Spirals of this exact shape were common in the USSR. They were produced in three sizes. It was very inconvenient to insert them, since the disposable conductor, which is now attached to each spiral and is made of transparent polymer, was missing; they used a metal conductor, with which it was difficult to control the insertion process. Therefore, complications such as perforation (perforation) of the uterus occurred more often than at present.

29-32 — T-shaped spirals or “teshki” are modern modifications of metal-containing spirals. 33 - also “teshka”. An extremely convenient option for insertion and removal. Due to the fact that the “shoulders” are pulled into the conductor, the manipulation is almost painless.

34-36 - multi-loud or umbrella coils. They perform their function perfectly, but when inserting and removing them, the cervical canal is often injured. There are also cases of defragmentation (when the “hangers” come off the rod).

Which spirals are better?

There is no ideal spiral that would suit everyone without exception. This issue is decided by the gynecologist individually for each woman.

How does the IUD work?

The effect of the IUD consists of several factors:

• thickening of cervical mucus (i.e. mucus of the cervical canal), which makes it difficult for sperm to penetrate into the uterine cavity;
• a change in the properties of the endometrium (the mucous membrane of the uterine cavity), which makes it unsuitable for the implantation (of) an egg;
• due to the effect of a foreign body, the peristalsis of the fallopian tubes increases, which accelerates the passage of the egg through them, during which time it does not have time to reach the degree of maturity required for implantation.

How to use an IUD?

During a short, simple procedure, the doctor inserts an IUD into the uterine cavity.

If you want to make sure that the IUD is in the uterus, you can insert your fingers into the vagina and feel the plastic strings attached to the IUD.

If pregnancy is desired, you can ask your doctor to remove the IUD. Your fertility will be restored immediately.

What are the advantages of this method of contraception?

• High efficiency, comparable to the effectiveness of hormonal contraceptives. To some extent, IUDs are more reliable than hormonal pills because there is no danger of missing pills. When using the IUD, absolutely no action is required on the part of the woman to maintain the contraceptive effect, and, therefore, any possibility of error or accident is eliminated.
• Provides protection from pregnancy for a long time (from 5 to 7 years depending on the type of IUD).
• Use is not associated with sexual intercourse.
• Compared to all other contraceptive methods, the intrauterine device is the cheapest contraceptive method. Despite the fact that the cost of one IUD is many times higher than the cost of one package of birth control pills or one regular package of condoms, recalculating its cost over 5 years (the usual period of wearing one IUD) shows its undeniable superiority in economic terms.
• Unlike birth control pills, metal or plastic IUDs, which do not contain hormones, have absolutely no overall “hormonal” effect on the body, which many women (in some cases justifiably) fear. For this reason, IUDs, which do not contain hormones, are recommended as the primary method of birth control for women over 35 years of age, with active smoking, or with other conditions that make the use of birth control pills impossible, but require a very high level of protection against unwanted pregnancy.
• The spiral is not felt at all during sexual intercourse and does not interfere with partners.

What are the disadvantages of the method?

• Unlike, for example, a condom, an IUD does not protect against sexually transmitted diseases.
• Installation and removal of the IUD should only be performed by a doctor.
• After installation of the IUD, side effects are possible.

What side effects might there be?

Installation of an intrauterine device can lead to some complications, but not all women wearing the device develop complications. Modern research shows that more than 95% of women wearing IUDs consider them to be a very good and convenient method of contraception and are satisfied with their choice.

During or immediately after installation (for all types of spirals):

• Perforation of the uterus (extremely rare);
• Development of endometritis (very rare).

During the entire period of use of the spiral (for metal-containing or plastic spirals without hormones):

• Menstruation may become heavier and more painful.
• There may be bloody vaginal discharge between periods.
• Women with sexually transmitted infections (STIs) are at greater risk of developing pelvic inflammatory disease.
• In some cases, expulsion (complete or incomplete loss) of the IUD from the uterus is possible.

When should an IUD not be installed?

Contraindications for installing the IUD are determined by a gynecologist. Only a specialist can determine exactly how safe it is to install a spiral in your case.

An IUD cannot be installed if:

• You think you might be pregnant.
• You have more than one sexual partner.
• There is an acute form of inflammatory diseases of the cervix or pelvic organs, including STIs.
• Over the past three months, inflammatory diseases of the pelvic organs have been observed.
• Vaginal bleeding of unknown origin is observed.
• There is a fast-growing one, also if the myomatous node deforms the uterine cavity.
• There is cancer of the genital organs.
• There is a severe form of anemia (hemoglobin<90 г/л).

• There is a high risk of contracting an STI.

How to prepare for installing a spiral?

The procedure for inserting an intrauterine device cannot be performed in the presence of any sexually transmitted infections or other gynecological diseases, therefore, before installing the device, the gynecologist conducts a general gynecological examination, taking smears to determine the degree of cleanliness of the vagina and a smear for oncocytology, in some cases an ultrasound is necessary. research. If any infections or gynecological diseases are detected, the insertion of the IUD is postponed until cured.

Before installing the spiral:

How to behave after inserting the IUD?

Within 7-10 days after installing the spiral, you cannot:

• Have sex;
• Do douching;

After 7-10 days it is necessary to undergo a follow-up examination.

Be sure to see your doctor sooner if:

• Within a few days of having the IUD installed, you have a fever, very heavy vaginal bleeding, abdominal pain, or an unusual vaginal discharge with a foul odor.
• Any time after inserting the IUD, you feel the IUD in your vagina, notice that the IUD has moved or fallen out, or if you notice your period is 3-4 weeks late.

What is the follow-up?

If menstruation does not occur within 4-6 weeks after insertion of the IUD, seek advice. You should contact us for a preventive examination at least once a year, and at any time if you have questions or problems.

What symptoms should you see a doctor for?

Application is necessary if:

• You suspect pregnancy.
• You have heavy vaginal bleeding (heavier or longer than usual).
• You experience severe abdominal pain;
• pain is felt and bleeding occurs during sexual intercourse.
• There are signs of infection, unusual vaginal discharge, chills, and fever.
• You cannot feel the IUD strings or feel that they are shorter or longer than before.

Will there be any changes in how you feel and the nature of your menstruation after the insertion of an IUD?

After installing IUDs without hormones, the following changes are possible:

• Your periods become more painful, slightly longer, and more abundant than before the IUD was installed.
• Spotting bloody discharge from the vagina may be observed, before or after menstruation, sometimes (less often) and in the interval between two menstruation.
• In some cases, due to increased pain during menstruation and irregular bleeding, women are forced to stop using the IUD and remove it before the end of the period.

After installing the IUD with hormones (in particular):

• There may be a significant shortening of menstruation and a decrease in the total amount of bleeding during menstruation.
• Approximately 20% of women using Mirena experience complete disappearance of menstruation (amenorrhea). The restoration of menstruation in this case occurs only after the IUD expires and is removed from the uterus. It is reliably known that the disappearance of menstruation in women using Mirena is not associated with inhibition of the ovaries (as with the use of oral contraceptives), but with the suppression of the development of the uterine mucosa by small doses of hormones.
• Despite the fact that many women are afraid of the disappearance of their periods, there is no reason to consider it dangerous to health. Moreover, this effect of hormonal IUDs can even be beneficial, since it significantly improves a woman’s quality of life and is an effective method of treating anemia, which many women with long and heavy periods have. The Mirena IUD is used to treat severe uterine bleeding.

How is the intrauterine device removed?

Removal is usually done after 5-7 years (depending on the modification of the spiral). But if the woman wishes, this can be done at any time. The reason may be the desire to become pregnant or the occurrence of any complications.

Before removal, the same examination is carried out as before insertion of the spiral. If necessary, vaginal sanitation (improvement) is prescribed.

Removal is done by pulling the spiral tendrils at a certain angle. In some cases, for example, in the case of wearing a spiral beyond the prescribed period, removal must be carried out in a hospital setting, with anesthesia, by curettage of the uterine cavity.

Within 4-5 days after removing the IUD you cannot:

• Have sex;
• Use vaginal tampons (you can use regular pads);
• Do douching;
• Take a bath, visit a sauna or steam bath (you can take a shower);
• Engage in heavy physical labor or intense exercise.

Removing the IUD does not cause changes in the menstrual cycle. The exception is the Mirena IUD, when worn, there is an absence of menstruation or scanty cyclic bleeding. After Mirena removal, the menstrual cycle usually returns in about 3-6 months.

Be sure to consult a doctor if, within a few days after removing the IUD, you have a fever, very strong vaginal bleeding, abdominal pain, or unusual vaginal discharge with an unpleasant odor.

Is it possible to remove the spiral yourself?

Do not under any circumstances try to do this!

The spiral is removed by pulling on the tendrils, which may break before it is removed. After this, the IUD can only be removed instrumentally and only by penetrating the uterine cavity. In addition, the mustache may break as the spiral passes through the cervical canal and it will get stuck there. Take my word for it, it is very painful.

To remove the IUD, be sure to consult a gynecologist.

How often should the coil be changed?

Metal-containing spirals (for example, copper or gold) can be used for 5-7 years without replacement. IUDs with hormones (for example, Mirena) require replacement every 5 years.

Can I get pregnant if I wear an intrauterine device?

Pregnancy in women wearing an intrauterine device is extremely rare. The probability of pregnancy when using copper coils is no more than 8 chances out of 1000 during the year. When using IUDs with hormones, the chance of getting pregnant is reduced to 1 in 1000 within a year.

In this case, the course of pregnancy is no different from the course of a normal pregnancy, the spiral is located behind the membranes, and during childbirth it is born along with the placenta. Many women are afraid that the IUD may grow into the child’s body. These fears are unfounded, since the child’s body is surrounded by and. Pregnant women who have the IUD are observed to be at risk.

The risk of pregnancy increases significantly if the IUD becomes dislodged or falls out of the uterus. This happens especially often after menstruation, when the IUD can be thrown out of the uterine cavity along with the rejected tissue.

In this regard, all women who wear the IUD are recommended to check the presence of the IUD in the uterus at least once a month by feeling the antennae of the IUD deep in the vagina. If you previously felt the antennae of the spiral well, but can no longer find them, contact your gynecologist, as the spiral may have fallen out and you did not notice it.

How do I know if I am pregnant while wearing the IUD?

If While wearing a non-hormonal intrauterine device, your period is delayed by more than 2-3 weeks, you need to take a home pregnancy test and consult a doctor.

Could the IUD interfere with my ability to get pregnant in the future?

The contraceptive effect of intrauterine devices is easily reversible and disappears soon after their removal from the uterine cavity. The probability of pregnancy occurring within 1 year after removal of the IUD reaches 96%.

Planning a pregnancy is possible as early as the next month after removal of the intrauterine device.

Well, if a woman has already become a mother, and maybe more than once, then there are very few people who want to repeat this feat a dozen more times and give birth every year. That is why, since ancient times, people have adapted to avoid becoming pregnant without desire. In order to deceive nature, they came up with simple methods of contraception (from the Latin word contraceptio - exception). We started with various essential oils, fruit juices, tampons, lotions, interrupted contact, fabric bags (the predecessor of a condom), and so on.

As you can see, the spiral affects all processes necessary for conception:

• vital activity and speed of sperm movement;
• egg maturation and ovulation;
• attachment of the fertilized egg to the endometrium.

Pros and cons of using intrauterine devices

Indications for installation of an intrauterine device

• uterine fibroids, especially if it is accompanied by heavy spotting and uterine bleeding;
• heavy, painful periods;
• estrogen replacement therapy at the beginning of menopause or after removal of the appendages, in order to prevent the growth of the endometrium.

Contraindications

Absolute contraindications to the use of all intrauterine devices

• Presence of pregnancy at any stage, suspicion of possible pregnancy;
• oncological pathologies of the genital organs, as well as breast cancer;
• acute and chronic inflammatory diseases of the female genital organs: adnexitis, colpitis, endometritis, including postpartum, salpingitis and so on, including the presence of sexually transmitted diseases;
• a history of ectopic pregnancies;
• allergic reactions to the materials from which the spiral is made;
• tuberculosis of the reproductive system;

Relative contraindications to the use of non-hormonal IUDs

• if the woman does not have children yet;
• a woman is promiscuous and is at risk for contracting sexually transmitted diseases;
• childhood and adolescence*;
• woman's age over 65 years;
• uterine bleeding and heavy painful periods;
• abnormalities of the uterus (for example, bicornuate uterus);
• hematological diseases (anemia, leukemia, thrombocytopenia and others);
• endometrial growths, endometriosis;
• urethritis, cystitis, pyelonephritis - acute or exacerbation of a chronic course;
• benign tumors of the uterus and appendages (submucosal myoma and uterine fibroids);
• loss of the intrauterine device or the development of side effects after previous use of the device.

Relative contraindications to the use of hormonal intrauterine devices (systems):

• cervical dysplasia;
• abnormalities of the uterus;
• urethritis, cystitis, pyelonephritis - acute or exacerbation of a chronic course;
• uterine fibroids;
• liver diseases, liver failure;
• severe cardiovascular pathologies: malignant arterial hypertension, conditions after a stroke or heart attack, severe heart defects;
• migraine;
• decompensated (uncontrolled) diabetes mellitus;
• thrombophlebitis of the lower extremities;
• woman's age over 65 years.

When can I get an IUD after childbirth, cesarean section, or abortion?

After a cesarean section, the IUD can be installed in the uterine cavity only after 3-6 months. It takes time for a postoperative scar to form.

After a medical termination of pregnancy (up to 12 weeks), it is better to install an IUD within seven days after the start of the next period after the abortion. But a gynecologist may suggest installing an IUD immediately after an abortion, without getting up from the gynecological chair. This is possible, but in this case the risk of developing side effects of the intrauterine device associated with complications of the abortion itself increases significantly. After a miscarriage, the decision on the feasibility and safety of installing an IUD is made only by a doctor; he assesses the situation individually, analyzes the cause of spontaneous abortion, and weighs the pros and cons. If it is necessary to use a device after a miscarriage, it is installed in the uterine cavity during the next menstruation.

Is an intrauterine device installed after the age of 40?

How is an intrauterine device installed?

Recommended examination before inserting an intrauterine device:

• gynecological examination and palpation (palpation) of the mammary glands;
• vaginal smear, if necessary, culture for microflora;
• cytological examination of smears from the cervix;
• Ultrasound of the pelvic organs;
• in some cases, a pregnancy test or blood test to determine hCG levels;
• Ultrasound of the mammary glands (for women under 40 years of age) or mammography (after 40 years of age).

Preparing for installation

Immediately before the procedure, you must empty your bladder.

On what day of menstruation is it better to install an intrauterine device?

An intrauterine device can be installed as emergency contraception, that is, if a woman has had unprotected sexual intercourse and expects an unwanted pregnancy. In this case, the device is inserted in the period after ovulation, this can prevent the attachment of the fertilized egg in 75% of cases.

Technique for inserting an intrauterine device

In most cases, local anesthesia is not required. Anesthetics in the cervical area can be used in nulliparous women and when installing hormonal intrauterine systems, since they are wider.

The insertion technique for different types of spirals may differ. The installation features of each spiral are described in detail in the device instructions.
1. A gynecological speculum is inserted into the vagina, with the help of which the cervix is ​​fixed.
2. The cervix is ​​treated with disinfectants.
3. Using special forceps, the cervical canal (the canal in the cervix that connects the vagina to the uterus) is straightened, and the cervix is ​​opened.
4. A special probe is inserted through the cervical canal into the uterine cavity to accurately measure the length of the uterus.
5. If necessary, the cervix is ​​anesthetized (for example, lidocaine or novocaine). The insertion of the spiral itself begins after 4-5 minutes, when the anesthetic takes effect.
6. The spiral is inserted using a special guide with a piston. A ring is placed on it on a scale according to the size of the uterus, this is necessary in order not to damage its walls. Then a conductor with a spiral is inserted into the uterus. Having reached the corresponding mark, the doctor slightly pulls the piston towards himself so that the shoulders of the spiral open. After this, the spiral is moved directly to the wall of the uterine fundus. When the gynecologist is sure that the device is installed correctly, the guidewire is slowly and carefully pulled out. When installing some spirals (for example, ring-shaped), the opening of the shoulders is not required, so the spiral is inserted to the wall of the uterine fundus, and then the guide is simply pulled out.
7. The spiral threads are cut into the vagina at a distance of 2-3 cm from the cervix.
8. The procedure is completed, it usually takes 5-10 minutes.

Is inserting an intrauterine device painful?

After installation of the intrauterine device

• The uterus completely gets used to the IUD within several months, so during this period some changes in women’s health may be observed; you need to listen to your body.
• In some cases, a course of antibacterial therapy will be required after insertion of the spiral, for example, if chlamydia is suspected, or if there is another chronic infection of the genitourinary system.
• Bloody spotting and nagging pain in the lower abdomen or back may bother you for 1 week after insertion of the IUD. To relieve spasms, you can take No-shpa.
• The hygiene regime is normal; you need to wash yourself with intimate hygiene products twice a day.
• You can have sex only 8-10 days after the installation of the intrauterine device.
• For several months, you should not lift weights, engage in intense physical activity, or overheat (sauna, bathhouse, hot baths).
• It is necessary to periodically probe the spiral threads, control their length, it should not change.
• After 2 weeks, it is better to visit a gynecologist to see if everything is normal.
• Menstruation in the first months after installation of the IUD may be painful and heavy. Over time, menstruation normalizes.
• When using hormonal intrauterine systems, after six months or several years, menstruation may disappear (amenorrhea). After the first loss of a cycle, it is necessary to exclude pregnancy. The menstrual cycle will be restored immediately after the IUD is removed.
• If you have any complaints, you should consult a doctor.
• In the future, examination by a gynecologist is necessary every 6-12 months, as for any healthy woman.

Can an intrauterine device fall out?

How long does it take to use an intrauterine device?

• Inert IUDs are usually installed for 2-3 years.
• Copper spirals – up to 5 years.
• Copper spirals with silver and gold - 7-10 years or more.
• Hormonal intrauterine systems – up to 5 years.

It is not recommended to use an IUD after the expiration date due to the risk of the IUD growing into the uterine tissue. Hormonal IUDs lose their properties due to depletion of hormonal drug reserves. This reduces the effectiveness of the intrauterine device, which can lead to unplanned pregnancy.

Intrauterine devices (copper, hormonal): installation, operating principle, effectiveness (Pearl index), shelf life. How to check if the spiral is in place - video

Removal and replacement of the intrauterine device

• the period of use has expired, and it is possible to replace the intrauterine device;
• a woman is planning a pregnancy;
• there were side effects from the use of an intrauterine device.

Removal of the IUD often does not require pain relief; local anesthesia will be required when removing or replacing hormonal IUDs. The doctor fixes the cervix with a gynecological speculum, and then, using a special tool (forceps), grabs the threads of the spiral and carefully pulls out the device, while carefully stretching the cervix.

Usually this procedure goes without difficulty, the woman experiences less pain than when inserting a spiral. But there are situations when the spiral cannot be pulled out so easily, then the doctor widens the cervical canal and makes it easier to remove the IUD. You may also encounter the problem of broken threads, then the doctor inserts a special hook through the cervix, with the help of which the foreign body is removed from the uterine cavity.

But there are situations when the doctor simply does not detect the spiral threads. The question arises: is there a spiral in the uterus at all? If so, where is she? To do this, the woman is offered an ultrasound of the pelvic organs, and, if necessary, radiography. Sometimes there are cases when the spiral is located outside the uterine cavity (due to perforation of its wall), then laparoscopic surgery is urgently needed to remove the foreign body.

Replacing the spiral intrauterine contraception can be performed immediately after removal of the old IUD; the risk of developing any complications does not increase.

Special instructions before removing and replacing the intrauterine device:

• timely replacement of the IUD facilitates the procedure and guarantees continuous contraceptive action;
• It is better to carry out the procedure during menstruation;
• removing the IUD during or before ovulation increases the risk of pregnancy;
• before replacing the IUD, it is necessary to use other methods of contraception (condom, oral contraceptives or spermicides) 7 days in advance to prevent an unwanted pregnancy.

Possible side effects

Possible side effects and complications when using an intrauterine device

• "Nulliparous cervix";
• irritation of the autonomic nervous system;
• increased emotionality of a woman;
• The size of the intrauterine device does not correspond to the size of the uterus.

Additional side effects from the use of a hormonal intrauterine system (related to the hormone progestogen):

• absence of menstruation (amenorrhea), after removal of the device the menstrual cycle is restored;
• functional ovarian cysts (benign formations), hormonal therapy with estrogen hormones will be required;

Also, an allergic reaction may develop to the administration of gestagen, requiring urgent removal of the device from the uterus.

Intrauterine device (IUD): composition, action, indications, possible negative consequences of use - video

Intrauterine device (IUD): mechanism of action, dangerous complications (therapist's opinion) - video

How can pregnancy proceed with an intrauterine device?



As has already become clear, intrauterine contraceptives do not protect 100% from pregnancy. For the majority of these “lucky ones,” the pregnancy proceeds normally, the child can independently push the coil out in the second trimester and even be born with it in his hands; for some children it’s like a toy. But everything is not always so smooth, and if a woman decides to continue such a pregnancy, she should be prepared for various problems.

Basic principles of managing pregnancy with the IUD:

1. Difficulties arise with diagnosing pregnancy; the woman is confident in her contraception. And menstrual irregularities with an IUD are not uncommon; this leads to the fact that pregnancy can be diagnosed late, when abortion is already difficult. Therefore, it is very important to listen to your body and consult a doctor at the slightest deviations, changes or hints of pregnancy.
2. If a woman wishes, a medical abortion can be performed.
3. The IUD is not an indication for medical termination of pregnancy. The choice is up to the woman, because in most cases, pregnancy with the IUD proceeds normally and without complications. But still, the doctor must assess the possible risks of pregnancy and may recommend terminating it.
4. The IUD can be removed during pregnancy. The copper coil is often not removed as it does not affect the development of the fetus. The hormonal IUD will release hormones throughout pregnancy that can lead to fetal developmental abnormalities. The gynecologist can remove the IUD if its threads are preserved and it is removed from the uterus easily and smoothly.
5. Such a pregnancy requires constant monitoring by doctors; regular monitoring of fetal ultrasound is necessary.

Possible risks of pregnancy with an intrauterine device:

• High risk of ectopic pregnancy; ultrasound monitoring is required.
• Such a pregnancy can end in miscarriage at an early stage, which is associated with the effect of the coil on the endometrium, to which the fertilized egg is attached.
• The IUD can cause intrauterine infection of the fetus, as well as intrauterine growth retardation and pregnancy loss.
• High risk of fetal malformations during pregnancy with hormonal IUD.
Be that as it may, if a woman nevertheless becomes pregnant with such a powerful contraceptive as the IUD, then, probably, the child really needs to be born. Every woman can listen to herself and decide whether to give this baby a chance to live or not.

How to choose a good intrauterine device? Which spiral is better?

Your gynecologist should select the type of IUD, its size and manufacturer. Only he can determine the indications and contraindications for using a particular intrauterine contraceptive, and the individual characteristics of your body. But if the woman is absolutely healthy, then the doctor can provide a choice of IUDs. Then many questions arise.

“Which IUD should I choose, copper or hormonal?” Here a woman needs to choose between effectiveness and possible adverse reactions. The hormonal IUD has more possible side effects associated with gestagen, but they are temporary and stop after a few months. And the contraceptive effect of using such a device is much higher. If a woman has fibroids, then the hormonal IUD is a method of not only contraception, but also treatment. A copper IUD with silver and, especially, gold has higher efficiency than a conventional copper device, and the risk of side effects is lower; this is a kind of middle ground between a hormonal and a copper IUD.

“How much does an intrauterine device cost?” For many women, the issue of cost-effectiveness is of great importance and determines the choice of a spiral. Copper IUDs are much cheaper than hormonal systems. Also, spirals with silver and gold have a high cost.

“Which coil is used the longest?” Spirals with silver and gold can be used the longest, up to 7-10 years or more. Hormonal IUDs are usually used for no more than 5 years.

“Which IUD will not affect future pregnancies?” Any IUD can lead to problems with future pregnancies, including ectopic pregnancy and infertility due to an inflammatory process. The risk of developing an ectopic pregnancy during IUD use is higher with hormonal IUDs due to the action of progestogen. Copper IUDs pose a greater risk of complications such as inflammation of the uterus and appendages. When an IUD is removed, ectopic pregnancy often occurs after the use of copper IUDs.

“Which coil is painless?” During installation and removal of the coil, the woman experiences some pain. But this should not fundamentally affect the choice of an IUD. When the hormonal system is introduced, these painful sensations are more pronounced, which is why local anesthesia is used. Local anesthesia can be performed by introducing a copper spiral in women who are especially impressionable and emotional.

Review of various modern intrauterine devices: Juno, Mirena, Goldlily, Multiload, Vector extra, spirals with gold and silver

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