Pros and cons of the intrauterine device. Intrauterine device - photo. Which intrauterine device is better

One of the most popular methods of protection against unwanted pregnancy– installation of an intrauterine device (IUD). The IUD prevents the penetration of sperm and does not allow the fertilized egg to attach to the walls of the uterus. However, this method of protection against pregnancy has not only its advantages, but also some disadvantages.

Intrauterine device

Benefits of the intrauterine device

The intrauterine device is quite easy to use. It is installed by an experienced gynecologist, and manipulation does not cause any difficulties. The main contraceptive effect of the IUD begins immediately after installation. If married couple decides to conceive a child, then this issue can be addressed immediately after removing the IUD. The IUD is placed for up to five years and does not require constant monitoring. That is, a woman does not need to be constantly on guard, as when taking oral contraceptives.

Before inserting the IUD, the gynecologist must take a smear for flora

Lactation is not a reliable method of protection against new pregnancy, and hormonal contraceptives are not recommended to be taken during breastfeeding. That's why intrauterine device V in this case is the most a good option. It protects almost 90–95% from unplanned pregnancy and does not affect the lactation process in any way. In addition, the IUD does not interfere with sex life.

There are many types of intrauterine devices. You can buy a spiral at the pharmacy, the action of which is based on the release of hormones. In addition to its main contraceptive function, it also has medicinal properties. Helps fight endometriosis and some inflammatory processes in the female reproductive system. Due to its hormonal properties, this IUD shortens the duration of the menstrual cycle and makes the discharge less abundant.

Disadvantages of the intrauterine device

It is not recommended to insert an IUD nulliparous women. A woman may experience painful sensations and discomfort in the lower abdomen. For a month after installation of the IUD, you should not visit the sauna or swimming pool. Heavy ones should be avoided physical activity. During this period, the spiral should reliably take its place in the uterine cavity. You cannot install an IUD under the following factors:

• Pre-tumor processes are observed in the cells of the cervix;
• there are tumors on the genitals;
• there was an ectopic pregnancy;
• there are blood diseases.

No contraceptive method can guarantee 100% protection.

IN gynecological practice For the treatment of certain diseases, as well as as a means of contraception, the intrauterine device is often used. In this article we'll talk about the advantages and disadvantages of this method and which drug is the best and most effective.

An intrauterine device, or IUD for short, is a small device that provides high level effectiveness in preventing unwanted pregnancy. This contraceptive is prescribed by a gynecologist to protect many women from unplanned conception. In addition, some of the species are therapeutic and are used in the treatment of many gynecological diseases.

Modern spirals are represented by the following types:

1. For manufacturing materials:

• Copper spiral. It is a popular type of spirals. The principle of operation is to ensure increased amount leukocytes and local inflammatory reaction of the uterine cavity, which has a spermicidal effect. It is established for a period of no more than three years.
• Silver. Thanks to its composition, it not only prevents fertilization, but also has an antibacterial effect. Can be installed for up to five years.
• With the addition of gold or platinum. Such spirals belong to the group of new generation contraceptives.

1. Behind the lineup:

• Hormonal. This tool has a T-shape. Contains hormones that penetrate the organ cavity and interfere with the maturation of the egg. Another property is to increase mucous viscosity, resulting in reduced sperm movement.
• No hormones. They are usually used if other types of contraception are intolerant or if there are restrictions on their use.

1. According to the form, the intrauterine device is:

• T-shaped;
• round;
• ring-shaped;
• semi-oval.

The indication for using a contraceptive device is the desire to prevent unwanted pregnancy.

A qualified doctor will help you determine which of these models is better in terms of shape and composition in each individual case.

Which intrauterine device is better?

Many women are interested in the question: which IUD to choose for pregnancy protection? There are several types of such devices for protection against unplanned conception, depending on the composition and form. Each of these intrauterine devices has its own mechanism of action.

It is impossible to reliably say which of these IUDs is the best. Only an experienced gynecologist can choose the best IUD option for each woman, taking into account individual characteristics body. Therefore, when choosing such a product, the patient needs to consult a doctor, as well as conduct a study before installing the spiral.

Let's look at the pros and cons of using an IUD. The main advantages of this tool include:

• action long time(from three to ten years);
• efficiency more than 99 percent;
• no need to monitor the product every day;
• maximum reliability;
• efficiency;
• anti-inflammatory property of the silver IUD;
• availability of the method;
• simplicity and speed of installation;
• a small percentage of side effects.

Another advantage is the possibility of rapid recovery after removal of the IUD for pregnancy and childbirth. A woman can become pregnant after removing the IUD for a year.

In addition, when using some spirals, a woman’s health improves, since they have medicinal properties. Among the advantages is the opportunity to lead a normal lifestyle (sports and smoking are allowed).

Flaws

Among the disadvantages of the spiral are:

• the likelihood of developing depression;
• pain and cramps during menstruation and profuse discharge in the first stages of use;
• exhaustion;
• do not provide protection from venereal diseases and HIV infection;
• possibility of spontaneous loss;
• regular monitoring of the presence of spiral threads in the vagina;
• the occurrence of spotting between menstruation;
• increased risk of inflammatory processes in the pelvic organs.

The disadvantages of spirals, depending on their varieties, are:

• spirals containing hormones or precious metals, have a high cost;
• hormonal IUD as a result of ovarian dysfunction can cause side effects such as headache, depressed state, the appearance of acne on the skin, increased sweating, weight gain, decreased libido;
• Copper IUDs increase the duration and;
• IUDs with hormones increase the risk of developing cancer.

Other disadvantages of using this type of contraception are the development of undesirable consequences. These include increased risk ectopic pregnancies and miscarriages. It is better to ask your gynecologist about the dangers of this or that type of IUD.

There are also some restrictions on the use of intrauterine devices. These include:

• period of bearing a child;
• malignant neoplasm in the cavity or cervix;
• breast cancer;
• fibroids or myoma;
• inflammation of the reproductive system;
• deformation of the organ cavity;
• venereal diseases;
• bloody discharge of unknown origin;
• HIV infection;
• penchant for allergic reactions for copper.

IUDs are not used for hepatitis, cirrhosis, thrombosis, coronary disease heart and migraine.

A contraceptive like contraceptive device most often it is a device consisting of copper and plastic. Some contraceptives are made from silver.

The anti-pregnancy spiral, depending on its composition, acts as follows:

• helps slow down motor function spermatozoa in ;
• reduces the vital activity of the egg;
• changes a woman’s hormonal levels;
• reduces the endometrium in the uterus;
• ensures the production of thick mucus in the uterus;
• prevents the fertilized cell from attaching to the wall of the organ.

After unprotected sexual intercourse, an IUD prevents the fertilized egg from implanting in the uterine cavity, so the embryo cannot develop further.

The contraceptive IUD can be placed on women in the absence of gynecological diseases, if their periods are moderate, regular and painless.

Contraceptive device after childbirth

After childbirth or abortion, specialists do not recommend using an intrauterine device for contraception. However, there are some types of new generation IUDs that can be inserted immediately after delivery. Half an hour after birth, it is possible to install a Multiload spiral. It can also be used six weeks after the baby is born.

Is it painful to insert an intrauterine device?

The spiral is installed only qualified specialist in a hospital setting.

Many patients ask the question: when is an IUD placed, on what day of the cycle? Experts say that installation can be performed 6-7 days after menstruation. During this phase, the cervical canal is slightly open, which makes it easier to install the IUD.

The cervix is ​​dilated using gynecological speculum and washed antiseptic. The direction of the channel and its depth are then assessed. The IUD is inserted into the organ cavity using a special guide. After this, the conductor is removed, and the spiral threads are slightly trimmed.

Installation of the spiral takes approximately 5-10 minutes.

The patient may experience minor pain during this procedure. Generally, discomfort and unpleasant sensations may occur.

How to remove an intrauterine device

The IUD can be removed as soon as the woman wishes. This procedure performed in medical institution experienced specialist.

Indications for removal are:

• expiration of the period of use of the product;
• in the presence of side effects.

Before removing the IUD, you need to visit a gynecologist and undergo some tests.

Spiral Multiload

This intrauterine therapeutic system(IUD) is one of the reliable and popular means. It is often recommended to women by experts.

Compound

Is non-hormonal agent. Consists of polyethylene and copper. The threads are made of nylon.

Release form

It comes in the form of an intrauterine device that looks like the letter “T” and has flexible shoulders for better placement in the uterine cavity.

How it works

This barrier coil primarily affects male sperm, blocking the egg's ability to conceive.

Due to the presence of copper, it causes inflammatory changes at the local level, which leads to spermicidal effects. As a result, the risk of becoming pregnant is reduced by 99%.

Contraindications and side effects

Contraindications to the use of the Multiload spiral are:

• increased sensitivity to copper alloys;
• oncological formations;
• uterine bleeding;
• suspicion of pregnancy;
• infectious and inflammatory diseases of the genitourinary system;
• cervical dysplasia;
• endometriosis;
• infected abortion.

Install the IUD with caution when breastfeeding.

When using the IUD, menstruation sometimes intensifies, and spotting is possible between cycles. In some cases, dysmenorrhea and bradycardia may develop.

In the first months of using the product, the following reactions may be observed:

• pain in the lower abdomen;
• hives;
• lower back pain;
• development of genitourinary infections.

If such symptoms are observed, then it is necessary to inform a specialist, since the spiral may not be suitable for the woman.

This remedy can be used for girls who have not given birth. However, in some cases, after removal of the spiral, undesirable consequences. After using an IUD, the risk of miscarriage may increase. Therefore, it is advisable for girls to use other ways to prevent unplanned pregnancy.

How effective is this coil? Manufacturers claim more than 99 percent. However, it is important to remember that there is always a small risk of serious consequences.

Mirena spiral: instructions for use

Most good spiral hormonal ones are Mirena. This remedy takes a long time, has many advantages, but can cause hormonal imbalance.

Composition and form

Mirena is produced in the form of a T-shaped intrauterine device. It contains levonorgestrel.

Action

A small dose of the hormone is released daily from the IUD into the uterine cavity without being absorbed into the blood. As a result, conception does not occur during ovulation.

Thanks to its medicinal properties, the product helps with fibroids and endometriosis.

Contraindications and side effects

Mirena is contraindicated if the patient has:

• pregnancy;
• cancer diseases;
• inflammatory processes in the genitourinary organs;
• abnormalities in the structure of the uterus;
• submucous fibroid.

TO side effects include headache, acne on the face, sweating, menstrual irregularities, and depression.

Experts have proven the effectiveness of such a contraceptive as the intrauterine device. It has a lot of advantages compared to other methods of preventing unplanned conception.

On pharmaceutical market There is a wide variety of IUDs, which differ in their composition and action. However, only a qualified gynecologist can choose which remedy is the best and most suitable for a woman.

An IUD (intrauterine device) is a small device made of copper or plastic. It is injected directly into the uterus and protects the woman from unwanted pregnancy.

History of the intrauterine device

The intrauterine device is one of the oldest methods of contraception. The first spirals were used four thousand years ago. Of course, it bore little resemblance to the modern model. But already in 1926, the German doctor Ernst Gräfenber first proposed the use of an intrauterine ring consisting of copper, which would prevent unwanted pregnancy. And in 1960, the American Jack Lipps came up with the so-called “Lips Loop”, it was unique at that time, since he used elastic materials, this made it possible to reduce injury during installation of the spiral. Thanks to his discovery, came into being modern models intrauterine device.

What does a modern IUD look like?

Most often it is made of plastic and has two threads at the end to make it easier to remove. The intrauterine device is T-shaped and is inserted into the uterine cavity. Only a gynecologist can install and remove the spiral. Usually the spiral is placed for several years (one spiral can be worn for up to 10 years). It is best to install the IUD on the 3-4th day of menstruation, when the cervix is ​​slightly dilated and the uterine cavity is less traumatic.

Types of intrauterine devices

• copper spirals - secreted into the uterine cavity a small amount of copper, it prevents sperm from entering the fallopian tubes. Also copper changes inner layer uterus and does not allow the attachment of a fertilized egg;
• hormone-containing – consist of the hormone progestin. It works in the same way as copper spirals, only their duration is shorter.

Pros of intrauterine devices

• easy to install;
• can be used for a long time;
• no need for daily monitoring;
• high efficiency;
• after removal of the IUD, occurs fast recovery fertility (the ability to create viable offspring).

Disadvantages of the intrauterine device

• does not protect against sexually transmitted diseases;
• there is a possibility of the spiral shifting;
• should not be used by women who have not given birth;
• rupture of the uterine wall may occur;
• there is a possibility of intrauterine pregnancy;
• painful periods;
• menorrhagia ( big loss blood during menstruation).

When you should not use an intrauterine device:

• during pregnancy;
• for infertility;
• for vaginal infections;
• at inflammatory diseases;
• with bleeding;
• with severe anemia;
• for genital cancer.

When to see a doctor after insertion of an IUD:

• heavy bleeding ( a long period time);
• lower abdominal pain;
• suspicion of pregnancy;
• pain or bleeding during sexual intercourse;
• there were signs of infection ( unusual discharge from the vagina, increased body temperature);
• the spiral threads became longer or shorter.

Before inserting an intrauterine device, the doctor must:

• carefully examine the woman;
• do all the necessary tests;
• the doctor probes the uterine cavity;
• measures the length and distance between the uterine angles;
• does an ultrasound.

This helps reduce the number of possible complications.

What you should know about the intrauterine device

• It is better to administer in the first days after menstruation;
• It is recommended to use pain-relieving suppositories 1-2 days before;
• after insertion, women feel pain in the lower abdomen (pain appears as a result of contraction of the uterus, as it reacts to the insertion of a foreign body);
• bloody discharge may appear;
• after insertion of the IUD, you should rest for 30-40 minutes;
• in the first days after the insertion of the IUD, physical activity is prohibited;
• worth going through medical checkup after insertion of the IUD. The first one is after a month, the second one is after 3 months, and then every 6 months.

The effectiveness of the intrauterine device is 98%, it is convenient to use, does not require large expenses and can be used for a long time. This is a convenient method of contraception for women who have already given birth and have one sexual partner, since the IUD only protects against unwanted pregnancy, but not against sexually transmitted diseases.

Intrauterine device is one of the common methods of protection against unwanted pregnancy. The essence of this method is that injected into the uterine cavity foreign body(spiral) does not allow the uterine cavity to close.

In addition, the copper with which the “leg” of the spiral is braided causes a slight local inflammatory reaction as a result which causes sperm to lose its ability to fertilize. This is the contraceptive effect of the IUD.

The spiral is inserted into the uterine cavity on the 2-3rd day of menstruation for up to 5 years. There are two types of spirals - for women who have given birth and for women who have not given birth.

Types of intrauterine devices

Currently, there is a wide variety of intrauterine devices.

In addition to IUDs, the contraceptive effect of which is determined by mechanical and chemical factors, IUDs are also used that contain hormonal drugs and have a hormonal action on the body.

Intrauterine devices with hormonal drugs are placed not only to prevent unwanted pregnancy, but also for therapeutic purposes. Despite the significant cost (about 15 thousand rubles), the Mirena intrauterine device, which contains hormonal drug levonorgestrel(gestagen).

The most popular models of mechanical intrauterine devices are the Juno intrauterine devices. Besides, in Lately Such intrauterine devices as “Multiload”, “golden” device “GoldLily”, spirals “Nova-T”, “Vector”, etc. are widely used. The price of such intrauterine devices starts from 700 rubles. up to 5 thousand rubles.

Intrauterine device "Juno"

Intrauterine devices "Juno" are available in different forms: F-shaped, T-shaped and ring-shaped spirals. The Juno Multi intrauterine device with copper is one of the most affordable and widespread models of intrauterine devices, although recently the Juno Bio T model with copper has become more popular among women.

The most popular Juno spirals:

• Intrauterine device "Juno Multi" with copper;
• Intrauterine device "Juno Multi Ag" with silver;
• Intrauterine device "Juno Bio T" with copper;
  
• Intrauterine device "Junona Bio T Ag" with silver;
• Intrauterine device "Juno Bio T Super" with propolis;
• Intrauterine ring-shaped device Simurg Juno Bio-T;
• Ring-shaped intrauterine device "Junona Bio-T" with silver.

Pros and cons of the intrauterine device

Pros of installing an intrauterine device

Studies have shown that intrauterine contraception is the most common method of family planning among women of late age. reproductive age- 35 years and above (44.0%) with parity - 4 or more births (62.0%). Preference this method Contraception is predominantly used by housewives (91.0%) and rural residents.

Installation of the spiral is carried out once every five years. The use of a spiral allows you not to use birth control pills and other contraceptives. In the absence of contraindications, the IUD is suitable for couples living a regular sex life in a marital union. In this case, partners must be sure that each other does not have sexually transmitted infections.

Disadvantages of installing an intrauterine device

This method of contraception has its disadvantages. The main thing is that the constant openness of the uterine cavity allows microbes to easily penetrate through the ascending route.

The IUD cannot protect against sexually transmitted diseases.

The degree of reliability of the contraceptive effect of the IUD is 75-80%.

In order to install the IUD, you must consult a gynecologist, and only a gynecologist can install it.

You should also pay attention to the fact that the presence of a foreign body in the uterus provokes abundant, prolonged and sometimes very painful menstruation for a long time.

If there is a spiral, fluid from the uterus can flow into abdominal cavity, and not vice versa (as it should be). This may cause both endometriosis, when cells from the lining of the uterus spread into the abdominal cavity, and ectopic pregnancy.

It must be remembered that the IUD does not guarantee 100% protection against pregnancy; moreover, the percentage of ectopic pregnancies in women who have the IUD installed is almost 4 times higher than in other women.

In women using intrauterine contraception, installed high frequency inflammatory diseases of the genitals (39.4%), cervical pathology (20.4%), menstrual cycle disorders (12.5%).

However, for most women of average age category using IUDs is typical high index somatic pathology, of which the leading position is occupied by anemia (80.6%), diseases gastrointestinal tract(32.3%) and urinary system (12.5%).

A high incidence of complicated pregnancy, childbirth, and adverse perinatal outcomes has been established in women whose pregnancy occurred after removal of the IUD, especially in those women who did not undergo rehabilitation measures after removing the spiral.

Contraindications to the installation of an intrauterine device

This method of contraception has its contraindications. An intrauterine device should not be installed if there is cervical erosion, chronic infections uterus and appendages, as well as malignant tumors body or cervix.

In women who have scar deformity cervix after childbirth, the spiral simply does not hold on because uterine contractions push it out. A woman may not feel the device fall out, and conception will occur.

Intrauterine device "Mirena" (hormonal)

Currently, the Mirena hormonal intrauterine device is widely used by younger women.

Mirena is installed primarily to prevent unwanted pregnancy.

In addition, the Mirena spiral is often used not only for contraception, but also for the treatment of gynecological diseases associated with disorders hormonal levels, such as endometriosis, uterine fibroids and etc.

Mirena is used for very heavy menstrual bleeding for an unknown reason. As a local gestagenic agent, the intrauterine device is used to prevent endometrial hyperplasia, for example, during severe menopause or after bilateral oophorectomy.

Mirena has a T-shape, which helps to securely fit into the uterus. One of the edges is equipped with a loop of threads designed to remove the system.

In the center of the Mirena coil is a whitish hormone. It slowly enters the uterus through a special membrane. The hormonal component of the IUD is levonorgestrel(gestagen). One system contains 52 mg of this substance.

The Mirena contraceptive system begins to “release” levonorgestrel into the uterus immediately after installation.

The hormone enters the cavity at a rate of 20 mcg/day; after 5 years, this figure drops to 10 mcg per day. The spiral has local action, levonorgestrel is almost all concentrated in the endometrium. In the muscular layer of the uterus, the concentration is no more than 1%.

After insertion of the IUD active ingredient enters the bloodstream in about an hour. There it is highest concentration achieved after 2 weeks. This indicator can vary significantly depending on the woman’s body weight. Thus, with a body weight of up to 54 kg, the content of levonorgestrel in the blood is approximately 1.5 times higher. Active substance almost completely broken down in the liver and evacuated by the intestines and kidneys.

The contraceptive effect of Mirena does not depend on a weak local foreign body reaction, but is mainly associated with the effect of levonorgestrel. The introduction of a fertilized egg is not carried out due to the suppression of the activity of the uterine epithelium. At the same time, the natural growth of the endometrium is suspended and the functioning of its glands is reduced.

Also, the Mirena coil impedes the motility of sperm in the uterus and its tubes. Contraceptive effect means increases high viscosity cervical mucus and thickening of the mucous layer cervical canal, which complicates the penetration of sperm into the uterine cavity.

Compared to the use of other intrauterine devices and hormonal contraceptives, the Mirena intrauterine device has both pros and cons.

The degree of protection against unplanned pregnancy with this device is much higher than that of mechanical devices, since it contains a gradually released hormonal drug inside, which has a hormonal effect on the woman’s body for 5 years from the moment of installation.

After installation of the Mirena coil, a restructuring of the endometrium is observed for several months, manifested by irregular spotting. After some time, proliferation of the uterine mucosa provokes a significant decrease in the duration and volume of menstrual bleeding, up to their complete cessation.

During menstruation, there is a high risk of the IUD falling out. This process goes unnoticed by the woman. Accordingly, when Mirena falls out, the contraceptive effect ends. To avoid misunderstandings, it is recommended to inspect used tampons and pads for the spiral to fall out. The manifestation of the beginning of the IUD falling out in the middle of the cycle can be bleeding and pain. If incomplete expulsion (fallout) occurs, the doctor must remove the coil and install a new one.

Side effects of the Mirena intrauterine device

There are a number side effects Mirenas, which are found in almost every tenth woman who has installed a spiral:

• disorders of the central nervous system: short temper, headache, nervousness, Bad mood, decreased sexual desire;
• weight gain and acne;
• gastrointestinal dysfunction: nausea, abdominal pain, vomiting;
• vulvovaginitis, pelvic pain, spotting;
• chest tension and tenderness;
• back pain, as with osteochondrosis.

All of the above signs appear most clearly in the first months of using Mirena. Then, usually, their intensity decreases and, as a rule, unpleasant symptoms pass without a trace.

Possible undesirable consequences of using the Mirena spiral

• Ectopic pregnancy– develops extremely rarely and requires emergency treatment surgical intervention. This complication can be suspected if symptoms of pregnancy occur (long delay of menstruation, dizziness, nausea, etc.) together with severe pain lower abdomen and signs internal bleeding (severe weakness, pale skin, tachycardia). The likelihood of such a complication is higher after severe inflammatory or infectious pathologies pelvis or a history of ectopic pregnancy.
• Penetration(ingrowth into the wall) and perforation (perforation) of the uterus usually develop with incorrect position spirals. These complications may be accompanied by lactation, recent childbirth, or unnatural position of the uterus.
• Expulsion(loss of) IUD from the uterus occurs quite often. For its early detection, patients are recommended to check the presence of threads in the vagina after every menstruation.
• Inflammatory and infectious diseases pelvic organs usually develop in the first month of using the Mirena system. The risk of complications increases with frequent changes sexual partners. The indication for removal of the coil in this case is recurrent or severe pathology and the lack of results from the treatment.
• Amenorrhea(absence of menstruation) develops in many women while using an IUD. The complication does not occur immediately, but about 6 months after Mirena installation. When you stop menstruating, you must first rule out pregnancy. After removing the spiral menstrual cycle is being restored.
• Approximately 12% of patients develop functional cysts ovaries. Most often, they do not manifest themselves in any way and only occasionally may pain during sex and a feeling of heaviness in the lower abdomen occur. Enlarged follicles usually return to normal within 2-3 months on their own.

It must be remembered that the Mirena intrauterine device, being a highly effective contraceptive, nevertheless does not provide 100% protection against pregnancy. If pregnancy does occur while using the IUD, first of all you need to exclude its ectopic form. At normal pregnancy the spiral is carefully removed or medical abortion. If a woman wants to leave the pregnancy, she musttake into account the probable adverse effect hormone for fetal formation.

Contraindications to the use of the Mirena intrauterine device

The Mirena intrauterine device cannot be used for inflammatory diseases reproductive system, such as:

• endometritis after childbirth;
• inflammation in the pelvis and cervix;
• septic abortion performed 3 months before installation of the system;
• an infection localized in the lower part of the genitourinary system.

Price of the Mirena intrauterine device

The cost of the Mirena intrauterine device is quite high and ranges from 13 to 15 thousand rubles in different pharmacies. It cannot be returned, therefore, before purchasing this spiral, you should definitely undergo a preliminary examination and consult with a doctor.

Which intrauterine device is better?

All intrauterine devices have their pros and cons. It is impossible to unambiguously answer the question of which intrauterine device to choose, since the choice of contraception completely depends on a number of conditions and is not arbitrary.

Only your gynecologist can help you choose an intrauterine device after a thorough examination of the state of the reproductive system.

It is important to remember that no IUD provides a 100% guarantee against pregnancy. In addition, the IUD does not protect against sexually transmitted diseases, so if you are not confident in your partner, you should use additional funds protection. If there are contraindications to the use of an intrauterine device, other contraceptives are prescribed.