Spiral protection method. The contraceptive device as a method of contraception. When to install a spiral

Prevention from unwanted pregnancy, or contraception, helps a woman maintain her health:

• reduces the frequency of abortions;
• helps plan pregnancy and prepare for it;
• in many cases it has an additional therapeutic effect.

One type of contraception is intrauterine. It is used most often in China, the Russian Federation and Scandinavia. In everyday speech, the term “intrauterine device” is often used.

Advantages of intrauterine contraception:

• relatively low cost;
• long period of use;
• rapid restoration of fertility after removal of the IUD;
• Possibility of use during breastfeeding and with concomitant diseases;
• therapeutic effect on the endometrium (using a hormonal intrauterine system);
• preservation of the physiology of sexual intercourse, lack of preparation, fullness of sensations during intimacy.

Types of intrauterine devices

There are two types of intrauterine contraception:

• inert;
• medicinal.

Inert intrauterine contraceptives (IUDs) are plastic products of various shapes that are inserted into the uterine cavity. Their use has been discouraged since 1989, when the World Health Organization declared them ineffective and dangerous to women's health.

Currently, only spirals containing metals (copper, silver) or hormones are used. They have a plastic base of different shapes, close to the shape of the inner space of the uterus. Adding metals or hormonal agents can increase the effectiveness of the spirals and reduce the number of side effects.

In Russia, the following VMKs have gained the greatest popularity:

• Multiload Cu 375 – has the shape of the letter F, covered with copper winding with an area of ​​375 mm 2, designed for 5 years;
• Nova-T - in the shape of the letter T, has a copper winding with an area of ​​200 mm 2, designed for 5 years;
• Cooper T 380 A – copper-containing T-shaped, lasts up to 8 years;
• hormonal intrauterine system "Mirena" - contains levonorgestrel, which is gradually released into the uterine cavity, providing a therapeutic effect; designed for 5 years.

Less commonly used are IUDs that release medroxyprogesterone or norethisterone.

Which intrauterine device is better?

This question can only be answered after an individual consultation, taking into account the woman’s age, her state of health, smoking, the presence of gynecological diseases, planning a future pregnancy and other factors.

Mechanism of action

The principle of operation of the intrauterine device is the destruction of sperm and disruption of the process of attachment of the embryo in the uterine cavity. Copper, which is part of many IUDs, has a spermatotoxic effect, that is, it kills sperm that enter the uterus. In addition, it enhances the capture and processing of sperm by special cells - macrophages.

If fertilization does occur, the abortive effect of the contraceptive begins, preventing implantation of the fertilized egg:

• contractions of the fallopian tube intensify, while the fertilized egg enters the uterus too quickly and dies;
• the presence of a foreign body in the uterine cavity leads to aseptic (non-infectious) inflammation and metabolic disorders;
• as a result of the production of prostaglandins in response to a foreign body, the contractility of the uterine walls is activated;
• When using an intrauterine hormonal system, endometrial atrophy occurs.

The Mirena intrauterine system constantly releases the hormone levonorgestrel from a special reservoir at a dose of 20 mcg per day. This substance has a gestagenic effect, suppresses the regular proliferation of endometrial cells and causes endometrial atrophy. As a result, menstruation becomes scanty or disappears completely. Ovulation is not disturbed, hormonal levels do not change.

Is it possible to get pregnant if you have an intrauterine device?? The effectiveness of intrauterine contraception reaches 98%. When using copper-containing products, pregnancy occurs in 1-2 women out of a hundred within a year. The effectiveness of the Mirena system is several times higher; pregnancy occurs in only 2-5 women out of a thousand within a year.

How to place an intrauterine device

Before inserting an IUD, you need to make sure there is no pregnancy. The procedure can be carried out regardless of the phase of the menstrual cycle, but it is best on days 4-8 of the cycle (counting from the first day of menstruation). It is necessary to analyze smears for microflora and degree of purity, as well as an ultrasound examination to determine the size of the uterus.

The procedure takes place on an outpatient basis without anesthesia. This is a virtually painless procedure. In the first days after insertion of the IUD, you may experience aching pain in the lower abdomen caused by contractions of the uterus. The first and 2-3 subsequent menstruation may be heavy. At this time, spontaneous expulsion of the spiral is possible.

After an induced abortion, the IUD is usually installed immediately after manipulation, after childbirth - 2-3 months later.

The introduction of an IUD after a cesarean section is carried out six months later to reduce the risk of infectious complications. Spirals can be used during breastfeeding, which is their great advantage.

After insertion of an IUD for a week, a woman is prohibited from:

• intense physical activity;
• hot baths;
• taking laxatives;
• sex life.

The next examination is scheduled for 7-10 days, and then, if there are no complications, after 3 months. After each menstruation, a woman should independently check for the presence of IUD threads in the vagina. It is enough to undergo an examination by a gynecologist once every six months, if there are no complaints.

Removing the intrauterine device

Removal of the IUD is carried out at will, with the development of certain complications or after the expiration of the period of use. In the latter case, a new contraceptive can be introduced immediately after removing the previous one. To remove the IUD, an ultrasound examination is first performed and the location of the spiral is determined. Then, under the control of a hysteroscope, the cervical canal is expanded and the spiral is removed by pulling the “antennae”. If the “antennae” breaks, the procedure is repeated in the hospital. If the intrauterine device penetrates the wall of the uterus and does not cause complaints, it is not recommended to remove it unless necessary, as this can lead to complications.

Complications of intrauterine contraception

Side effects from the intrauterine device:

• pain in the lower abdomen;
• genital infection;
• uterine bleeding.

These symptoms do not develop in all patients and are considered complications.

Pain in the lower abdomen

Occurs in 5-9% of patients. Cramping pain accompanied by bloody discharge is a sign of spontaneous expulsion of the IUD from the uterine cavity. To prevent this complication, non-steroidal anti-inflammatory drugs are prescribed during the post-injection period.

Constant intense pain occurs if the contraceptive does not match the size of the uterus. In this case, it is replaced.

Sudden sharp pain may be a sign of uterine perforation with penetration of part of the spiral into the abdominal cavity. The incidence of this complication is 0.5%. Incomplete perforation often goes undetected and is diagnosed after unsuccessful attempts to remove the IUD. In case of complete perforation, emergency laparoscopy or laparotomy is performed.

Genital infection

The frequency of infectious and inflammatory complications (and others) ranges from 0.5 to 4%. They are difficult to tolerate and are accompanied by severe pain in the lower abdomen, fever, and purulent discharge from the genital tract. Such processes are complicated by the destruction of tissue of the uterus and appendages. To prevent them, broad-spectrum antibiotics are prescribed for several days after insertion of the IUD.

Uterine bleeding

Uterine bleeding develops in 24% of cases. Most often it manifests itself as heavy menstruation (menorrhagia), less often – intermenstrual blood loss (metrorrhagia). Bleeding leads to the development of chronic iron deficiency anemia, manifested by pallor, weakness, shortness of breath, brittle hair and nails, and degenerative changes in internal organs. To prevent bleeding, it is recommended to take combined oral contraceptives two months before insertion of the IUD and for 2 months after. If menorrhagia leads to anemia, the IUD is removed.

Onset of pregnancy

IUD reduces the likelihood of pregnancy. However, if it does occur, the risk is higher than among other women.

If pregnancy occurs while using the IUD, there are three scenarios:

1. Artificial termination, because such a pregnancy increases the risk of infection of the embryo and in half of the cases ends in spontaneous abortion.
2. Removal of the IUD, which can lead to spontaneous abortion.
3. Preservation of pregnancy, while the device does not harm the baby and is released along with the membranes during childbirth. This increases the risk of pregnancy complications.

The ability to conceive and bear a child is restored immediately after removal of the intrauterine contraception; pregnancy occurs within a year in 90% of women who did not use other methods of contraception.

Indications for use

This type of contraception in nulliparous women can cause serious complications that prevent future pregnancies. The intrauterine device for nulliparous women can be used only if it is impossible or unwilling to use other methods. For such patients, mini-spirals containing copper, for example, Flower Cuprum, are intended.

It makes no sense to install an IUD for a short period of time, so a woman should not plan a pregnancy for the next year or longer.

IUDs do not protect against sexually transmitted diseases. It is believed that, on the contrary, they increase the risk of developing and worsen the course of such diseases.

IUDs are most often used in the following situations:

• increased fertility, frequent pregnancies against the background of an active sexual life;
• temporary or permanent reluctance to have children;
• extragenital diseases in which pregnancy is contraindicated;
• the presence of severe genetic diseases in a woman or her partner.

Contraindications to the intrauterine device

Absolute contraindications:

• pregnancy;
• endometritis, adnexitis, colpitis and other inflammatory diseases of the pelvic organs, especially acute or chronic with constant exacerbations;
• cancer of the cervix or uterine body;
• previous ectopic pregnancy.

Relative contraindications:

• uterine bleeding, including heavy menstruation;
• endometrial hyperplasia;
• congenital or acquired deformation of the uterus;
• blood diseases;
• severe inflammatory diseases of internal organs;
• previously occurred spontaneous expulsion (expulsion) of the IUD;
• intolerance to the components of the spiral (copper, levonorgestrel);
• absence of childbirth.

In these situations, the use of an intrauterine hormonal system is often justified. Its use is indicated for endometrial pathology, heavy bleeding, painful menstruation. Therefore, the gynecologist will be able to choose the right intrauterine device after examining and examining the patient.

What are the pros and cons of using an intrauterine device and who is suitable for an IUD, read the article.

An intrauterine device is an intrauterine contraceptive, a miniature T-shaped device made of plastic and copper, which prevents the attachment of a fertilized egg to the wall of the uterus, slows down the movement of sperm into the uterine cavity and reduces the lifespan of the egg. Reviews prove that this is one of the most reliable.

The IUD releases the hormone progestogen into the uterus. This delays the development of the uterine mucosa, where the fertilized egg is implanted. Progestogen also thins the uterine lining, which prevents a fertilized egg from attaching to it. Some women may stop ovulating after having a hormonal IUD installed.

The IUD lasts for 5 years, or 3 years, depending on the type. So you don't have to think about contraception every day or every time you have sex. Using an IUD does not depend on whether you have children or not.

Intrauterine device: pros and cons

• The effectiveness of the intrauterine device is more than 99%. Pregnancy occurred in less than 1 in 100 cases when using the Mirena IUD for 5 years. The Jaydess brand has similar statistics (the coil is valid for 3 years).
• The IUD can be removed at any time with the help of a doctor, and fertility will quickly return to normal.

An IUD can make your period easier or stop it, so it can help women whose periods are consistently painful.

Jaydess is less likely to stop menstruation than Mirena.

• The hormonal IUD can be used by women who are not suitable for oral contraceptives due to migraines, for example.
• Some women may experience mood swings, skin problems, or breast pain after having the IUD inserted.
• You should also remember that there is a small risk of infection when inserting the IUD.
• The process of inserting the IUD can be unpleasant, but painkillers can help ease it.

• The IUD does not protect against sexually transmitted infections (STIs). To protect yourself from STIs, you should use condoms.

How does the intrauterine device work?

The hormonal IUD releases the hormone progestogen, which is similar to the natural hormone progesterone produced in a woman's ovaries.

Progestogen delays the development of the uterine lining, which prevents sperm from passing through and reaching the egg. It also thins the lining of the uterus, which prevents a fertilized egg from attaching to it.

The IUD may also stop ovulation in some women, but in most cases ovulation will continue as before.

Intrauterine device: how to place it

The IUD can be inserted at any time during your monthly menstrual cycle, as long as you are definitely not pregnant. Ideally, it should be installed within seven days of the start of your period because it will immediately protect you from pregnancy.

You will have to use condoms for the first seven days if the IUD is inserted at any other time in your cycle.

Before the IUD is inserted, you will have a full examination to determine the size and position of your uterus. You may also be tested for existing infections, such as STIs. It is best to do this before the IUD is inserted so that infections can be treated. You may also be offered antibiotics during insertion of the IUD.

The entire installation process takes about 15-20 minutes:

• the vagina is held open, as during a cervical smear test
• The IUD is inserted through the cervix and into the uterine cavity

The adjustment process may be uncomfortable or painful for some women, and may cause cramping afterwards.

You may be asked to use a local anesthetic or painkillers prior to installation. Discuss this with your doctor in advance. The anesthetic injection itself can be more painful, so many women undergo the procedure without it. Once the IUD is inserted, you will need to check with your doctor after 3-6 weeks to make sure everything is okay.

Be sure to tell your doctor if you or your partner have been exposed to an STI, as this can lead to an infection in the pelvis.

Consult your doctor in such cases, if after insertion of the IUD

• there was pain in the lower abdomen
• heat
• copious discharge with an unpleasant odor

This may mean that there is an infection in the body.

How to determine if the spiral is in place

The IUD has two thin strings that hang down from the top of the vagina. The doctor who installs the IUD will teach you how to feel for these strings and check if the IUD is in place.

Check your IUD several times during the first month and then after each period at regular intervals. It is extremely unlikely that the IUD will come out, but if you can't feel the threads or if the IUD appears to have moved, you are not protected from pregnancy.

If this happens, contact your doctor immediately and use additional contraception, such as condoms, until your IUD is checked. If you have had sexual intercourse recently, you may need to resort to remedies.

Your partner should not feel your coil during sex. If he feels the threads, see a doctor to check the position of the coil .

Doctors will also be able to shorten the threads slightly. If you feel pain during sexual intercourse, consult a doctor immediately.

Removing the intrauterine device

The spiral can be removed at any time. If you do not intend to have the IUD inserted again but are not planning to become pregnant, you will need to use another method of contraception (such as condoms) for seven days before the IUD is removed.

Sperm can remain in a woman's body for seven days and can fertilize an egg after the IUD is removed. Once the IUD is removed from the body, your fertility returns.

If a woman who is over 45 years of age has the IUD, the IUD can be left until the onset of menopause or until the period when contraception is no longer needed.

Intrauterine device: when and to whom it can be placed

Most women can use an IUD, including women who have never been pregnant and women who are HIV positive. Your healthcare provider will review your medical history to see if the hormonal IUD is suitable for you as a contraceptive.

Intrauterine device: contraindications

• breast cancer, or have had the disease within the last five years
• cervical cancer
• liver disease
• unexplained vaginal bleeding between periods or after intercourse
• arterial disease or a history of serious heart disease or stroke
• untreated STI or pelvic infection
• problems with the uterus or cervix

Intrauterine device after childbirth

The IUD can be installed 4-6 weeks after childbirth (vaginal birth and Caesarean section). From 21 days after birth, that is, three weeks, you will need to use alternative methods of contraception until the IUD is installed. In some cases, an IUD can be inserted within 48 hours after birth. It is safe during breastfeeding and does not affect the volume and flow of milk.

Intrauterine device after miscarriage or abortion

An IUD can be installed by a doctor immediately after an abortion or miscarriage, if the pregnancy has not exceeded 24 weeks. If you have been pregnant for more than 24 weeks, you may have to wait a few weeks before getting the IUD.

Thank you

Many women are interested in technical issues of implantation intrauterine device. For many, reliability in diagnostic methods and identification of contraindications for this type is important. contraception. Information about possible side effects with this type of contraception and issues of restoring fertility are also important. We will try to provide you with the most complete and reliable information.

What examinations need to be done before inserting a fallopian device?

Bacteriological analysis of smears from the vagina and cervix.

Thorough examination for sexually transmitted infections: syphilis, HIV, hepatitis B and C.

Conducting colposcopy (instrumental examination of the vaginal cavity and cervical mucosa).

Ultrasound of the pelvic organs.

When and how is the IUD inserted?

The IUD can be inserted immediately after or within 4 days after an artificial termination of pregnancy or miscarriage (spontaneous termination of pregnancy), provided there are no signs of inflammation or bleeding. If an IUD is not implanted during this period, then it must be inserted at the onset of the next menstruation.

Simultaneous termination of pregnancy and implantation of an IUD into the uterine cavity are practiced. Insertion of an IUD immediately after childbirth or in the postpartum period (within 48 hours after birth) greatly increases the risk of contraceptive expulsion (loss). If the IUD is not inserted during the specified period, then the procedure can be performed 4-6 weeks after birth.

Stages of intrauterine contraceptive insertion

Before administration, a vaginal examination and probing of the uterine cavity are mandatory.

The installation of the IUD is carried out in a special room under aseptic conditions. As a rule, insertion of an IUD is painless and does not require pain relief.

Insertion of the IUD is possible only with grades I and II of vaginal cleanliness. If an infectious-inflammatory disease of the internal genital organs is detected or the cleanliness of the vagina corresponds to grade III or IV, then an in-depth gynecological examination is necessary, followed by antimicrobial treatment. Upon completion of treatment, a control examination of its effectiveness is necessary. After effective antimicrobial treatment of an infectious-inflammatory disease of the pelvic organs, subject to complete recovery, a 6-10 month break is necessary for complete recovery and to prevent the disease from becoming chronic before introducing an IUD.

Is monitoring necessary for patients using intrauterine contraceptives?

The first follow-up examination should be carried out by a gynecologist after 7-10 days. During the examination, the doctor is interested in the presence of threads in the vaginal cavity - this is necessary to make sure that the IUD is installed correctly. Now, after the first gynecological examination, sexual activity is allowed without the use of an additional method of contraception. An ultrasound of the pelvic organs is also performed to clarify the location of the IUD in the uterine cavity.

The next examination is carried out after one month, during the first year - at least once every 6 months, then annually with a bacterioscopic examination of the discharge of the cervix. Ultrasound is recommended to be performed according to indications.

It is necessary to train a woman to palpate the presence of IUD threads after each menstruation in order to detect the IUD loss in time. If there are no threads in the vaginal cavity, a gynecological examination and ultrasound of the pelvic organs are necessary to clarify the location of the spiral.

Possible adverse reactions and complications when using intrauterine contraceptives

Damage to the cervix

Uterine bleeding

Damage to the uterus. This complication occurs rarely, usually due to incorrect IUD insertion technique or insertion contrary to contraindications.

Complications arising during the contraception process:

Pain syndrome – more often expressed in minor pain in the lower abdomen, which may appear immediately after insertion of the IUD, but it stops after a few hours or after treatment. Pain during menstruation is observed in 9.6-11% of cases.

IUD prolapse are more often observed in young nulliparous women - this is due to increased contractility and excitability of the uterus. The frequency of prolapse depends on the type of IUD and ranges from 3-16%. With age and an increase in the number of births and abortions, the frequency of this phenomenon decreases. Expulsion (loss) most often occurs during the first days or 1-3 months after the introduction of the IUD.

In identifying the causes of pain, the main role is played by such studies as: ultrasound and hysteroscopy, which make it possible to accurately determine the position of the IUD in the uterine cavity or outside it.

Pelvic inflammatory disease (PID) . Against the background of copper-containing IUDs, inflammatory reactions occur in 3.8-14.3% of cases and can manifest themselves in the form of cervicitis (inflammation of the cervix), endometritis (inflammation of the uterine mucosa), pelvioperitonitis (inflammation of the mucous membrane covering the pelvic organs) or pelvic abscess (limited capsule accumulation of purulent exudate). As a rule, the inflammatory process is associated with an exacerbation of an existing chronic infectious-inflammatory disease of the genital organs. If the inflammatory process occurs within 20 days after the insertion of the IUD, it can be associated with the introduction of a contraceptive. The issue of removing the IUD and conducting antibacterial therapy is decided by a gynecologist individually for each woman.

Menometrorrhagia (uterine bleeding) . After the introduction of an IUD, during the first 5-10 days, women, as a rule, experience slight or moderate bloody or clear discharge that does not require treatment; only in some cases (2.1-3.8%) is there a need for drug treatment. Intermenstrual bleeding may occur (in 1.5-24% of cases), which more often occurs in women with irregular menstrual cycles, as well as in the presence of induced abortions in the past. The question of prescribing treatment is decided by the gynecologist individually. If heavy bleeding during menstruation is accompanied by pain and does not stop with drug treatment, this is an indication for removing the IUD.

Onset of pregnancy . Intrauterine devices are recognized as highly effective means of contraception, but in 0.5-2% of cases an unwanted pregnancy can still occur. At the same time, the frequency of spontaneous abortions increases significantly, even if the woman wishes to continue the pregnancy and the pregnancy is maintained with medication. In approximately 1/3 of cases, pregnancy is associated with complete or partial prolapse of the IUD.

Complications that arise after removal of the intrauterine contraceptive device.

Chronic pelvic inflammation

Pregnancy and the birth of a baby are an important and significant event in the life of every woman, but it must be planned and desired. For those girls who are not yet ready to become mothers or who already have children, the use of intrauterine devices (IUDs) is best as a contraceptive. When used correctly, their effectiveness reaches 98 percent. What types of intrauterine devices are there and how do they work? How much does such a tool cost and what is the cost of installing it? Many women ask these questions.

What is an intrauterine device and how does it work?

An IUD is a special small device for effectively preventing pregnancy, which a gynecologist, using a guide, inserts into the uterine cavity through the vagina. This device is popular in modern medicine due to a number of advantages:

• affordable price;
• after removal of the product, the ability to bear children is quickly restored;
• allowed for use during breastfeeding;
• high effectiveness of the drug (pregnancy occurs in only 2% of cases);
• hormonal balance is not disturbed;
• long (from 3 to 10 years) period of use;
• easy to install and remove;
• does not cause discomfort and is not felt during sexual intercourse;
• there is no need to take oral contraception.

Depending on the type of intrauterine device, the principle of its operation is as follows:

• Copper and other metals in IUDs have a detrimental effect on sperm.
• Promotes the secretion of viscous mucus, which interferes with the movement of sperm and fertilization of the egg.
• Hormone-containing IUDs suppress ovulation.
• If fertilization of the egg has occurred, then VSM increases the contractile activity of the uterus, and the egg dies.

Classification by composition

There is no one universal VSM suitable for all girls. Depending on the physiological state of the patient and the structural features of the uterus, the gynecologist selects the optimal type of intrauterine devices. There are more than 50 types of contraceptive devices on the market today. Their creation and improvement took place in stages, so all types of IUDs are divided into 4 generations: inert, copper, silver and gold, hormone-containing. Let's look at each of them in more detail.

Inert

An outdated version of intrauterine devices (invented about a century ago), it belongs to the first generation. Inert IUDs are low-effective and have a high risk of dislodging or falling out, which is why their use is prohibited in many countries. Representatives of this group are:

• Lips plastic loop made in the shape of the letter S.
• Steel Mauch ring with two scrolls.
• Double helix Saf-T-Coil.
• Dalkon's shield.

This second generation of vaginal devices is a small T-shaped or semi-oval device, the rod of which is wrapped in copper wire. The product is easy to install and remove. Due to the presence of copper, an acidic environment is created in the uterine cavity, which significantly slows down the activity of sperm. Copper intrauterine contraceptives are installed for a period of 3-5 years. The most popular models are:

• Multiload;
• Nova T;
• Juno Bio;
• Para Grand.

With silver

Any metal tends to oxidize and deteriorate, so in order to extend the life of the copper IUD, manufacturers began to use silver in its rod. At the same time, the spermatostatic effect is doubled, and silver ions, which have antibacterial and disinfectant effects, have a beneficial effect on the woman’s body. Intrauterine contraceptives containing pure silver or with copper are allowed to be inserted into the uterine cavity for 5-7 years.

From gold

As an alternative to silver and copper products, an improved gold version was developed. The main advantages of the gold IUD are absolute biological compatibility with the female body, the absence of allergic reactions, and the resistance of gold to damage by corrosion. Products of this type have anti-inflammatory properties and effectively protect against unwanted pregnancy. Golden spirals are installed for a long period - from 5 to 10 years. Women's ability to bear children, after their removal, remains normal.

The fourth generation of intrauterine devices includes products containing hormones. According to doctors, this is the best means of contraception. This new generation IUD has the shape of the letter T, in the stem of which there is a hormonal drug (levonogrestrel, progesterone), which is evenly released in small doses into the uterine cavity. This contraception has no contraindications, since the hormone does not enter the blood, but has only a local effect: it relieves inflammation, slows down ovulation, and prevents the fertilization of the egg. You can wear an IUD for 5-7 years.

Shapes of contraceptive devices

It is impossible to say which IUD is better. Depending on the anatomical features of the uterus and the personal preferences of each woman, the form of the contraceptive product is individually selected. Before choosing the ideal contraceptive and deciding to use it, you should consult a gynecologist. Let's look at the main forms of intrauterine devices, how they look in the photo and their distinctive features.

• T-shaped

The most popular type of intrauterine device among women. They are easy to use and easy to install and remove. The T-shaped IUD has the form of a rod from which two flexible shoulders extend. With the help of hangers, the product is fixed in the uterine cavity. A special thread is attached to the end of the rod, allowing the doctor, if necessary, to easily remove the spiral from the uterus.

• Ring shaped

The ring-shaped intrauterine device is a modern method of contraception that is recommended for patients who have had an abortion. This product is made of plastic and contains gold, silver or copper. The product is securely attached to the uterus and is easily removed, so the presence of special ropes attached to the contraceptive product is not necessary.

• Loop or umbrella shaped

The outer edges of the umbrella-shaped spiral have protrusions in the form of spikes, due to which the product is securely fixed inside, this reduces the risk of its spontaneous falling out. The umbrella-shaped contraceptive device is used by women who have a non-standard uterine structure, which makes it impossible to install a T-shaped intrauterine device.

The most popular IUDs for contraception

Pharmacies offer a wide range of different contraceptives. Contraceptive IUDs are in particular demand among women all over the world. Depending on your financial capabilities and the characteristics of your body, your doctor will determine which model is best for you. Let's look at the most popular types of intrauterine devices, their photos and descriptions.

It is considered the most effective hormone-containing IUD. It has a T-shape, consists of a vertical membrane, inside of which there is a hormone and two horizontal hangers (attached to the uterus). The product provides a high degree of protection against unwanted conception, suppresses the ovulation process, reduces the risk of ectopic pregnancy, relieves inflammation of the woman’s genital organs, and regulates the menstrual cycle. The cost of the product ranges from 7-10 thousand rubles, the validity period is 5-7 years.

Multiload

This spiral has the shape of an umbrella, on the side elements of which there are spike-like protrusions used for reliable fixation on the walls of the uterus. The leg of the spiral is wrapped in copper, which has a depressing effect on sperm and suppresses their ability to fertilize. Multiload is allowed to be installed by nulliparous girls. The cost of the spiral is from 3.5 thousand rubles.

This intrauterine device is T-shaped. The products are made of plastic and copper; in more expensive versions, it is possible to add silver. Nova T has a detrimental effect on sperm, slows down their movement and reduces the ability to fertilize an egg. The cost of the spiral is from 2 thousand rubles, the shelf life is up to 5 years.

Invention of Belarusian doctors. Pharmacies sell many varieties of Juno spirals. There are options for both women who have children and those who have not. The cost of a contraceptive varies from 250 to 1000 rubles. We list the common types of contraceptive devices of the Juno model:

• Juno Bio-T is a budget option. A spiral in the shape of an anchor, the rod of which is covered with copper thread.
• Juno Bio-T Super. Identical to the previous model, but has an antimicrobial composition.
• Juno Bio Multi Ag. A T-shaped product, the leg of which is wrapped with copper and silver thread.
• Juno Bio Multi. It has an F-shape with jagged edges. Suitable for use by women after childbirth or girls who have had an abortion.
• Juno Bio-T Au. An expensive spiral containing gold. Designed for patients with allergies to metals.

Where to buy and how much does it cost to install a spiral?

You can purchase an intrauterine device at any pharmacies in your city or order it from specialized online catalogues. The cost of a vaginal contraceptive depends on many factors: model, material, manufacturer, shape, presence or absence of side effects. Intrauterine devices are sold in the following retail outlets in Moscow:

• "Lepharm". Customs Prospect, 9, building 8. Price 700-9000 rub.
• "Omega". st. Skobelevskaya, 25. Cost – 169-10000 rubles.
• "Social Pharmacy". st. Dubninskaya, 44a. Price 200 -5000 rub.

Online stores where you can order a spiral:

• vsepessarii.ru. Cost from 300 to 5500 rub.
• brief-med.ru. Price 250-6000 rub.

In order to correctly install the spiral, you must contact an experienced gynecologist. There are many gynecological offices in Moscow where they will provide you with this service, but pay attention to the following factors:

• How many years has the clinic been operating?
• Experience of a gynecologist, and what patient reviews about him.
• Service cost.

The price for installing an intrauterine device in some Moscow clinics is as follows:

• LLC Medical Clinic "NORMA", Nikitsky Boulevard 12, building 3. Price - 2000-3000 rubles.
• Gynecology Sikirina O.I., Bolshoi Demidovsky Lane, 17/1. The cost of the service is 1500 rubles.
• MEDICAL CENTER, st. Koktebelskaya, house 2, bldg. 1. Price – 2500-3500 rubles.
• ON clinic. Tsvetnoy Boulevard, building 30, building 2. Cost from 5,000 rubles.

Video: doctors’ opinion on installing an intrauterine device

The IUD is a reliable method of preventing unplanned pregnancy. You can learn about the principle of operation of this contraceptive device by reading an article with instructions on the Internet, going to a consultation with a gynecologist, or watching the following video. TV presenter Elena Malysheva will tell you how effective the use of intrauterine devices is, what the possible consequences are, how to place them correctly and when.

In modern medicine, the intrauterine device is popular among women who want to protect themselves from unplanned pregnancy. This method of contraception is famous for its high level of protection, however, a large number of girls refuse to use the IUD due to information about possible side effects.

In fact, if you choose the right device and a specialist who can correctly install the IUD and take into account the indications and contraindications, the IUD will become one of the most reliable contraceptive options.

An intrauterine device is a device made of copper and plastic. It looks like a small T-shaped or O-shaped anchor. The device is placed in the uterine cavity.

How does the spiral work? The IUD interferes with the movement of sperm, as a result of which their bodies are damaged and the life cycle of the egg is shortened. In the event of fertilization (which is extremely rare), it prevents the egg from implanting in the uterus.

Modern devices also contain metals and levonorgestrel hormones, which further protect the female genital organs from inflammation. The video below shows how this new method of contraception works:

All vaginal devices have a complex mechanism of action:

• Slowing ovulation, decreased ovarian function;
• Implantation failure;
• Obstruction of sperm movement;
• Changes in the pattern of movement of the egg through the fallopian tube.

Spirals are convenient for women who are sexually active. In the case of an IUD, strict self-discipline is not needed, unlike the option with taking hormonal drugs.

Advantages and disadvantages

The IUD is an effective form of contraception, proven and reliable, provided that the insertion is carried out by an experienced and skilled gynecologist.

If the device is correctly positioned in the uterine cavity, the woman will not feel any discomfort.

Advantages:

• Highly effective in terms of contraception;
• Long validity period – up to 5 years;
• After extraction, complete restoration of fertility is guaranteed after several cycles;
• During sexual intercourse, the woman and her partner do not feel the IUD;
• The presence of the device will not interfere with the use of medications or surgical intervention;
• No need for additional
• Wide selection of manufacturers and different pricing policies.

Flaws:

• The uterine body will be constantly slightly open, which is fraught with the entry of pathogenic flora;
• There is a foreign body in the uterus;
• As the critical days increase, the amount of blood released will become significantly greater;
• The likelihood of an ectopic pregnancy increases several times;
• The device may fall out on its own;
• Risk of damaging the walls of the uterus;
• There is no protection against ;
• If pregnancy occurs, the device threatens the development of the baby.

The presence of an IUD increases the likelihood of complications during childbirth; almost always such a pregnancy must be terminated through surgery.

Types and forms

What spirals exist and which one should you choose? There are approximately 50 types of devices of various shapes. Due to such a huge selection of devices, the spiral should only be selected by the attending physician.

First generation:

• The device does not contain metals or hormones and is made only of plastic;
• Does not interfere with the movement of sperm to the egg, fertilization occurs as usual;
• Only prevents the possibility of penetration of the fertilized egg into the endometrium;
• Causes side effects: itching and burning in the vaginal area, pain in the lower abdomen;
• It is possible that the device may fall out.

First-generation spirals are practically no longer inserted, since other types of devices have been developed with fewer side effects.

Second generation:

• The second generation IUDs are made of plastic and metals that have a contraceptive effect - copper, silver, gold.
• The devices damage sperm and interfere with their movement through the fallopian tubes, so the likelihood of getting pregnant is reduced.

Third generation:

• Hormonal intrauterine devices;
• Used as a therapeutic and contraceptive agent.

Devices can take various forms:

• Letter "T";
• In the form of a circle or semicircle;
• Umbrella-shaped;
• Resembling a horseshoe.

The selection of a device takes into account your medical history, weight, and personal anatomical differences, so you cannot independently determine which type is right for you.

"Umbrella"

The semi-oval shape of the contraceptive is called an “umbrella” or “horseshoe”. There are small spikes on the outer protrusions of the spiral, which firmly secure the contraceptive in the uterus, preventing the device from falling out.

Ring

Round spirals are called "ring" or "semi-ring". In some countries, only these types of spirals are used. The ring-shaped spiral has only one curl and no tendrils.

T-shaped

T-shaped coils are considered very comfortable, easy to install and remove and do not cause discomfort when worn. The T-shaped device fits most firmly into the uterus. This type of spiral is perfect for girls after a caesarean section.

Review of the best

Today there are a large number of different IUDs. They have different names. Which intrauterine device is better?

Nova T

The spiral is T-shaped, materials such as silver and copper are used for manufacturing. Thanks to the use of two types of wire, the service life increases to five years.

It is suitable for women who have experienced childbirth several times and have previously suffered from inflammatory processes in the genital area. The average price for installing the Nova T intrauterine device is 4 thousand rubles.

Jaydess

The silver ring-shaped spiral Jaydes is manufactured in Bayer and has a service life of 3 years. The device should not be installed on women who have not given birth. It is impossible to buy Jaydess in Russia; in Ukraine the cost is 2 thousand hryvnia. A side effect of use is the cessation of menstruation.

Multiload - a T-shaped spiral, allowed for use during lactation. There are two types that differ in wire thickness - 25 cm and 37.5 cm. Duration of use is 5-8 years.

After installing the Multiload coil, it is advisable to refrain from using tetracycline antibacterial agents. The cost is about 4 thousand rubles.

Juno

IUD Juno is represented in the shape of a horseshoe and the letter "T". The material used is silver and gold wire. Cost from 550 rub. up to 4 thousand rubles.

Mirena

A T-shape was used to make the intrauterine device. The product is positioned as a therapeutic device, used for disorders of the monthly cycle and endometriosis. Duration of operation – 5 years. Price – 14 thousand rubles.

Installation

Install the spiral according to this plan:

1. The woman is placed on the gynecologist's chair;
2. A speculum is inserted into the vagina, the cervix is ​​treated with an antiseptic;
3. Using a probe, measure the length of the uterus;
4. A plastic guide is inserted;
5. Using a plunger, the IUD is pushed into the uterine cavity;
6. Threads are removed from the vagina and cut to the required length.

Threads (spiral tendrils) are necessary to control the location of the device in the uterine cavity.

After installing an intrauterine device, it is recommended to follow a number of rules:

• Sitting for about 30 minutes is prohibited; getting up is prohibited;
• Do not use laxatives;
• For the first 24 hours, do not take a bath with hot water;
• Tampons should not be used during menstruation.

You will have to abstain from sexual activity for about two weeks. It is strictly forbidden to engage in hard sex to avoid the IUD falling out.

Contraindications

Installation of intrauterine devices has certain contraindications. Before using this method of contraception, you should study the existing contraindications, which are divided into absolute and relative.

Absolute:

• Pregnancy;
• Oncology of the genitals;
• Exacerbation of inflammatory diseases of the genitals;
• If you have an active sexual life, there is a risk of contracting infections transmitted through sex;
• Bleeding.

Relative:

• Chronic forms of inflammatory diseases of the uterus;
• Menstruation that occurs with painful sensations;
• Too much discharge during menstruation;
• Underdevelopment of the uterus;
• Previously there was an ectopic pregnancy;
• Cervical distortion;
• Anemia and other blood diseases;
• Decreased cervical tone;
• No history of labor.

Complications

Complications after using the IUD include the following:

• Damage to the cervix;
• Painful sensations during the period;
• Failure of the menstrual cycle.

It is not a fact that complications will arise, but it is better to familiarize yourself with them and be prepared for it.

Removing the spiral

Often, the intrauterine device is removed in the middle of the monthly cycle. The process of removing the coil is not accompanied by pain relief. To remove the spiral, use special tweezers. This method of removing the device is considered the simplest, safest and most painless.

It happens that the spiral grows into the walls of the uterus. In this case, its extraction becomes difficult and occurs only by curettage of the uterine cavity with further histological diagnosis.

Sometimes surgical intervention is required if the spiral is located near large vessels, the bladder, or has grown into the abdominal tissue.

Whatever the situation, only a specialist should perform the removal of the spiral. Doing this on your own is strictly prohibited.