The spiral is currently a reliable method of protection (up to 98%). An intrauterine contraceptive device looks like a miniature device made of copper wire and plastic. The most reliable and expensive are the IUDs with the addition of silver and gold, which have an anti-inflammatory effect.
Many patients of our medical center in Moscow ask specialists the question of which spiral is better: Multiload or T Nova? Of course, each IUD has its pros and cons, but they are selected individually for each patient. The doctors of our center will conduct examinations to find out your indications, and then select the appropriate option. If you need to remove the IUD, you just need to contact us, as the doctors will carry out the necessary manipulation.
The principle of operation of the intrauterine device
The device prevents the egg with the embryo from attaching to the wall of the uterus, and also prevents the further formation of embryos. The introduction of the spiral into the cavity of the organ does not allow it to close. In addition, copper, which is part of the IUD, provokes local inflammation, which contributes to the production of spermicidal fluid. It influences motor activity spermatozoa, which leads to the impossibility of their contact with the egg.
Some representatives of the fair sex do not accept this method of protection for religious reasons, since non-hormonal spirals interrupt the conception that has already occurred. In such situations, intrauterine devices containing hormones are selected for women. Hormonal coils have a complex effect: they mechanically prevent fertilization, and also change the background of hormones. In the uterine cavity, there is a decrease in the volume of the endometrium, so the egg cannot catch on to it; the thick mucus produced by the uterine cavity prevents sperm from getting inside. The duration of the hormonal spiral is five years.
The most popular intrauterine contraceptives
These include:
Mirena is a T-shaped spiral with a plastic rod and elastic shoulders, as well as a ring for future pulling the IUD out of the uterus. In addition, the rod performs the function of storing the drug levonorgestrel. The wall of the container helps to evenly release the medication in the required volume.
Multiload is a semi-oval intrauterine contraceptive with protrusions in the form of spikes that are perfectly fixed on the uterine wall. This property reduces the risk of spontaneous prolapse of the IUD.
Nova T is a plastic coil with copper winding, which has a flexible hanger, providing a non-hazardous installation. Valid up to 5 years.
How to choose a spiral?
Which intrauterine device is more suitable: Multiload or Nova T? One type of spiral, which is ideal for absolutely all women, does not exist because each has individual characteristics. Almost all spirals have the shape of the letter "T", which is considered the most suitable for the physiological characteristics of the structure of the uterus. However, if this form is not suitable, the patient is offered a semi-oval type of spiral with spikes. In any case, the IUD should only be selected by a specialist!
Side effects of IUDs Multiload and T Nova
The spiral, as a type of contraceptive, has certain negative effects:
Regular monitoring of the presence of threads in the vagina.
Increased volume and duration of menstruation.
Discharge between menstrual cycles.
The risk of pregnancy outside the uterus increases.
Discharge from the vagina with an unpleasant odor.
The depleted inner layer of the uterus, which makes it difficult to carry the fetus.
The Multiload spiral is used for:
- The need for a long contraception;
This spiral is made from high density polyethylene. She has two flexible shoulders that help the product stay inside the uterus. Instructions for the drug Spiral Multiload informs about general principles its use. Before using it, the patient must undergo a complete diagnosis to confirm that she has no diseases of the genital area, pregnancy. It is for the purpose of additional protection from the introduction of a spiral in the early stages, after conception, it is customary to prescribe this procedure for the last days menstrual bleeding or immediately after it.
After abortion or childbirth, the Multiload spiral is administered either immediately (after ten minutes) or after a month and a half. For cesarean section, you must wait at least three months. The total duration of this contraceptive in the uterine cavity should not exceed five years.
The procedure for inserting the Multiload coil is performed only by a doctor.
Multiload spiral is contraindicated in case of:
- Pregnancy or suspicion of it;
- Malignant neoplasms of the genital organs;
- Unspecified bleeding, as well as those caused by fibromyomatosis;
- outside uterine pregnancy in the past or factors that increase the risk of its development;
- Anomalies of the anatomical structure of the uterus or its cervix;
- Endometriosis or cervical dysplasia;
- Infectious and inflammatory diseases of the genital area (except for thrush) or pelvic organs - in the acute period or chronic recurrent;
- Some venereal infections;
- Recovery after an infected abortion (in the first three months);
- copper intolerance;
Side Effects of the Multiload Spiral
During the first months, after the introduction of the spiral, spotting, bleeding during breaks, between menstruation are possible. The menstruation itself can become more abundant and prolonged. Rarely, patients complain of pain during and after intercourse. There are also possible perforation of the uterine wall or infection of the genitals, other organs of the small pelvis. Described reactions such as pain in the legs, back, lower abdomen.
If pregnancy still occurs with the delivered spiral, it is necessary to establish as quickly as possible whether it is uterine or ectopic. In the second case, an operation is required. With a uterine pregnancy, a woman can decide to keep it. In this case, the Multiload spiral is taken out for early term(up to twelve weeks). At a later date, the spiral remains in the body of the uterus. There is no evidence that this can disrupt the course of pregnancy and cause birth defects in the fetus. At breastfeeding should be respected special care during the introduction of the spiral, since the walls of the uterus are most sensitive and can be perforated.
Multiload spiral reviews
Women who leave reviews about the Multitiload spiral speak about it in completely different ways. Obviously, it suits some, and not others:
- After the second birth, I decided that now I need to protect myself more reliably. The doctor advised Multiload. The spiral does not hurt. In the first six months I had a little more abundant periods, but then everything returned to normal. I am very pleased.
- Of the minuses of the Multiload spiral, I can name only more frequent examinations at the doctor - once every six months you need to show yourself. At the beginning there were strong periods, but without torment. In general, this is an excellent and reliable method of contraception.
- The first spiral had to be removed after a year and a half, since inflammation began. Put after treatment Multiload. But she had to clean her up faster - hemoglobin fell, blood gushed for ten days, began cystitis. She went through a long treatment, drank heavy medicines. And it was worth just taking out the spiral!
- I could not live with the spiral - the bleeding was such that I simply found myself without strength. Then added to them thrush and pain in the lower abdomen. So this contraception is not for me.
I must say that this type of protection is really not good for all patients. And it is impossible to predict in advance how a woman's body will react to a spiral. For some, the health of the sexual sphere does not suffer, while others face a whole "bouquet" of side effects. But the Multiload spiral is recommended by many gynecologists - they consider it effective and safe.
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Last update of the description by the manufacturer 31.07.1998
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Pharmacological group
Nosological classification (ICD-10)
3D images
Composition and form of release
T-shaped contraceptive (for intrauterine administration), made of polyethylene with a copper wire spiral wound around the rod; the total surface area of copper is 375 mm2. A monofilament nylon thread is attached to the rod; rod length - 35 mm.
pharmachologic effect
pharmachologic effect- contraceptive.Copper causes a local inflammatory reaction and lysosomal activation, leading to a spermicidal effect (sperm loses its ability to fertilize an egg).
Pharmacodynamics
Copper exhibits contraceptive properties and makes the helix shaft radiopaque.
Indications for Multiload Ku-375
Contraception intrauterine.
Contraindications
Hypersensitivity; malignant tumors of the body or cervix, uterine bleeding of unknown etiology, ectopic pregnancy history, salpingitis, endometritis, pelvic peritonitis, congenital or acquired malformations and deformation of the uterine cavity or cervix, multiple uterine fibromyomatosis, profuse bleeding during menstrual cycle, endometrial hyperplasia, cervical dysplasia, microbial lesions of the genital organs (excluding candidiasis), sexually transmitted diseases within the last 12 months (excluding bacterial vaginitis, candidiasis, herpes, viral infections, hepatitis B, cytomegalovirus infections), inflammatory diseases of the pelvic organs (including history), hepatolenticular degeneration (Wilson-Konovalov's disease), pregnancy (including suspected).
Side effects
Pain in abdominal cavity(endometrial spasms) during or immediately after insertion or removal (especially in nulliparous), syncope, bradycardia, neurovascular seizures; excessive bleeding during your first period or bloody issues("daub") and spontaneous bleeding in the middle of the cycle, prolonged menstruation and increased menstrual bleeding during the first two or three menstrual cycles (after administration), dysmenorrhea, Iron-deficiency anemia; rarely - pain in the back and legs, abnormal vaginal discharge, perforation of the body or cervix, increased risk of miscarriage, microbial diseases of the urinary tract, sepsis, skin allergic reactions (urticaria).
Dosage and administration
Intrauterine. It is intended for single use and is administered by a physician. Optimal time injections - the last days of the menstrual cycle or the first days after its end. Can be administered immediately after childbirth or abortion (no later than 10 minutes).
Precautionary measures
If, after an abortion or childbirth, the introduction was not made immediately, it should be postponed for at least 6 weeks. After caesarean section the introduction is made after 12 (not earlier) weeks. An intrauterine contraceptive should be used with caution in women with epilepsy, valvular heart disease, anemia or a history of heavy uterine bleeding, coagulopathy, copper metabolism disorders, severe dysmenorrhea, uterine scarring (except for caesarean section), uterine perforation in the past, uterine fibroids, endometrial polyps , endometritis, with long-term treatment with steroids or NSAIDs, prolonged immunosuppressive therapy, against the background of infections of the lower genital tract, concomitant anticoagulant therapy, the presence of several sexual partners, the period of breastfeeding. In nulliparous women, the pros and cons should be carefully weighed, given the possible decline in fertility in the future.
special instructions
The coil is recommended to be removed every 5 years or earlier in the following cases: pregnancy, pelvic inflammatory disease, excessive and persistent bleeding or cramping pain in the uterus, perforation of the wall or cervix, partial displacement into the cervical canal, translocation.
Storage conditions Multiload Ku-375
In a dry place, at a temperature not exceeding 25 °C.Keep out of the reach of children.
Shelf life Multiload Ku-375
4.5 years.Do not use after the expiry date stated on the packaging.
The site provides background information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!
Every woman has a moment when she thinks about becoming a mother. But many girls sex life begins before they are ready for motherhood, and even for family life generally. Especially in modern women the planning of the child is postponed until the full realization of oneself in other areas of life.
Well, if a woman has already become a mother, and maybe more than once, then there are few 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 not getting pregnant without desire. In order to deceive nature, unpretentious methods of contraception were invented (from the Latin word contraceptio - exception). Started with various essential oils, fruit juices, tampons, lotions, broken contact, cloth pouches (precursor to the condom) and so on.
As you can see, the spiral affects all the processes necessary for conception:
- vitality and speed of movement of spermatozoa;
- egg maturation and ovulation;
- attachment of the fetal egg to the endometrium.
Pros and cons of using intrauterine devices
| Advantages of the IUD | Disadvantages of the Navy |
| Convenient to use, the spiral is set for a period of 3 to 10 years or more. It does not require daily procedures, special hygiene care and drinking pills by the hour. In a word, for a long time you can not think about contraception at all and not be afraid of an unwanted pregnancy, but enjoy your sexual relationships. | Not suitable for all women, as it has a number of contraindications. For some women, the spiral does not take root. |
| High Efficiency Method: pregnancy occurs in only 2 out of 100 cases. Inert spirals give lower efficiency, and when using hormonal intrauterine systems, the risk of getting pregnant is reduced to zero. | Yet there is a risk of unplanned pregnancy with a spiral. In addition, the spiral may fall out and the woman may not notice it. But 100% result is given only by removal of appendages or bandaging fallopian tubes and complete abstention from sexual activity. |
| Preservation of childbearing function immediately after removal of the IUD. | From the use of non-hormonal spirals, it is recommended to refrain from young and nulliparous women., since as a side effect, inflammatory changes in the endometrium of the uterus and appendages may develop, reducing the chances of becoming pregnant in the future. |
| Does not affect the quality of sexual life, that is, sexual attraction, sexual intercourse for both partners and orgasm. | An IUD can cause painful and heavy periods. While hormonal spirals, on the contrary, solve the problems of painful periods. But gestogen spirals can lead to the absence of menstruation, which also negatively affects women's health. |
| Low cost. At first glance, it may seem that some types of spirals are an expensive pleasure. But given the long period of use, this method will be much more economical than those that require application during each sexual intercourse, daily and monthly. | Possible side effects from the use of spirals, unfortunately, their development is not uncommon. |
| IUDs can be used after childbirth during lactation when oral hormonal agents are contraindicated. | Increases the risk of developing inflammatory processes genitals, also the spiral does not protect against sexually transmitted diseases. |
Additionally for hormonal intrauterine systems:
| Increases the risk of developing an ectopic pregnancy. The use of hormonal coils significantly reduces the risk of pathological pregnancy. |
| The procedure for inserting an IUD requires a trip to the gynecologist's appointment, brings discomfort and pain, in nulliparous women, the pain syndrome is especially pronounced, sometimes local anesthesia is required. |
Indications for the installation of an intrauterine device
1.
Temporary or permanent prevention of unwanted pregnancies, especially if the family already has children. Intrauterine devices are ideal for women who have given birth and have one sexual partner, that is, for those who are at risk of infection sexually transmitted diseases very low. 2. Frequent unwanted pregnancies, ineffectiveness or inattention of a woman in the use of other contraceptives .
3. Prevention of pregnancy after childbirth, especially caesarean section, after medical abortions or spontaneous miscarriages when the onset of the next pregnancy is temporarily not desirable.
4. A woman has temporary or permanent contraindications to pregnancy.
5. The presence in the family history of genetic pathologies that a woman does not want to inherit ( hemophilia , cystic fibrosis , down syndrome and many others),
6. For hormonal intrauterine devices - some gynecological pathologies:
- uterine fibroids, especially if it is accompanied by abundant spotting and uterine bleeding ;
- plentiful painful periods ;
- replacement therapy estrogen at the beginning of menopause or after the removal of appendages, in order to prevent the growth of the endometrium.
Contraindications
Absolute contraindications to the use of all intrauterine devices
- The presence of pregnancy at any time, suspicion of a possible pregnancy;
- oncological pathologies of the genital organs, as well as crayfish mammary gland ;
- acute and chronic inflammatory diseases of the female genital organs: adnexitis , colpitis , endometritis, including postpartum salpingitis and so on, including sexually transmitted diseases ;
- a history of ectopic pregnancies;
- allergic reactions to the materials from which the spiral is made;
- tuberculosis reproductive system;
Relative contraindications to the use of non-hormonal coils
- if the woman has no children yet;
- woman leads a mess sexual life and belongs to the risk group for infection with sexually transmitted diseases;
- childhood and adolescence*;
- the woman's age is over 65;
- uterine bleeding and heavy painful periods;
- anomalies in the development of the uterus (for example, a bicornuate uterus);
- hematological diseases ( anemia , leukemia , thrombocytopenia and others);
- overgrowth of the endometrium, endometriosis;
- urethritis, cystitis, pyelonephritis- acute or exacerbation of a chronic course;
- benign tumors of the uterus and appendages (submucosal fibroids and uterine fibroids);
- prolapse of the intrauterine device or the development of side effects after the previous use of the device.
Relative contraindications to the use of hormonal intrauterine devices (systems):
- cervical dysplasia;
- anomalies in the development of the uterus;
- urethritis, cystitis, pyelonephritis - acute or exacerbation of a chronic course;
- fibromyoma of the uterus;
- diseases liver , liver failure ;
- severe cardiovascular pathologies: malignant arterial hypertension, state after stroke or heart attack, heavy heart defects ;
- migraine;
- decompensated (uncontrolled) diabetes ;
- thrombophlebitis lower limbs;
- the woman's age is over 65 years.
When can I put a spiral after childbirth, caesarean section, abortion?
The intrauterine device can be placed already on the 3rd day after uncomplicated physiological childbirth. But usually gynecologists it is recommended to wait until the end of the discharge of lochia (on average 1-2 months). So it will be safer. After childbirth, the uterus recovers, so early insertion of the coil increases the risk of side effects and early rejection of the device. To start using the hormonal intrauterine system, you need to withstand 2 months after the birth of the baby, this is necessary not only for the complete restoration of the uterus, but also for the normalization of the hormonal background. After operation caesarean section the spiral can be installed in the uterine cavity only after 3-6 months. It takes time for the postoperative scar to form.
After a medical termination of pregnancy (up to 12 weeks), it is better to install the IUD within seven days after the start of the following after abortion monthly. But the gynecologist may offer to install the spiral immediately after the 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 the complications of the abortion itself increases significantly. After a miscarriage, the decision on the appropriateness and safety of installing a spiral is made only by a doctor, he individually assesses the situation, analyzes the cause of spontaneous abortion, weighs the pros and cons. If it is necessary to use a spiral after a miscarriage, it is installed in the uterine cavity during the next menstruation.
Is an intrauterine device installed after the age of 40?
An intrauterine device can be used for any woman who is ovulating, has her menstrual cycle, and is likely to become pregnant. Hormonal intrauterine systems are also installed in the period after the onset menopause to obtain a therapeutic effect. Therefore, 40 years is not a limitation for the use of the IUD. According to the instructions, IUDs are not recommended for women over 65 years of age, but this restriction appeared only due to insufficient research on the use of intrauterine devices at an older age.How is an intrauterine device installed?
The intrauterine device is installed only by a gynecologist in a gynecological office. Before the introduction of the IUD, the doctor assesses the possibility and risk of side effects of using this contraceptive , explains to the woman about the possible reactions of the body to the introduction of one or another type of spiral. Before intrauterine contraceptives are installed, a woman needs to be examined to completely exclude a possible pregnancy and contraindications.Desirable examination before installing an intrauterine device:
- gynecological examination and palpation (palpation) of the mammary glands;
- smear from the vagina, if necessary, sowing on microflora ;
- cytological examination of smears from the cervix;
- Ultrasound of the pelvic organs;
- in some cases pregnancy test or blood analysis to determine the level hCG ;
- Breast ultrasound (for women under 40) or mammography(after 40 years).
Preparing for installation
Usually, special preparation for the introduction of the spiral is not required. If inflammatory diseases are detected, you will first need to undergo a course of appropriate therapy.Immediately before the procedure, it is necessary to empty bladder.
On what day of menstruation is it better to install an intrauterine device?
Intrauterine contraceptives are usually inserted during menses or to its end, that is, within 7 days from the beginning of menstruation. The optimal time is 3-4 days. This is necessary in order not to miss the onset of pregnancy.The intrauterine device can be placed as emergency contraception, that is, if a woman had unprotected intercourse and suggests an unwanted pregnancy. In this case, the device is introduced in the period after ovulation, this can prevent the attachment of the fetal egg in 75% of cases.
Intrauterine device insertion technique
Any spiral packed in a vacuum package is sterile. You need to check the expiration date. The spiral must be opened immediately before installation, otherwise it loses its sterility and can no longer be used. The IUD is a one-time use device, its reuse is strictly prohibited.In most cases, local anesthesia is not required. Cervical anesthetics can be used in nulliparous women and when placing hormonal intrauterine systems, as they are wider.
Insertion technique for various kinds spirals may vary. The installation features of each spiral are described in detail in the device instructions.
1.
A speculum is inserted into the vagina to fix the cervix.
2.
The cervix is treated with disinfectants.
3.
With the help of special forceps, the cervical canal (the canal in the cervix that connects the vagina with the uterus) is straightened, 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 introduction of the spiral itself begins after 4-5 minutes, when the anesthetic takes effect.
6.
The spiral is introduced using a special conductor with a piston. A ring is set 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 pulls the piston a little towards himself in order to open the shoulders of the spiral. After that, the spiral is moved directly to the wall of the fundus of the uterus. When the gynecologist is satisfied that the device is installed correctly, the guidewire is slowly and gently pulled out. When installing some spirals (for example, annular ones), the opening of the shoulders is not required, so the spiral is inserted to the wall of the uterine fundus, and then the conductor is simply pulled out.
7.
The threads of the spiral are cut into the vagina at a distance of 2-3 cm from the cervix.
8.
The procedure is over, it usually takes 5-10 minutes.
Does installing an intrauterine device hurt?
The procedure itself, of course, is unpleasant, brings some discomfort. But the pain felt is tolerable, it all depends on the woman's pain threshold. These sensations can be compared to painful menstruation. Abortion and childbirth are more painful.After insertion of the intrauterine device
Ultrasound photo: Intrauterine device in the uterine cavity.
- The uterus completely gets used to the IUD within a few months, so during this period there may be some changes from the side women's health you need to listen to your body.
- In some cases, a course of antibiotic therapy will be required after the introduction of the spiral, for example, if you suspect chlamydia, in the presence of another chronic infections urinary system.
- Bloody spotting and drawing pain in the lower abdomen or in back may disturb for 1 week after the introduction of the spiral. To relieve spasms, you can take No-shpu.
- The hygienic regimen is normal, it is necessary to wash with means for intimate hygiene twice a day.
- You can have sex only 8-10 days after the installation of the intrauterine device.
- For several months, you can not lift weights, engage in intense physical activity, overheat (sauna, bath, hot baths).
- It is necessary to periodically probe the threads of the spiral, control their length, it should not change.
- After 2 weeks, it is better to visit a gynecologist so that he can see if everything is fine.
- Menstruation in the first months after the installation of the spiral can be painful and plentiful. Over time, menstruation normalizes.
- When using hormonal intrauterine systems, menstruation may disappear after six months or several years ( amenorrhea). After the first loss of the cycle, pregnancy must be excluded. The menstrual cycle will be restored immediately after the removal of the spiral.
- If you have any complaints, you should consult a doctor.
- In the future, an examination by a gynecologist is necessary every 6-12 months, as for any healthy woman.
Can an intrauterine device fall out?
If the intrauterine device is not inserted correctly or if it does not take root, the intrauterine device may fall out. This must be followed. The most common prolapse of the IUD occurs during menstruation or after heavy physical activity. Therefore, it is important to control whether the spiral threads are in place, to inspect sanitary napkin.How long is the use of an intrauterine device?
The term for which intrauterine contraception is installed differs depending on the type of spiral. - Inert IUDs - 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 the IUD after the expiration date due to the risk of the spiral growing into the uterine tissue. Hormonal spirals lose their properties due to depletion of reserves hormonal drug. This reduces the effectiveness of the intrauterine device, which can lead to an unplanned pregnancy.
Intrauterine devices (copper, hormonal): installation, principle of operation, efficiency (Pearl index), expiration date. How to check if the spiral is in place - video
Removal and replacement of the intrauterine device
Indication for IUD removal:- the period of use has expired, while the replacement of the intrauterine device is possible;
- woman planning a pregnancy ;
- there were side effects from the use of an intrauterine device.
Removal of the coil often does not require anesthesia, local anesthesia required when removing or replacing hormonal coils. The doctor fixes the cervix with a gynecological speculum, and then, using a special tool (forceps), grabs the spiral threads and carefully pulls out the device, while gently stretching the cervix.
Usually this procedure goes without difficulty, the woman experiences less pain than with the introduction of a spiral. But there are situations when the spiral is not so easy to pull out, then the doctor expands the cervical canal and facilitates the removal of the IUD. You can also face the problem of thread breakage, then the doctor inserts a special hook through the cervix, with which he removes the foreign body from the uterine cavity.
But there are situations when the doctor simply does not detect the thread of the spiral. The question arises, is there a spiral in the uterus at all? If yes, where is she? To do this, the woman is offered to do ultrasound pelvic organs, if necessary radiography. Sometimes there are cases that the spiral is outside the uterine cavity (with perforation of its wall), then it is urgently needed laparoscopic surgery to remove a foreign body.
Coil replacement intrauterine contraception can be carried out immediately after the removal of the old spiral, 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;
- the procedure is best done during menstruation;
- removing the coil during or before ovulation increases the risk of pregnancy;
- before replacing the coil for 7 days, it is necessary to use other methods of contraception ( condom, oral contraceptives or spermicides) to prevent an unwanted pregnancy.
Possible side effects
The intrauterine device is a modern, convenient and effective method of contraception. But it is also a foreign body, to which our body can react with undesirable reactions. In most cases, intrauterine contraception is well tolerated, but some women may be intolerant to this method and develop side effects, some of which can have a very negative impact on health and lead to severe pathologies. To reduce the risk of developing these side effects will help the choice of the type of spiral suitable for this woman, a detailed assessment of contraindications to its introduction, its timely removal and, of course, sufficient professionalism of the gynecologist who will install this device in the uterine cavity. Possible side effects and complications when using an intrauterine device
| Side effect | Reasons for development | How often does it occur? | Treatment of adverse reactions |
| Pain in the lower abdomen immediately after the insertion of the IUD | Often. |
|
|
| Prolapse of the spiral from the uterine cavity or expulsion |
| Often. |
|
| Painful and heavy periods |
| Up to 15%. |
|
Inflammation of the genital organs (colpitis, endometritis, salpingitis, adnexitis):
|
| Up to 1% of cases |
|
| Severe uterine bleeding |
| Very rarely |
|
Anemia:
|
| Very rarely. |
|
| Fibroids development |
| Rarely. |
|
| Risk of ectopic pregnancy |
| 1:1000 | Surgical treatment, removal of the fallopian tube. |
| Soreness during intercourse, difficulty in achieving orgasm. |
| Up to 2%. | Removal of the coil or replacement with a hormonal IUD. |
| The onset of pregnancy | The IUD is not 100% effective. | From 2 to 15%. | Individual approach. |
Perforation (puncture) of the walls of the uterus:
| Damage to the walls of the uterus during the introduction, operation and removal of the spiral. Increase the risk of uterine perforation:
| Very rarely. | Surgical treatment and emergency medical care. |
| Ingrown spiral into the wall of the uterus |
| Up to 1%. | Removal of the spiral through the cervix using special tools. Sometimes laparoscopic surgery may be required. |
| Copper intolerance or Wilson's disease | individual intolerance or allergy on copper. | Rarely. | Replacement with another type of contraception or hormonal intrauterine device. |
Additional side effects from the use of a hormonal intrauterine system (associated with the hormone progestogen):
- absence of menstruation (amenorrhea), after the removal of the spiral, the menstrual cycle is restored;
- high risk ectopic pregnancy, ultrasound control is required.
- Such a pregnancy can end in an early miscarriage, which is associated with the effect of the spiral on the endometrium, to which the fetal egg is attached.
- The IUD can cause intrauterine infection of the fetus, as well as intrauterine growth retardation and fading pregnancy.
- High risk of fetal malformations during pregnancy with a hormonal spiral.
Also, an allergic reaction may develop on the introduction of a progestogen, requiring urgent removal of the spiral from the uterus.
Intrauterine device (IUD): composition, action, indications, possible negative consequences from the use - video
Intrauterine device (IUD): mechanism of action, dangerous complications (therapist's opinion) - video
How can a pregnancy proceed with an intrauterine device?
As it has already become clear, intrauterine contraceptives do not protect 100% from pregnancy. Most of these “lucky women” have a normal pregnancy, the child can independently push the spiral out in the second trimester and even be born with it in their hands, for some children this is such a toy. But not everything is always so smooth, and if a woman decides to keep such a pregnancy, she should be ready for various problems.
Basic principles of pregnancy management with a spiral:
1.
Difficulties arise with diagnostics pregnancy, the woman is confident in her contraception. And menstrual irregularities with IUDs are not uncommon, which 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, with the slightest deviations, changes and hints of pregnancy, consult a doctor.
2.
At the request of the woman, a medical abortion can be performed.
3.
The spiral is not an indication for medical termination of pregnancy. The choice is up to the woman, because in most cases, pregnancy with a spiral proceeds normally and without complications. But still, the doctor must evaluate the possible risks of pregnancy and may recommend terminating it.
4.
The IUD may be removed during pregnancy. The copper coil is often not removed as it does not affect fetal development. The hormonal spiral throughout pregnancy will release hormones that can lead to abnormalities in the development of the fetus. The gynecologist can remove the coil if its threads are preserved and it is removed from the uterus easily and without hindrance.
5.
Such a pregnancy requires constant monitoring by doctors, regular monitoring of the ultrasound of the fetus is necessary.
Possible risks of pregnancy with an intrauterine device:
How to choose a good intrauterine device? Which spiral is best?
Your gynecologist should deal with the selection of the type of spiral, its size and manufacturer. Only he can determine the indications and contraindications for the use of one or another intrauterine contraceptive, individual characteristics your body. But if the woman is absolutely healthy, then the doctor can provide an IUD to choose from. Then many questions arise. "Which spiral to choose, copper or hormonal?" Here, a woman needs to choose between effectiveness and possible side effects. The hormonal spiral has more possibilities side effects associated with the progestogen, but they are temporary and stop after a few months. And the contraceptive effect of using such a spiral is much higher. If a woman has fibroids, then the hormonal spiral is a method not only of contraception, but also of treatment. A copper coil with silver and, especially, with gold, has a higher efficiency than a conventional copper device, and the risk of side effects is lower, this is such a middle ground between a hormonal and a copper coil.
"And how much does an intrauterine device cost?" For many women, the issue of economy is of great importance and determines the choice of a spiral. Copper coils are much cheaper than hormonal systems. Also, spirals with silver and gold have a high cost.
"Which spiral is used longer?" The longest you can use spirals with silver and gold, up to 7-10 years or more. Hormonal spirals are usually used for no more than 5 years.
"Which spiral will not affect the next pregnancy?" Any spiral can lead to problems with future pregnancies, this is an ectopic pregnancy, and infertility due to inflammatory process. The risk of developing an ectopic pregnancy during the use of the IUD is higher with hormonal coils due to the action of the progestogen. Copper spirals give a greater risk of complications in the form of inflammation of the uterus and appendages. When removing the IUD, ectopic pregnancy often occurs after the use of copper coils.
"Which spiral is painless?" During the installation and removal of the spiral, the woman experiences some pain. But this should not fundamentally affect the choice of the IUD. With the introduction of the hormonal system, these painful sensations are more pronounced, which is why they use local anesthesia. Local anesthesia can be carried out with the introduction of a copper spiral in women who are especially impressionable and emotional.
Overview of various modern intrauterine devices: Juno, Mirena, Goldlily, Multiload, Vector extra, spirals with gold and silver
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