More than 60 million women in the world prefer such a means of protection from pregnancy, as an intrauterine device. Which intrauterine spiral is better, for how long are they being established, is this a painful procedure? These questions are of interest to many women.
Classification of the Navy
This type of contraception is used by more than 16% of the Sissi women of reproductive age. To find out what is good about the intrauterine device, which one best protects against pregnancy, you need to know what spirals can be purchased in the domestic market. There are several varieties of intrauterine contraceptives:
- is non-drug;
- medical first generation - "Multiload", "Nova", "Juno Bio";
- medicament third generation - "Mirena".
The first are made of synthetic materials with the addition of barium sulfate. They come in different shapes: T-shaped or S-shaped. These are ineffective intrauterine devices. The doctors' comments say that they are not currently used because of frequent inflammatory complications after their administration.
The second group is represented by IUDs( intrauterine contraceptives) containing copper, gold, silver. In this case, it is possible to have one metal or a combination of several: the rod is silver and the winding is copper. Intrauterine spirals with silver and other metals are not corroded, contribute to the prevention of various inflammations of the internal genital organs and are put on for quite a long time - for 5 years.
Contraceptives belonging to the third group are similar in shape to the previous ones, but contain a container with synthetic gestagen that is secreted in microdoses - up to 20 μg daily. Such spirals are put for 7 years. They have not only a contraceptive effect, preventing the attachment of a fertilized egg, but are also used to treat various diseases: endometriosis, dysfunctional uterine bleeding, and hormonal replacement therapy with estrogens in order to prevent endometrial hyperplasia. Such spirals are suitable for women with religious prejudices, because fertilization does not occur due to changes in the hormonal balance under the influence of a constant allocation of progestogens.
Mechanism of action
To decide which intrauterine device is best, you need to know how they function. This method of contraception leads to the development of a specific inflammation as a reaction to a foreign body: leukocyte infiltration of the endometrium, morphofunctional changes that are uncommon for the normal menstrual cycle and in which the introduction of a fertilized egg is impossible.
IUD causes uterine contractions, prevents the normal growth of the endometrium for implantation of the ovum, promotes peristalsis of the fallopian tubes and adversely affects the spermatozoa with copper, gold and silver ions.
One should not consider each theory of contraceptive action as prevalent, the mechanism of action consists of several components.
Advantages of
To find out which intrauterine device is the best, it is necessary to familiarize yourself with the advantages of all types of IUDs:
- efficiency up to 98%;
- uncomplicated when used;
- a minimum of adverse reactions;
- recovery of fertility after removal of IUDs within the first month;
- does not suffer from breastfeeding( not suitable for IUDs with gestagens);
- is introduced for a long time;
- low cost;
- there is no need for daily taking of tablets and control over use when using oral contraceptives.
Disadvantages of
Among the drawbacks, it should be noted pulling pains in the lower abdomen, especially in the early days, profuse menstruation, a high risk of inflammation, constant control of antennae, restrictions for young women.
Contraindications
Which intrauterine spirals are better: "Multiload", "Juno Bio", "Nova"?Are there any contraindications for a particular type of spiral? It should be noted that for all types there are relative and absolute contraindications.
Absolute contraindications include acute inflammation, oncological neoplasm of the cervix and uterus body, bleeding from the vagina of an unclear nature, presumed or existing pregnancy. With these symptoms, the introduction of the spiral is categorically contraindicated.
Relative contraindications are those in which IUD insertion is possible after an appropriate examination or treatment or when the contraceptive does not contribute to the progression of the process. These are:
• exacerbation of chronic diseases and six months after cure;
• sexually transmitted diseases;
• cervicitis, vaginitis;
• profuse menstruation, intermenstrual bleeding;
• endometrial hyperplasia or polyps;
• uterine myoma with submucous site of nodes;
• some forms of endometriosis;
• malformations of the uterus: inadequate development, abnormal structure;
• changes in the cervix, in which the insertion of the IUD is not possible;
• ectopic pregnancy six months before the introduction;
• an expulsion( self-extraction) of the IUD in a history;
• Infectious-inflammatory complications after abortion within the last three months;
• if there are many sexual partners;
• somatic diseases: chronic inflammation, including.tuberculosis;anemia or coagulopathy;Rheumatic heart disease, valvular apparatus flaws;
• allergy to metal ions;
• Westphal-Wilson-Konovalov's disease is a hereditary affliction, in which the exchange of copper is disturbed;
• treatment with immunosuppressants.
In each case, after finding out all the unfavorable factors and a thorough examination, the doctor determines the possibility of using the IUD.In pharmacies are sold various intrauterine spirals. The photos of the packages are presented above. Their cost varies from 200 to 10,000 rubles.
Before the introduction of the spiral
Before using this method of contraception, individual consultation with your gynecologist and the necessary minimum of examinations are necessary:
- clinical blood test;
- examination of kidney function;
- screening for syphilis, hepatitis B and C, HIV carrier;
- advanced colposcopy;
- ultrasound of the uterus and appendages.
The timing of the introduction of IUD
According to WHO experts, the spiral can be administered on any given day, but the most favorable days are the 4-7th day of the menstrual cycle. This is due to the fact that at the indicated time the uterine mucosa is restored after endometrial rejection, the cervical canal is ajar, the presence of menstruation is a reliable sign of the absence of pregnancy, and the minimal spotting that occurs after the introduction does not bring a woman discomfort. After an artificial abortion or self-abortion,or for 4 days in the absence of signs of bleeding and inflammation.
After giving birth( within 48 hours), it is not recommended to immediately enter the IUD because there is a high probability of spiral expulsion. The most optimal time is at 6 weeks after childbirth.
Complications of
Complications are possible immediately and after a time after the intrauterine device is installed. Which is better in terms of minimum unpleasant side effects? Often after the introduction of the spiral, there is a pain symptom, which can last for an hour. This is reported in the reviews. Most often, discomfort occurs after taking analgesics. If the pain is not not stopped by the use of analgesics and antispasmodics, ultrasound or hysteroscopy should be performed to establish the correctness of the IUD insertion and to diagnose the presence of a spiral in the uterus or outside it( with perforation of the uterus when administered).
The expulsion of the IUD is most often observed in young nulliparous women because of the increased contractility of the uterus. It occurs mainly in the first days after administration. Moreover, the frequency of this complication depends on the type of spiral: copper-containing self-deletion in 6-16% of cases, progestogen-containing - in 3-6,5%.With age, an increase in the number of births and abortions, the probability of this complication is reduced.
Inflammatory diseases - complications, which are observed in 3,8-14,5% of cases with the introduction of IUDs of the second group. In this case, if the inflammation has occurred in the first 3 weeks, then its occurrence can be associated with the introduction of IUD;if after 3 months - then this is a newly emerging disease. The formation of purulent tubovarial formation is the most formidable inflammatory complication. It occurs when the spiral is used for a long time - more than 6-7 years. Bloody discharge is possible in the first days after the administration( 2.1-3.8% of cases) and are stopped by the appointment of hemostatic agents. If bleeding continues, accompanied by a pain syndrome or occurs between menstruation and does not respond to treatment, then you need to remove the spiral.
In 0.5-2% of cases, pregnancy may occur. This occurs when the IUS is fully or partially expelled. Most often, such a pregnancy ends in a spontaneous abortion, even if the woman wants to keep it.
And what kind of intrauterine spiral is better in terms of complications, the gynecologist will help to solve.
Efficiency of intrauterine contraceptives
Many varieties of the IUD puts such questions before a woman: how to avoid complications, and which intrauterine device is better? Comments of doctors and patients speak in favor of copper or silver containing IUDs.
The addition of copper and silver has reduced the incidence of complications 2-10 times. The effectiveness of such IUDs is 93.8%.Inert spirals have an efficiency of 91-93%.At present, copper-containing spirals are the most acceptable because of the low percentage of complications and the high percentage of contraceptive activity.
The Mirena hormonal release system is the most effective contraceptive and is considered to be almost a biological sterilization, as it has many actions aimed at preventing the fertilization of the ovum, attaching it to the endometrium, increasing the viscosity of the mucus in the cervical canal to protect against entering the uterus of spermatozoa.
We examined the positive and negative effects that the intrauterine device has. Which is better to put? This issue should be solved together with a gynecologist. At the same time, the price for which the woman counts and the indications that the doctor identifies after the examination is determined.