Childbirth is one of the most pleasant and joyful events that can happen in the life of a spouse. However, you should carefully prepare for it mentally, physically and financially.

It's very good that every married couple can decide for herself how many children she should have and when. To do this, spouses use different contraceptives, one of which is hormonal IUD. Pros and cons this method contraception, details of installation and use, reviews and frequently asked questions - you will find all this in our article.

Now let's look at the principle of operation of the spiral and give its description.

Description of the spiral

The hormonal intrauterine device is one of the most effective contraception. It is made of plastic and has the shape of the letter “T”. On the spiral, the size of which varies from three to five centimeters, there is a small compartment containing essential hormone. The essence of this device The idea is that the drug is introduced into the body gradually, in equal doses. What is its effect?

The hormone affects the uterus in such a way that its ability to close is lost. This occurs due to inhibition of the growth of the uterine epithelium, weakening of the function of the glands and self-compaction of cervical mucus. As a result, the fertilized egg cannot reach the uterine cavity, which means pregnancy does not occur.

As you can see, many types of hormonal IUDs are abortifacients, since their task is not to prevent the egg from being fertilized, but to limit its access to the uterus. That is, pregnancy occurs, but the development of the fertilized egg stops.

What are the positive and negative aspects installation of a hormonal IUD? Let's find out.

Pros and cons of using a spiral

Before deciding which contraceptive to use, a woman should weigh all the pros and cons of a particular method. Let's discuss them in more detail in the light of our topic.

Positive points of the hormonal contraceptive device:

• Almost one hundred percent guarantee of preventing unwanted pregnancy.
• Comfortable to use.
• Local action of the drug.
• Duration of use.
• No discomfort during sexual intercourse.
• Therapeutic effect for certain diseases.

To the main negative Aspects of the hormonal spiral include:

• Expensive installation.
• Existence of side effects.
• Fertility is fully restored only six to twelve months after removal of the device.
• The possibility of installing a spiral is only for those who have children ( nulliparous women may prescribe a contraceptive only for medical reasons).
• Application hormonal drugs during the treatment of diseases is carried out only after consultation with a specialist.
• Takes some getting used to (some women may experience discomfort at first).
• Lack of protection against sexually transmitted infections.
• Inability to use for certain diseases.

What side effects does the hormonal IUD have?

Negative consequences

Side effects of the hormonal IUD are:

1. The likelihood of bleeding.
2. Appearance benign cysts on the ovaries (which may go away on their own).
3. Possibility of ectopic pregnancy.
4. Painful sensations in the mammary glands.
5. Various pathological changes in the organs of the reproductive system.
6. Irritability, bad mood, depression.
7. Pain in the pelvic organs.
8. Frequent headaches.

According to various studies, many of the above symptoms occur during the initial period of action of the hormone and disappear immediately after the body gets used to it.

What about birth control pills? Are they effective in the fight against unwanted pregnancy? Do they have negative impact? And what is better to choose: pills or spirals?

Hormonal drugs

The age-old question: “Intrauterine device or hormonal pills- which is better?” - should be decided based on your views and preferences. What can be taken into account?

First of all, you should know that hormonal contraceptives are very different both in composition and in their principle of action. Some of them have an abortifacient effect (they make the lining of the uterus so thin that a newly formed embryo cannot attach to it), while others thicken the uterine mucus so that it does not allow the sperm to be fertilized.

Are there pros and cons to the birth control “pill”? Of course, and here are some of them.

Flaws. These include an inconvenient dosage schedule, which can be missed or forgotten, and then the likelihood of pregnancy will increase. As well as a number of side effects similar to side effects spirals.

Advantages. To this advantage medicines can be attributed to the formation hormonal levels women, including stabilization of the menstrual cycle, which relieves the “weaker sex” from pain during the “ critical days”, and can also have a beneficial effect on appearance (condition skin and hair).

Another important positive feature The use of tablets is that their use prevents the development of tumors in the female genital organs and prevents the occurrence of ectopic pregnancy. Moreover, hormones in the form medicines do not affect basic reproductive functions - the likelihood of conception is restored almost immediately after cessation of contraception.

So, the advantages, disadvantages and negative consequences hormonal spirals are determined, and the solution is established this type contraception adopted and approved. What should you do next?

Installation of a contraceptive

The installation of the hormonal IUD must take place under sterile conditions. The manipulation is carried out by an experienced doctor. If these conditions are met, the intrauterine device will not cause pain, and the risk of infection of the uterine cavity will be minimized.

Is it necessary to undergo any procedures or examinations before installing the IUD? Certainly.

First of all, the possibility of pregnancy should be excluded (for this there is a specialized test or a specific blood and urine test). You will also need to go through universal studies: general analysis blood/urine, vaginal swab and gynecological ultrasound. If a woman is sick with any chronic diseases, consultations with narrow specialists will be required.

Now let's move on to next question: what types of hormonal IUDs are there and how do they differ from each other?

Types of intrauterine contraceptives

Greatest demand in Russian Federation The following types of hormonal intrauterine devices are used:

1. "Mirena" (manufactured in Germany).
2. "Levonova" (produced in Finland).

Both protection devices have almost identical design and characteristics.

But since the most common method of contraception is the Mirena intrauterine device (IUD), then further we'll talk exactly about her.

What is Mirena

This type of contraceptive is securely fixed in the woman’s uterus due to its “T”-shaped design. A thread loop is placed on the lower edge of the product to make it easy to remove the system from the body.

At the center of the Mirena IUD is a device with fifty-two milligrams of the hormone white(levonorgestrel), which slowly penetrates the body through a special membrane.

The contraceptive begins to act immediately after installation. Released directly into the uterine cavity, gestagen acts predominantly locally. This achieves sufficient high concentration levonorgestrel directly into the endometrium.

Like other hormonal IUDs, Mirena suppresses the activity of the uterine epithelium and reduces sperm mobility. Over the course of several months, transformation occurs in the endometrium, which leads to infrequent bleeding and ultimately to a shortening of the menstrual cycle or its complete cancellation.

Are there any contraindications to the use of this method of contraception? Yes, and we’ll talk about this below.

When should you not install Mirena?

The Mirena hormonal device should not be used if:

1. There is a possibility of pregnancy.
2. There are inflammatory processes in the pelvic organs or in the urinary system.
3. Chronic sexually transmitted infections appear.
4. Oncological, precancerous conditions of the uterus or mammary glands are noted.
5. There is a history of thrombosis.
6. There are serious illnesses liver.
7. Present allergic reaction onto the spiral components.

Indications for use

Sometimes Mirena is recommended to be used as auxiliary treatment some diseases. For example, uterine fibroids, accompanied by severe pain and bleeding. In this case, an intrauterine device will alleviate such symptoms. It will also relieve pain during monthly menstruation and can significantly reduce or stop the increase in fibroid nodes.

How to install Mirena

As noted above, an IUD should be installed by a gynecologist. After a careful examination and examinations, the doctor will install Mirena in his office, and will do it quickly and painlessly. If a woman has low pain threshold, she may be given a local anesthetic.

When is the best time to carry out this manipulation? During the first week after the start of the critical days, when the likelihood of getting pregnant was reduced to zero.

Does Mirena have side effects? Of course, like other hormonal IUDs.

Negative influence

Which undesirable consequences Can this hormonal spiral have? The harm to the body caused by Mirena is usually temporary and minimal. First of all this:

• acne;
• nausea;
• weight gain;
• headaches;
• sudden mood swings;
• absence of menstruation, minimization of discharge;
• decreased sexual activity;
• pain in the spine.

Such symptoms are rare and disappear soon. If discomfort and accompanying discomfort do not go away, you should consult a doctor.

Is it possible to place the Mirena hormonal device immediately after childbirth?

Childbirth and breastfeeding

It is not recommended to install an intrauterine contraceptive immediately after delivery. This is due to an increase in the volume of the uterus, which can provoke rapid prolapse of the device. According to the instructions, it should take about two months (and in some cases more) before the uterus returns to its original size and the gynecologist allows the introduction of Mirena.

If a woman is breastfeeding, this is not a reason to refuse contraception. The fact is that a hormone acting in a spiral will in no case spread throughout blood vessels and absorbed into milk. As mentioned above, the principle of action of Mirena is the local distribution of the main substance.

Is it possible to install an IUD after a miscarriage or abortion? Sometimes this can be done on the same day, sometimes a week later. Be that as it may, the decision is made by the attending gynecologist after a detailed examination of the patient.

Spiral falling out

Although Mirena is installed for at least five years, sometimes there are cases of it being dropped without permission. How can this be determined?

For example, during menstruation, you should carefully examine pads and tampons in order to notice a fallen device. In addition, any change in the position of the helix will be indicated feeling unwell or painful sensations experienced by a woman.

Why can a helix self-remove? This happens quite rarely, often during the first stages of installation of the intrauterine system and most often in nulliparous women. The reasons for this phenomenon have not been scientifically determined or substantiated.

It has been precisely proven that neither vomiting, nor diarrhea, nor playing sports, nor drinking alcohol affect the partial or complete slipping of the Mirena from the uterine cavity.

Yes, the hormonal IUD is effective remedy against pregnancy. But what to do if fertilization does occur?

Pregnancy and Mirena

It is worth mentioning here that pregnancy occurs extremely rarely when using intrauterine contraceptive device. However, if this happens, it is recommended to do an ultrasound as soon as possible to determine the place where the fetus is attached.

If the fertilized egg is implanted in the uterus, the IUD should be removed. This will prevent the development of a threat to the child's development.

If Mirena is deeply embedded in the placenta, then it is not recommended to remove it so as not to harm the fetus.

For birth healthy child It has virtually no effect on whether the hormonal IUD remains in the uterus or not. In such incidents, no pattern is possible: births have been observed as healthy children, and with pathologies. It is still difficult to determine whether abnormalities in fetal development are a consequence of the presence of the contraceptive in the uterus or whether it was influenced by other, more objective factors.

Removal of the IUD

Since the validity period of Mirena is limited to five years, after this period the system is removed and, at the woman’s request, a new one is installed. If necessary, the spiral can be removed earlier.

This is very easy to do. On any day of the menstrual cycle, you should contact your treating gynecologist, who will carefully pull out the Mirena, grasping its threads with special forceps.

After such a procedure, the doctor is obliged to check the integrity and integrity of the system. If some element is missing (for example, the core containing the hormone has slipped out), the specialist will carry out the necessary manipulations to remove them from the body.

Is it possible to get pregnant immediately after taking off the contraceptive? In some cases, this may happen as early as the next month. Often the body will need certain time in order to adapt to the function of childbearing. Sometimes this period can last a whole year.

In practice

What are the real opinions regarding the use of hormonal IUDs? Reviews about this are quite ambiguous and contradictory.

First of all, many patients are not satisfied with the abortifacient effect of some types of hormonal IUDs, as well as their negative effect on the skin and weight. However, the latter negative action easily removable - experts recommend that women with IUDs move more and give up sweets, starchy foods and fatty foods.

Others are very happy with the choice contraceptive method and are happy to note the absence or minimization of menstruation, ease of use and favorable cost (if calculated over a five-year period total price birth control pills, then installing a spiral no longer looks so expensive).

Gynecologists also cannot clearly agree on the use of an IUD. They confirm quite high level protection and some medicinal properties spirals, however, they note that it should be installed carefully, after a thorough diagnosis.

The hormonal IUD is a contraceptive. It is used to prevent pregnancy, but can also have healing effect. Let's take a closer look at this type of intrauterine contraceptive, its types, installation method and features of use.

Are all IUDs hormonal?

In gynecology, among intrauterine contraceptives, there are several types of spirals. However, not all of them are hormonal. The spiral itself, due to its shape, can prevent pregnancy. Hormonal IUDs not only are they a mechanical barrier for male germ cells, but they also constantly secrete a hormonal component. Under the influence of this substance, there are structural changes uterine endometrium, which is why conception does not occur.

What types of IUDs are there?

Over the years, types of IUDs have been improved. In modern gynecology, 3 generations of intrauterine devices are used:

1. Inert (first generation). These spirals are made entirely of plastic, which explains their low cost. Their contraceptive effect is achieved by creating an obstacle for the fertilized egg - it cannot implant. This type of coils is no longer used due to its low effect, high degree of expulsion (loss of the coil), and frequent inflammatory processes.
2. Metal-containing spirals (second generation). An IUD containing copper was originally created. This metal has an anti-anidation effect - it interferes with the normal process of implantation of the fertilized egg. The basis of the spiral is a plastic frame, around which a thin metal wire is wound. Later they began to use silver and gold as metals. This reduced the risk of inflammatory processes in the uterus, increased the effectiveness of the product and the service life of such IUDs.
3. Hormone-containing (third generation). These contain a progestin, levonorgestrel. Distinctive feature Such IUDs have an almost 100% contraceptive effect. In addition, these devices are often used with therapeutic purpose, at gynecological diseases provoked by hormonal imbalance.

Hormonal IUD - indications

The hormonal intrauterine device is installed at the request of the woman herself. However, doctors can also recommend its use if certain diseases. Before use, a preliminary examination is prescribed, which is aimed at excluding malignant neoplasms in the reproductive system. Among the diseases and disorders for which a hormonal IUD can be installed, it is necessary to highlight:

• risk ;
• bilateral oophorectomy (removal of the ovaries);
• severe menopause.

Hormonal IUDs for endometriosis

A hormonal IUD for the treatment of endometriosis can be prescribed for severe, extensive damage to the inner layer of the uterus. The progesterone analogue contained in the composition actively suppresses the further development and proliferation of new lesions in the uterine cavity. This helps prevent the development of inflammatory processes against the background of endometriosis. When a hormonal IUD for endometriosis is used for a long time, doctors often fix positive trends to further recovery, as indicated by:

• reduction in the volume of menstrual blood;
• decrease ;
• normalization of the cycle.

Hormonal IUD for menopause

An intrauterine device with hormonal injection can also be actively used during menopause. This time is accompanied by a decrease in the synthesis of sex hormones in female body. The use of a spiral helps balance the concentration of estrogen and progesterone. The IUD releases 20 mg of levonorgestrel daily. This substance effectively affects the inner layer of the uterus and increases the rate of its epithelization. At the same time, the spiral does not disrupt the functioning of the gonads, but complements the deficiency of the hormone they synthesize.

IUD - contraindications

Like any medicine, the hormonal IUD has its own contraindications (hormonal contraceptive IUD). Before installing it, consultation and examination by a gynecologist is mandatory. Based on the results of the examination, the doctor decides whether an intrauterine device can be installed, the contraindications for its use are as follows:

• period of pregnancy or suspicion of it;
• oncological processes reproductive system, hereditary predisposition to them;
• acute inflammatory and chronic processes reproductive system;
• presence of sexually transmitted infections;
• bleeding from the genital tract of unknown etiology.

These violations are absolute contraindications. At the same time, gynecologists also distinguish relative ones:

• inflammation and infections of the appendages in the past;
• painful periods;
• hyperplastic processes in the endometrium;
• underdevelopment of the uterus and its defects (saddle-shaped, bicornuate);
• cervical deformities;
• anemia and blood diseases;
• cervical canal stenosis;
• submucosal fibroid;
• history of spontaneous expulsion of the IUD.

IUD - application

Hormonal contraceptive device not only helps prevent unwanted pregnancy, but also to restore the functioning of the reproductive system. Thanks to the secreted hormone, the functioning of the uterus and appendages is normalized. Every day, the IUD releases a substance similar in structure to progesterone. Under the influence of this connection:

• the process of restoration of the uterine endometrium improves;
• the menstrual cycle is normalized;
• menstruation decreases in volume and duration.

Intrauterine device - how to place it?

Before the intrauterine device is inserted, the woman will have to undergo an examination. The following tests are required:

• flora smears from the vagina, urethra and cervix;
• general blood test;
• PCR for sexually transmitted infections;
• general urinalysis;

The procedure itself is carried out in an outpatient clinic. The manipulation algorithm looks like this:

1. The patient is located in a gynecological chair.
2. A Simps speculum is inserted into the vagina, which exposes the cervix.
3. The vagina and cervical area are formed with an antiseptic.
4. Using bullet forceps, the doctor fixes the cervix and measures the length of the uterus.
5. A conductor is inserted into the cervical canal and reaches the uterine cavity.
6. By pressing the plastic piston, the spiral is pushed out so that its shoulders rest against the fundus of the uterus.
7. The guide is carefully removed, some of the threads that protrude into the vagina are cut off, and they help control the location of the IUD in the uterus.

The whole procedure takes no more than 5 minutes. After installation, the doctor outpatient card record the time and date, indicate the model of the spiral, and inform the patient about its period of action. After 10 days, a follow-up visit is scheduled. For 14 days after the procedure, the woman is recommended to:

• abstain from sexual intercourse;
• avoid lifting heavy objects;
• do not take hot baths;
• do not use sanitary tampons.

Removing the intrauterine device

After the installation of a hormonal IUD is completed, a woman can forget about oral and mechanical contraceptives. The average lifespan of an IUD is 5 years. However, the IUD can be removed earlier, when the woman decides to conceive a child. The procedure is carried out regardless of the day of the menstrual cycle. Most often, manipulation is prescribed for the first days. After removal, the system is inspected to ensure that the hormonal component has not slipped into the uterine cavity.

Hormonal IUD - side effects

The uterus often reacts negatively to the insertion of a foreign body, which is the IUD. After an intrauterine device is inserted, some women experience side effects within a few hours. However, more often complications arise that are a consequence of the installation procedure itself:

• cervical injury;
• tissue perforation cervical canal and uterus;
• intense pain during menstruation;
• pain during sexual intercourse;
• spontaneous expulsion (fallout of the IUD);
• menstrual irregularities – prolongation of menstruation, heavy periods;
• adnexitis and endometritis after removal of the coil.

Hormonal IUDs - names

When talking about what hormonal IUDs are, it should be noted that all of these IUDs contain a hormone. Common among such funds are pharmaceutical market are:

• Mirena (manufactured by Schering, Germany);
• Levonov (produced by Leiras, Finland).

An intrauterine device (IUD) is a T-shaped device that is inserted into the uterine cavity to achieve a contraceptive effect.

There are 2 types of coils: coils containing copper or silver, and coils containing hormones. Spirals containing hormones are recognized as more effective, and therefore are now more often used in gynecological practice.

What is the Mirena intrauterine device?

The Mirena IUD is a coil containing the hormone levonorgestrel. Every day, Mirena releases a certain small dose of a hormone into the uterine cavity, which acts only within the uterus and is practically not absorbed into the blood. Thanks to this, the risk of side effects of hormonal effects is significantly reduced, the ovaries are not suppressed and there is a therapeutic effect, which we will discuss below.

How effective is the Mirena IUD?

More than 20 years have passed since the introduction of the Mirena IUD. During this time Mirena showed high efficiency in preventing unwanted pregnancy.

According to statistics, within one year of using Mirena, pregnancy occurs in one woman out of 500. Compared to birth control pills, the Mirena spiral is a more reliable means of contraception.

What are the pros and cons of the Mirena IUD compared to other methods of contraception?

Mirena has its advantages and disadvantages, so it is not suitable for all women. After learning about the pros and cons of Mirena, you can decide whether this method of pregnancy protection is right for you.

Pros of Mirena:

• Once you install the IUD, you no longer need to worry about contraception. While birth control pills must be taken every day in order for the contraceptive effect to remain reliable.
• The spiral does not need to be changed often: you can walk with one spiral for up to 5 years in a row. While birth control pills or condoms need to be replenished monthly.
• Unlike condoms, during sexual intercourse the coil is not felt by either you or your sexual partner.
• Unlike birth control pills, the IUD does not increase appetite and does not cause water retention in the body, which means it will not cause weight gain.
• Can be used as a treatment method for adenomyosis (endometriosis of the uterus) and.
• Reduces blood loss during menstruation and.

Cons of Mirena:

• It is impossible to install the IUD yourself: to do this you need to visit a gynecologist.
• In contrast, it does not protect against sexually transmitted diseases (including HIV infection, herpes, etc.), therefore it is not suitable for women who have sex with unfamiliar partners.
• In the first 4 months after installation of the IUD, a woman has an increased risk of inflammation fallopian tubes ().
• May cause long-term appearance in the first months after installation.
• May cause irregular periods in the first months after installation.
• It may cause a temporary cessation of menstruation, but after removal of the device, menstruation returns within 1-3 months.
• May cause . These cysts are not dangerous to health and rarely require any treatment. Usually, they resolve on their own within a few months after their appearance.
• There is a risk of the IUD falling out unnoticed, which can lead to an unwanted pregnancy.
• If pregnancy occurs while wearing the IUD, there is a risk of miscarriage. early.

At what age can Mirena be installed?

There is an unwritten rule among gynecologists that intrauterine devices can only be installed in women who have given birth. However, there are studies in which IUDs were installed in nulliparous women, and even girls under 18 years of age, and the IUDs were effective and safe.

And yet, most gynecologists will not undertake to install an IUD if you are under 25 years old and have not yet given birth.

What tests need to be done before placing the Mirena coil?

Before installing the IUD, your doctor will prescribe:

• to make sure there is no inflammation. If the smear reveals inflammation, you will need to be treated first and only after recovery the doctor will install the IUD.
• to make sure your cervix is ​​normal and there are no precancerous or cancerous changes.
• to make sure the uterus has regular form and installation of the spiral will be safe. You will not be able to have an IUD if you have a bicornuate uterus, the presence of uterine septa, or other abnormalities in the development of the uterus.
• or to make sure you are not pregnant.

Who is the Mirena IUD contraindicated for?

There are not many contraindications for installing Mirena. This:

• Pregnancy or suspected pregnancy
• Inflammation of the vagina or cervix
• Chronic genital tract infections that often get worse
• Inflammation of the urethra or bladder
• Precancerous or cancerous changes in the cervix
• Breast cancer or suspected breast cancer
• Inflammation of the uterus (endometritis) after childbirth or abortion within the last 3 months
• Uterine development abnormalities: bicornuate uterus, septum in the uterus, etc.

To make sure that the spiral is in place, you can try to feel its “antennae” yourself. To do this, wash your hands thoroughly and insert the fingers of one hand deep into the vagina to reach the cervix. The “antennae” feel like threads of fishing line. The length of the “antennae” can vary: you can feel only the tips, or feel 2-3 cm. If the threads are longer than 2-3 cm, or if you cannot feel them, then you need to contact a gynecologist.

How often should you visit a gynecologist if you have a Mirena spiral?

If nothing worries you, then the first visit to the gynecologist should be made a month after installing the IUD. Then visit your doctor after another 2 months. If the doctor confirms that Mirena is in place, then further visits should be made once a year.

Spotting after installation of the Mirena coil

In the first months after Mirena installation, prolonged spotting (dark brown, brown, black) discharge may appear. This normal phenomenon associated with the installation of the spiral. Such discharge may be observed during the first 3-6 months after Mirena installation. If spotting persists for more than 6 months, then you need to visit a gynecologist.

Irregular periods after Mirena installation

Some women who use intrauterine device Mirena, periods may become irregular. This not related with hormonal disorders or ovarian dysfunction. The cause of the menstrual cycle failure is the local effect of the IUD on the endometrium of the uterus. This is not hazardous to health and does not lead to any negative consequences.

Consult your gynecologist if irregular cycle will last for 6 months or more after installation of the spiral.

No periods after installing the Mirena IUD

About 20% of women who use the Mirena IUD for a year or more stop having periods altogether.

If your next period has not come, and more than 6 weeks have passed since your last menstruation, first of all it is necessary to exclude pregnancy. To do this, you can either turn it in.

If pregnancy is excluded, then the absence of menstruation is caused by the IUD. The hormones released by the intrauterine device act on the endometrium, suppressing its growth. The endometrium remains thin and therefore menstruation does not occur. Lack of menstruation has no effect negative influence on the body and does not cause any consequences in the future.

Menstruation recovers on its own within 1-3 months after removal of the IUD.

What to do if pregnancy occurs while wearing Mirena?

The likelihood of pregnancy while wearing Mirena is quite small, and yet such cases have been described.

If the pregnancy test showed positive result, then you need to visit a gynecologist as soon as possible. The gynecologist will examine you and refer you for an ultrasound. An ultrasound will help determine where the fetus is located: in the uterus or is it an ectopic pregnancy. If the fetus is located in the uterus, then there is a chance to maintain the pregnancy.

Do I need to remove the IUD if pregnancy occurs?

In order to reduce the risk of early miscarriage, doctors recommend removing the intrauterine device. In the first hours and days after removal of the IUD, the risk of miscarriage will be quite high, but if the pregnancy can be maintained, then nothing will threaten the unborn child.

If you decide not to remove the IUD, or if its removal is impossible for other reasons, then during pregnancy you will need more careful medical supervision in order to prevent or detect it in time. possible complications(miscarriage, inflammation, premature birth).

Can Mirena cause developmental abnormalities in an unborn child?

Unfortunately, this is not yet known, since there were not many cases of pregnancy, and it is impossible to compile any reliable statistics.

Cases of healthy children being born after pregnancy with the IUD have been described. Cases of children being born with developmental anomalies also exist, but it has not yet been possible to establish whether there is a connection between these anomalies and the fact that the IUD was not removed during pregnancy.

How is the Mirena IUD replaced or removed?

The Mirena spiral works for 5 years. After this period, the IUD should be removed (if you are planning a pregnancy or want to switch to another method of contraception), or replaced with another IUD (if you are not planning a pregnancy and do not want to switch to other methods of contraception).

You can remove the IUD earlier if you are planning a pregnancy. To do this, you do not have to wait until Mirena’s five-year term expires.

It is best to remove the Mirena coil during your next period. If you stop menstruating while wearing Mirena, or if you want to remove the IUD outside of your period, you will need to start using condoms 7 days before removing the IUD.

If you want to replace the IUD, you do not need to use condoms, and the replacement can be done on any day of the cycle.

When can I get pregnant after Mirena removal?

The Mirena spiral does not affect the functioning of the ovaries, so you can become pregnant in the next cycle after Mirena removal.

Pregnancy is a long-awaited period for many women. However, there are situations when the birth of a child is postponed for a long time. This may be due to various reasons.

To prevent conception and avoid such an unpleasant and ethically controversial procedure as abortion, many representatives of the fairer sex use various means. Most women refuse to take oral medications, citing the fact that they are ineffective and also have a negative impact on their figure and health. Therefore, many of them give their preference to the so-called intrauterine devices.

General information

An intrauterine device is called a contraceptive, which is a small device made of plastic and copper. This device slows down the movement of sperm into the uterus and also significantly reduces the lifespan of the egg.

It should also be noted that the intrauterine device can prevent the attachment of an already fertilized egg to the wall of the uterus. Thus, it represents a kind of abortifacient method of contraception.

Type of spirals

Speaking about intrauterine devices, we cannot help but say that in addition to conventional devices, there are also hormonal devices. What are they? Hormonal devices are unique analogues of conventional intrauterine devices. They have a special plastic cylinder that contains a hormone called levonorgestrel.

According to experts, hormonal IUDs are very reliable. This is due to the fact that in addition to the effect “ foreign body"in the uterus, they have a direct contraceptive effect, which is similar to birth control pills.

How do they work?

Indications

Used in the following cases:

• for reliable contraception;
• with idiopathic menorrhagia;
• for the prevention of endometrial hyperplasia during replacement treatment estrogens.

Contraindications

At chronic infections, availability serious illnesses, malignant neoplasms use must be agreed with a specialist.

Other contraindications to the use of this device include the following:

• pregnancy, as well as suspicions of it;
• hypersensitivity to the ingredients of the product;
• diseases with high susceptibility to infections;
• postpartum endometritis;
• deep vein thrombosis of the legs (including the presence in the past);
• malignant neoplasms in the cervix and uterus;
• previous therapy for breast cancer;
• cervical dysplasia;
• diseases of the pelvic organs (inflammatory);
• urinary tract infections;
• uterine anomalies (acquired or congenital);
• cervicitis;
• abortion (septic) within the last 3 months;
• uterine bleeding of unknown origin;
• acute liver diseases, including tumors.

Directions for use

The product in question is used as follows:

• For contraception for women (in childbearing age) the IUD is installed within a week from the start of menstruation. Moreover, it can be replaced with a new intrauterine device on any day of the cycle. This device can also be installed immediately after an abortion in the first trimester of pregnancy.
• In order to protect the endometrium during estrogen replacement therapy in patients with amenorrhea, the IUD can be inserted at any time. As for women with preserved menstruation, the installation is carried out for them in last days menstrual bleeding.
• After childbirth, the IUD is introduced only after uterine involution occurs, but not earlier than 6 weeks. With prolonged subinvolution, postpartum endometritis should be excluded, and the decision to install the structure should be postponed (until the involution is completed). If insertion is difficult or very severe pain, bleeding before and after the procedure, it is necessary to perform an ultrasound scan to exclude perforation.

"Levonova"

"Levonova" contains 52 mg of levonorgestrel. It's reliable active substance has a direct local effect on the endometrium, reducing its implantation function, as well as on the fallopian tubes and the viscosity of mucus in the cervical canal. Such properties of the device increase the efficiency and duration of use of the IUD without suppressing the ovulation process.

This remedy should be administered on the 4-5th day of the menstrual cycle. If an induced abortion was performed, the IUD is installed immediately or after the next menstruation. For uncomplicated spontaneous childbirth, it is advisable to use a hormonal construct no earlier than six weeks later.

Hormonal IUD: contraindications and side effects

The Levonov spiral is contraindicated for:

• acute and subacute inflammatory processes external and internal genital organs;
• pregnancy;
• metrorrhagia of unknown origin;
• malignant tumors of the body and cervix;
• chronic salpingoopharitis and endometritis;
• congenital anomalies of the body and cervix;
• erosion;
• history of ectopic pregnancy.

The hormonal IUD in question is also not used for uterine fibroids. In addition, it is not installed in nulliparous women.

In the first months of use this remedy may cause intermenstrual bleeding, nausea, disturbances in menstrual cycle, mastalgia, fluid retention in the body, headache and acne.

The design of the Levonov intrauterine device ensures the release of the hormone at a rate of 20 mcg/day. The validity period of this device is 5 years. After removing it reproductive function women recover quickly and well.

This product should not be used during breastfeeding. This is due to the fact that levonorgestrel is able to penetrate into mother's milk. For persistent and prolonged intermenstrual periods bloody discharge additional is required gynecological examination in order to clarify the diagnosis.

Tablets or spiral?

IUD or hormonal pills - which of these contraceptives to choose? It is quite difficult to answer this question, since each of the presented methods has its own advantages and disadvantages. However, most patients choose the first option. This is due to the following points:

• the reliability and efficiency of the spiral is 99%;
• such a device does not require daily monitoring;
• the use of the spiral is long-term (about 5 years);
• After removal of the IUD, fertility is restored very quickly.

Regarding oral medications, then most often they are not used due to possible weight gain and the development of health problems.

More than 80 million women around the world use intrauterine devices (IUDs) as a means of contraception and treatment of uterine diseases. This contraceptive prevents 92-99% of pregnancies and is often recommended for use by healthy women of reproductive age who have given birth.

Spiral - from the sixteenth century to the present day

The prototype of the intrauterine device is silver balls, which were inserted into women in China and Japan back in the sixteenth century. In 1909, the German scientist Richter proposed using another intrauterine insert - silk threads twisted into a ring. In 1958, the first plastic spiral appeared - the Jack Lipps loop. Not a very reliable thing - one in five women with a plastic IUD became pregnant. Reliability has improved since 1968, when the contraceptive effects of copper were discovered. And since 2001, the IUD has been “stuffed” with gestagens - analogues female hormone progesterone. Thus, IUDs began to not only prevent pregnancy, but also treat many hormone-related conditions. women's diseases– fibroids, endometriosis, adenomyosis. Nowadays, gynecologists use more than 50 types of IUDs. We will talk about the most modern, hormone-containing Mirena spiral, which works for 5 years. Why do they install such a spiral?

What does a hormonal IUD look like and work?

The Mirena hormonal coil is made in the shape of the letter T, which allows it to be securely fixed in the body. One of the edges of the spiral is equipped with a thread loop designed for extraction. In the center of the intrauterine device, the tube contains a hormone in the amount of 52 mg, which gradually enters the endometrium of the uterus through the membrane. Store the system at room temperature in a dark place. It must be installed before the end of the 3-year period from the date of issue.

The hormonal IUD prevents pregnancy in several ways:

1. Suppresses the growth of the endometrium - cells of the uterine mucosa in which the fertilized egg is implanted. Irritation of the endometrium leads to the production of prostaglandins, which increase uterine tone. As a result, the embryo cannot implant.
2. Increases the amount of macrophage substances that have a toxic effect on sperm.
3. Strengthens the contractions of the uterus and fallopian tubes, which “drive” the fertilized egg. As a result, the egg prematurely enters the endometrium, which is not prepared to receive it, and is not implanted.
4. Cervical mucus is condensed in the cervix until it becomes viscous. Sperm cannot overcome this barrier in the narrow cervical canal.
5. Partially suppresses ovulation.

The active substance of the system is levonorgestrel, an analogue of progestron. in the first year it is released from the spiral at a rate of 20 mcg per day, then its intensity gradually drops to 10 mcg per day. The Mirena hormonal coil concentrates the substance in the endometrium of the uterus, so that one thousandth of the substance enters the blood plasma. Levonorgestrel is completely broken down and eliminated within 24 hours, without having a destructive effect on the woman’s body.

How to insert the coil

The insertion and removal of the IUD can only be entrusted to a gynecologist on days 1-2 of the cycle. The abundance of menstrual discharge will not allow injury to the cervix. Before inserting the spiral, the doctor must:

• Gynecological examination
• Mammography (it is important to exclude oncological diseases chest)
  Colposcopy - examination of the vagina and cervix with a colposcope (this is a binocular device with lighting)
• Ultrasound of the pelvic organs
• Take smears from the vagina and cervical canal, which is especially important for oncocytology.

Place the spiral under aseptic conditions. How do you know if it is being administered correctly? The doctor must first clean the cervix disinfectant solution, then measure its depth, insert the IUD, trim the antennae from the spiral and disinfect the cervix again. After installation of the system, a maintenance course of antibiotics is prescribed so that the coil takes root well in the body. After 3-5 days, an examination and ultrasound are scheduled, the hormone begins to act, and you can begin sexual activity.

The IUD can come out of the uterus randomly. Repeated examinations should be carried out every six months, and during each menstruation, check to see if the IUD has come out (this happens rarely, but vigilance will not harm anyone).

Pros and cons of Mirena

Pros:

• Efficient and long-term contraception- about 98% within 5 years
• Spiral renders local action without affecting other organs, unlike oral contraception
• After removing the IUD, 80% of women regain their ability to conceive within 1-2 menstrual cycles
• Fast insertion procedure
• Affordable price compared to OK, spread over 5 years of use
• Prevents cancer and growth of the endometrium (endometriosis)
• Restores the condition of the endometrium during menopause, when removing the ovaries
• Increases hemoglobin levels in the blood
• Normalizes iron metabolism
• Reduces pain during menstruation
• Stops the growth of fibroids. True, not everyone. There are fibroids that do not allow the installation of an intrauterine device. Such important aspects women's health Only a good gynecologist can take into account.

Cons:

• Not everyone can afford a one-time expenditure of 150-250 euros. The Mirena uterine device is manufactured by the German concern Schering from high-quality materials using precision equipment. This high-tech medical product does not come cheap. Beware suspicious advantageous offers on the Internet.
• There is a risk of developing menorrhagia ( heavy menstruation with blood loss above normal 150 ml)
• In women who frequently change partners (for example, in sex work), the risk of inflammatory processes increases
• An incorrectly installed IUD causes pain and bleeding.
• The first few months after insertion of the IUD, your periods are heavier.
• An IUD does not protect against STDs, unlike a condom.
• There are cases of expulsion (loss) of the spiral
• Hormone-containing IUDs stimulate breast tumors that have already arisen but have not yet been identified.

An important question for women is: does the spiral affect weight? Yes, in the first year after Mirena installation, every tenth patient experiences weight gain. Then body weight normalizes.

Who is suitable for the Mirena spiral?

Indications for use:

• Breastfeeding women who need contraception
• Healthy women who have given birth and require long-term contraception
• For those for whom OCs are contraindicated
• Women with high tolerance to gestagenic drugs
• Suffering from heavy, painful periods
• Women who need prevention of fibroids, endometriosis, endometrial hyperplasia. IUD hormones have a therapeutic effect in this case.

Who should not have an IUD inserted?

Unfortunately, this convenient view There are many contraindications to contraception, absolute and those that can be neutralized or minimized.

Absolute contraindications:

• Pregnancy – established or suspected
• Miscarriage within the last three months before installation of the system
• Experienced ectopic pregnancy
• Inflammatory, infectious processes in the pelvis
• Uterine bleeding of unknown etiology
• Malignant tumors of the mammary glands, uterus and genitals
• Pathological features and deformations of the uterus: cervical stenosis, ectopia, cervicitis, dysplasia, bicornuate uterus, fibromatosis
• Young age (under 18 years old)
• Some age-related changes endometrium
• Endometritis after childbirth
• Tuberculosis of female organs.

Contraindications that need to be discussed with your doctor:

• Postpartum period from several days to 4 weeks
• Thrombosis, thromboembolism pulmonary artery, trophoblastic disease
• Breast cancer in the past 5 years
• High risk of inflammatory and infectious diseases: frequent change sexual partners, STDs, HIV
• Serious liver diseases (hepatitis, cirrhosis, pyelonephritis and others)
• Hypersensitivity to IUD components
• Heart attacks, strokes and others acute diseases cardiovascular system
• Arterial hypertension
• Diabetes mellitus
• Severe migraines of unknown etiology.

Side effects and complications

Common side effects The use of IUDs are those that appear in every tenth - every hundredth patient:

• Cycle changes. In 20% of women the number increases menstrual days, in 60-70% menstruation becomes more abundant. After 3-6 months, the cycle returns to normal. After about a year, amenorrhea may appear - absence of menstruation (in 15%). Rare and light bleeding noted in 60% of patients
• Disorders nervous system: headache, depressive states, short temper, nervousness, lack or decreased libido
• Weight gain
• The appearance of rashes, acne, comedones, urticaria, less often - furunculosis
• Digestive dysfunction: diarrhea, nausea, abdominal pain, vomiting
• Spotting scanty discharge, pelvic pain
• Inflammation of the vulva, vaginal mucosa (vulvovaginitis)
• Breast engorgement and pain
• Back pain
• Increased blood pressure
• The occurrence of functional ovarian cysts (in 12%). This painful attack goes away in the first year after the installation of the IUD. Virtually no surgical intervention is required.

Frequent side effects usually appear clearly in the first three to four months after insertion of the IUD, then the intensity decreases or disappears.

Side effects include expulsion of the IUD (expulsion of the IUD from the uterus). Gynecologists advise feeling the threads in the vagina after every period. If they are in place, everything is fine.

Rare side effects(in every hundredth - every thousandth patient).

• Quincke's edema
• Growth or loss of body hair – hirsutism ( increased hairiness), alopecia (baldness)
• Frequent mood swings (emotional lability)
• Bloating
• Edema of the extremities
• Eczema
• Perforation of the uterus (perforation)
• Penetration of the uterus (ingrowth of the spiral into the wall)
• Ectopic pregnancy.

Are pregnancy and Mirena compatible?

No contraception is 100% effective. If you are among the 1% of “lucky” women on whom the IUD did not work, you must first exclude ectopic pregnancy. At normal pregnancy the spiral can be removed if the threads are preserved. If there are no threads, the coil is often left in place until delivery. The doctor informs the woman about the risks and consequences, after which a decision is made to save the fetus. In the future, such a pregnancy must be carefully monitored. There are few observations of fetal development with IUD, because There are few such pregnancies themselves. Theoretically possible negative consequences for the fetus if it is a girl. Such consequences are called “virilization” - the manifestation of male sexual characteristics in women (hair growth according to male type, male skeleton, acne, clitoral hypertrophy, urogenital sinus, atrophy of the labia minora, etc.).

And about the compatibility of lactation and IUD. Levonorgestrel – active substance Mirena - enters the bloodstream in small quantities and can pass into the baby's milk. However, the concentration is so low that doctors rule out harm to the child.

Women's opinions about the Mirena IUD are strikingly varied. One writes: “No libido, no sex, no husband, but there is beastly appetite and weight gain,” another rejoices: “How much the spiral costs, that’s how much I feel like a human being. There are no heavy periods and no fear of pregnancy.” Do you need the Mirena IUD or not? This choice belongs to you and partly to your doctor after jointly calculating the possible consequences.

And finally, last question– Is there really only one hormonal IUD on the market? Are there any analogues? The Mirena IUD, produced by the German concern Schering, has a Finnish competitor, Levonova (manufactured by the Leiras concern). It has the same principle of action, the same main substance - levonorgestrel.

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