How does the anti-pregnancy device work? What is an intrauterine device and how does it work. Possible reaction of the body to the establishment of a spiral

Intrauterine contraception- This is a fairly affordable method of contraception, which is popular among women who have already given birth and do not plan to have children in the near future. This method has its advantages and disadvantages. How it works contraceptive device(Navy), where to get it, how to insert it and who should do it?

The IUD is installed exclusively by a doctor. This is usually done on days 5-6 of the menstrual cycle, when the internal os is slightly open. Thus, the contraceptive device can be installed without its preliminary mechanical expansion, which is quite painful.
Sometimes IUDs are placed outside of menstruation. For example, if a woman had unprotected sexual intercourse less than 5 days ago. In this case, it plays the role of emergency contraception. Even if fertilization of the egg has occurred, it will not be able to attach to the wall of the uterus; the IUD will prevent this.

But not everything is as good as it seems; the contraceptive device also has pros and cons due to the fact that sometimes it provokes the onset of an ectopic pregnancy. After all, an egg that could not implant in the uterus can return back to the fallopian tube and begin to develop there...

The Mirena contraceptive device is safer in this regard, since it not only mechanically prevents the development of an egg in the uterus, but also prevents ovulation from occurring directly. That is, the risk of ectopic pregnancy is reduced to zero.

After reading reviews about the contraceptive device, you can draw conclusions about its advantages and disadvantages. Decide if it's worth using. Let's start with the advantages.

1. Long term use and convenience. A contraceptive intrauterine device is usually installed for a period of 5 years. And it works all this time. It is recommended that a woman only periodically check the length of the thread coming from the IUD in her vagina. Visit a gynecologist once a year. And if necessary, undergo an ultrasound of the uterus. But if the need for contraception disappears earlier than after 5 years, then the IUD can be removed without any problems. This is again done by a gynecologist. Contraceptive effect the spiral immediately stops.

2. High reliability. More than 90%. If the IUD is positioned correctly in the uterus and does not move, the effectiveness of contraception approaches 100%.

3. Affordable price. This contraceptive costs from 300 rubles on average. And this is for 5 years! The price of contraceptive IUDs largely depends on the coating. If it is copper, silver, gold, then the IUD will be more expensive. The most expensive in terms of cost is the Mirena spiral. It costs about 10,000 rubles.

And these are disadvantages.

1. Intermenstrual bleeding. Gain menstrual bleeding. This negative impact a regular, non-hormonal IUD has on the endometrium. However, the principle of action of the Mirena contraceptive spiral, which is hormonal, is precisely to reduce blood loss.
If women with heavy menstruation should get an IUD, it should be a Mirena.

2. Ectopic pregnancy. The same. With Mirena installed, this risk is practically zero. But with a regular IUD, there is a possibility of both ectopic and intrauterine pregnancy.

3. Risk of occurrence inflammatory diseases. Unfortunately, the IUD is a kind of conductor for infections from the vagina to the uterus. That is why, before inserting the IUD, a woman must undergo a series of smears for infections. They must be treated.
If the infection penetrates the uterus, it provokes inflammation there - endometritis. And subsequently, all this can lead to the formation of adhesions in the tubes, which again is the root cause of ectopic pregnancy.

When deciding which is better - the IUD or birth control pills, read not only reviews on the Internet, but also listen to the opinion of your gynecologist. Tell him about how long you plan to use contraception, whether you will have more children, about your chronic diseases, and he will definitely suggest the most suitable contraceptive option for you.

09.05.2019 18:35:00 Flat stomach: these 9 foods you can't eat! A flat stomach in your favorite jeans or a swimsuit - can you only dream about it? Then you should do without the following 9 products.
08.05.2019 20:31:00 Do you want to increase your muscles? Avoid these products! If you want to build muscle, you must not only go full throttle in your workouts, but also pay attention to your diet. To achieve maximum success, you should cross out the following foods.
08.05.2019 20:16:00 25 short tips for losing weight Many people want to lose weight, but not everyone wants to go into details of how the body works and look for best way weight loss. It is for them that we have prepared 25 short but effective tips!

Intrauterine devices are contraceptives, a means of controlling the onset of pregnancy. Their efficiency is very high: when correct use they protect Birth Control Methods: How Well Do They Work? from pregnancy by 99%. They are even used after unprotected sexual intercourse.

Externally, most of the spirals that are now used resemble the letter T with different tails. But there are intrauterine implants of other forms.

Spirals are divided into two large types:

healthinfi.com

The principle of operation is this: copper supports aseptic inflammation in the uterus. Aseptic means that it does not happen due to microbes and does not threaten anything. But the action of copper changes the composition of cervical mucus, making it more difficult for sperm to penetrate the uterine cavity. In addition, copper prevents attachment to the uterine wall. Intrauterine device (IUD).

healthtalk.org

These are plastic spirals that contain progesterone, an analogue of the human hormone that prevents pregnancy. They also interfere with sperm and egg implantation, and at the same time also suppress ovulation in some women Intrauterine system (IUS).

How long does an intrauterine device work?

Spirals from different manufacturers and with different composition established for a period of three to ten years.

Costs intrauterine device quite a lot: from several thousand rubles (including the installation procedure). However, it quickly pays off and is one of the most available methods contraception for women who have regular sex life.

How to install a spiral

Only a doctor can install any type of spiral, and the same can remove it. Therefore, you cannot do without consulting a specialist who will help you choose a product (with copper or hormones) and decide on the installation.

Usually this simple procedure, but an extremely rare complication is uterine perforation INTRAUTERINE DEVICES. Sometimes the spiral may fall out. Therefore, in the first three months you need to regularly visit the gynecologist; the doctor himself will prescribe a schedule.

fancy.tapis.gmail.com/Depositphotos.com

After installation, the spiral is not felt, only two short antennae are released from the cervical canal (from the cervix). These are threads Intrauterine device (IUD), which help ensure that the spiral is in place. Subsequently, they will help the gynecologist remove the IUD.

These same mustaches do not interfere in everyday life, including during sex.

Sometimes after installation a woman may feel discomfort and discomfort, but they pass quite quickly. The procedure itself is not very pleasant, but not much worse than a regular examination by a gynecologist.

What are the advantages of an intrauterine device?

The main advantage is the reliability of contraception. Nothing here depends on the woman, her partner or the masses. external factors. Condoms, you can forget about the pill, but the spiral stays in place and doesn’t go anywhere.

In addition, the IUD can be used by breastfeeding women who cannot afford, for example, hormonal contraceptives.

In most cases, women do not notice the spiral at all.

Contrary to popular belief, the IUD can be installed in women who have never given birth before (but it is better to use the IUD after 20 years, when the internal organs are fully formed). IUDs have a reversible effect, and you can get pregnant literally in the first month after removing the IUD.

In addition, IUDs do not increase the risk of cancer and can be combined with any medications. Your contraception guide.

When should you not insert an intrauterine device?

There are not many contraindications Birth Control and the IUD (Intrauterine Device):

Pregnancy. If you want to use the IUD as emergency contraception, you need to hurry.
Infectious diseases of the pelvic organs (including sexually transmitted diseases or those associated with complications after termination of pregnancy). That is, we first treat infections, then introduce the IUD.
Oncological diseases of the uterus or cervix.
of unknown origin.
For a spiral with hormones, there are additional restrictions, as for taking it.

What side effects may there be

Apart from complications when installing the IUD, the most common side effect is changes in the menstrual cycle. As a rule, periods become heavier and last longer. This is especially noticeable in the first months after the installation of the spirals.

Sometimes bleeding becomes too heavy and long, bleeding appears between cycles - in any case, this should be discussed with your doctor. Sometimes you have to abandon this method of contraception.

IUDs do not protect against infections, and in some cases increase the risk of ascending genital tract infection. Therefore, with a new partner you need to use additional methods contraception.

What happens if you get pregnant while on the IUD?

Although the IUD is one of the most reliable methods, pregnancy is rarely possible. If a woman decides to keep the child, they try to remove the spiral early so as not to damage amniotic sac and not to provoke.

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

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

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

Advantages intrauterine contraception:

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

Types of intrauterine devices

There are two types of intrauterine contraception:

inert;
medicinal.

Inert intrauterine contraceptives (IUDs) are plastic products of various shapes that are inserted into the uterine cavity. Their use has been discouraged since 1989, when World organization health authorities declared their ineffectiveness and danger to women's health.

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

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

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

Less commonly used are IUDs that release medroxyprogesterone or norethisterone.

Which intrauterine device is better?

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

Mechanism of action

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

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

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

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

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

How to place an intrauterine device

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

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

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

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

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

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

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

Removing the intrauterine device

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

Complications of intrauterine contraception

Side effects from the intrauterine device:

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

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

Pain in the lower abdomen

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

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

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

Genital infection

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

Uterine bleeding

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

Onset of pregnancy

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

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

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

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

Indications for use

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

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

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

IUDs are most often used in the following situations:

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

Contraindications to the intrauterine device

Absolute contraindications:

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

Relative contraindications:

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

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

Every woman has a moment when she thinks about becoming a mother. But for many girls, sexual activity begins earlier than they are ready for motherhood, and for family life in general. Especially modern women planning for a child is postponed until one fully realizes oneself in other areas of life.

Well, if a woman has already become a mother, and maybe more than once, then there are very few people 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 avoid becoming pregnant without desire. In order to deceive nature, they came up with simple methods of contraception (from the Latin word contraceptio - exception). We started with various essential oils, fruit juices, tampons, lotions, interrupted contact, fabric bags (the predecessor of a condom), and so on.

As you can see, the spiral affects all processes necessary for conception:

vital activity and speed of sperm movement;
egg maturation and ovulation;
attachment of the fertilized egg to the endometrium.

Pros and cons of using intrauterine devices

Benefits of the IUD	Disadvantages of the IUD
Convenient to use, the spiral is installed for a period of 3 to 10 years or more. No daily procedures required, special hygiene care and taking 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 IUD does not take root.
High effective method: pregnancy occurs in only 2 out of 100 cases. More low efficiency provide inert IUDs, and when using hormonal intrauterine systems, the risk of becoming pregnant is reduced to zero.	Still 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% results can only be achieved by removing the appendages or tying the fallopian tubes and completely abstaining from sexual activity.
Preservation of reproductive function immediately after removal of the IUD.	No use hormonal IUDs recommend abstinence for young and nulliparous women, since they may develop as a side effect inflammatory changes in the endometrium of the uterus and appendages, reducing the chances of becoming pregnant in the future.
Does not affect the quality of sexual life, that is, on sexual desire, sexual intercourse for both partners and achieving orgasm.	An IUD can cause painful and heavy periods. While hormonal IUDs, on the contrary, solve the problems of painful periods. But progestogen IUDs can lead to 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 considering long period use, this method will be much more economical than those products that require use 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, and the spiral does not protect against sexually transmitted diseases.
Additionally for hormonal intrauterine systems: can be used for women of any age; are used not only for contraception, but also in the treatment of certain gynecological diseases (fibroids, endometriosis, painful menstruation, uterine bleeding, etc.).	Increases the risk of developing an ectopic pregnancy. The use of hormonal IUDs significantly reduces the risk of pathological pregnancy.
	The procedure for inserting an IUD requires a visit to a gynecologist, brings discomfort and painful sensations , in nulliparous women pain syndrome particularly pronounced, sometimes requiring local anesthesia.

Indications for installation of an intrauterine device

1. Temporary or constant prevention 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 whose risk of contracting sexually transmitted diseases is very low.
2. Frequent unwanted pregnancies, ineffectiveness or carelessness of women in using other contraceptives.
3. Prevention of pregnancy after childbirth, especially cesarean section, after medical abortion or spontaneous miscarriage, when the onset of another pregnancy is temporarily not desirable.
4. The woman has temporary or permanent contraindications to pregnancy.
5. The presence in the family history of genetic pathologies that the woman does not want to pass on by inheritance (hemophilia, cystic fibrosis, Down syndrome and many others),
6. For hormonal intrauterine devices – some gynecological pathologies:

uterine fibroids, especially if it is accompanied by heavy spotting and uterine bleeding;
heavy, painful periods;
replacement therapy estrogens at the beginning of menopause or after removal of the appendages, in order to prevent the growth of the endometrium.

Contraindications

Absolute contraindications to the use of all intrauterine devices

Presence of pregnancy at any stage, suspicion of possible pregnancy;
oncological pathologies of the genital organs, as well as breast cancer;
acute and chronic inflammatory diseases of the female genital organs: adnexitis, colpitis, endometritis, including postpartum, salpingitis and so on, including the presence of sexually transmitted diseases;
a history of ectopic pregnancies;
allergic reactions to the materials from which the spiral is made;
tuberculosis of the reproductive system;

Relative contraindications to the use of non-hormonal IUDs

if the woman does not have children yet;
a woman is promiscuous and is at risk for contracting sexually transmitted diseases;
childhood and adolescence*;
woman's age over 65 years;
uterine bleeding and heavy painful periods;
abnormalities of the uterus (for example, bicornuate uterus);
hematological diseases (anemia, leukemia, thrombocytopenia and others);
endometrial growths, endometriosis;
urethritis, cystitis, pyelonephritis - acute or exacerbation of a chronic course;
benign tumors of the uterus and appendages ( submucosal fibroid and uterine fibroids);
loss of the intrauterine device or the development of side effects after previous use of the device.

* Age restrictions are conditional, gynecologists usually do not offer young nulliparous women the use of intrauterine contraceptives, for fear of harm. But, in principle, the spiral can be successfully installed in any childbearing age, followed by successful pregnancy.

Relative contraindications to the use of hormonal intrauterine devices (systems):

cervical dysplasia;
abnormalities of the uterus;
urethritis, cystitis, pyelonephritis - acute or exacerbation of a chronic course;
uterine fibroids;
liver diseases, liver failure;
heavy cardiovascular pathologies: malignant arterial hypertension, condition after a stroke or heart attack, severe heart defects;
migraine;
decompensated (uncontrolled) diabetes mellitus;
thrombophlebitis of the lower extremities;
woman's age over 65 years.

When can I get an IUD after childbirth, cesarean section, or abortion?

An intrauterine device can be placed already on the 3rd day after an uncomplicated physiological birth. But usually gynecologists recommend waiting until the end of lochia discharge (on average 1-2 months). It will be safer that way. After childbirth, the uterus recovers, so early insertion of the IUD increases the risk of side effects and early rejection of the device. To start using the hormonal intrauterine system, you need to wait 2 months after the baby is born; this is necessary not only for full recovery uterus, but also normalization of hormonal levels.

After a cesarean section, the IUD can be installed in the uterine cavity only after 3-6 months. It takes time for a postoperative scar to form.

After a medical termination of pregnancy (up to 12 weeks), it is better to install an IUD within seven days after the start of the next period after the abortion. But a gynecologist may suggest installing an IUD immediately after an 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 complications of the abortion itself increases significantly. After a miscarriage, the decision on the feasibility and safety of installing an IUD is made only by a doctor; he assesses the situation individually, analyzes the cause of spontaneous abortion, and weighs the pros and cons. If it is necessary to use a device after a miscarriage, it is installed in the uterine cavity during the next menstruation.

Is an intrauterine device installed after the age of 40?

The IUD can be used for any woman who is ovulating, has maintained her menstrual cycle, and is likely to become pregnant. Hormonal intrauterine systems are also installed in the period after menopause to obtain a therapeutic effect. Therefore, 40 years is not a limitation for using an IUD. According to the instructions, IUDs are not recommended for women over 65 years of age, but this limitation appeared only due to insufficient study of the use of intrauterine devices in older age.

How is an intrauterine device installed?

The intrauterine device is installed only by a gynecologist in a gynecological office. Before inserting an IUD, the doctor assesses the possibility and risk of developing side effects from 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 must undergo an examination to completely exclude possible pregnancy and contraindications.

Recommended examination before inserting an intrauterine device:

gynecological examination and palpation (palpation) of the mammary glands;
vaginal smear, if necessary, culture for microflora;
cytological examination of smears from the cervix;
Ultrasound of the pelvic organs;
in some cases, a pregnancy test or blood test to determine hCG levels;
Ultrasound of the mammary glands (for women under 40 years of age) or mammography (after 40 years of age).

Preparing for installation

Usually special training no spiral is required for insertion. If inflammatory diseases are detected, you will first need to undergo a course of appropriate therapy.

Immediately before the procedure, you must empty your bladder.

On what day of menstruation is it better to install an intrauterine device?

Intrauterine contraceptives are usually installed during menstruation or towards its end, that is, within 7 days from the start of menstruation. Optimal time is the 3-4th day. This is necessary in order not to miss the onset of pregnancy.

An intrauterine device can be installed as emergency contraception, that is, if a woman has had unprotected sexual intercourse and expects an unwanted pregnancy. In this case, the device is inserted in the period after ovulation, this can prevent the attachment of the fertilized egg in 75% of cases.

Technique for inserting an intrauterine device

Any spiral packed in vacuum packaging is sterile. You need to check the expiration date. The coil must be opened immediately before installation, otherwise it loses its sterility and can no longer be used. The IUD is a single-use device; its reuse is strictly prohibited.

In most cases, local anesthesia is not required. Anesthetics in the cervical area can be used in nulliparous women and when installing hormonal intrauterine systems, since they are wider.

The insertion technique for different types of spirals may differ. The installation features of each spiral are described in detail in the device instructions.
1. A gynecological speculum is inserted into the vagina, with the help of which the cervix is fixed.
2. The cervix is treated with disinfectants.
3. Using special forceps, the cervical canal (the canal in the cervix that connects the vagina to the uterus) is straightened, and the cervix is opened.
4. A special probe is inserted into the uterine cavity through the cervical canal to accurately measure the length of the uterus.
5. If necessary, the cervix is anesthetized (for example, lidocaine or novocaine). The insertion of the spiral itself begins after 4-5 minutes, when the anesthetic takes effect.
6. The spiral is inserted using a special guide with a piston. A ring is placed 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 slightly pulls the piston towards himself so that the shoulders of the spiral open. After this, the spiral is moved directly to the wall of the uterine fundus. When the gynecologist is sure that the device is installed correctly, the guidewire is slowly and carefully pulled out. When installing some spirals (for example, ring-shaped), the opening of the shoulders is not required, so the spiral is inserted to the wall of the uterine fundus, and then the guide is simply pulled out.
7. The spiral threads are cut into the vagina at a distance of 2-3 cm from the cervix.
8. The procedure is completed, it usually takes 5-10 minutes.

Is inserting an intrauterine device painful?

The procedure itself, of course, is unpleasant and brings some discomfort. But the pain felt is tolerable, it all depends on pain threshold women. These sensations can be compared to painful menstruation. Abortion and childbirth are more painful.

After installation of the intrauterine device

Ultrasound photo: Intrauterine device in the uterine cavity.

The uterus completely gets used to the IUD within several months, so during this period some changes in women’s health may be observed; you need to listen to your body.
In some cases a course will be required antibacterial therapy after insertion of the spiral, for example, if chlamydia is suspected, or if there is another chronic infection of the genitourinary system.
Bloody spotting and nagging pain in the lower abdomen or back may bother you for 1 week after insertion of the IUD. To relieve spasms, you can take No-shpa.
The hygiene regime is normal; you need to wash yourself with intimate hygiene products twice a day.
You can have sex only 8-10 days after the installation of the intrauterine device.
For several months, you should not lift weights, engage in intense physical activity, or overheat (sauna, bathhouse, hot baths).
It is necessary to periodically probe the spiral threads, control their length, it should not change.
After 2 weeks, it is better to visit a gynecologist to see if everything is normal.
Menstruation in the first months after installation of the IUD may be painful and heavy. Over time, menstruation normalizes.
When using hormonal intrauterine systems, after six months or several years, menstruation may disappear (amenorrhea). After the first loss of a cycle, it is necessary to exclude pregnancy. The menstrual cycle will be restored immediately after the IUD is removed.
If you have any complaints, you should consult a doctor.
In the future, 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 installed correctly or if it does not take root, the intrauterine device may fall out. We need to keep an eye on this. Most often, IUD loss occurs during menstruation or after heavy physical activity. Therefore, it is important to check whether the spiral threads are in place and inspect sanitary pads.

How long does it take to use an intrauterine device?

The period for which intrauterine contraception is installed differs depending on the type of device.

Inert IUDs are 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.

The issue of premature removal of the IUD is decided by the gynecologist.

It is not recommended to use an IUD after the expiration date due to the risk of the IUD growing into the uterine tissue. Hormonal IUDs lose their properties due to depletion of reserves hormonal drug. This reduces the effectiveness of the intrauterine device, which can lead to unplanned pregnancy.

Intrauterine devices (copper, hormonal): installation, operating principle, effectiveness (Pearl index), shelf life. How to check if the spiral is in place - video

Removal and replacement of the intrauterine device

Indications for IUD removal:

the period of use has expired, and it is possible to replace the intrauterine device;
a woman is planning a pregnancy;
there were side effects from the use of an intrauterine device.

The removal procedure, as well as the insertion of an intrauterine device, can only be performed by a gynecologist in a gynecological office. Perfect time to remove the IUD - the first days of menstruation, during this period the cervix is soft, which facilitates manipulation. In principle, the IUD can be removed at any time during the menstrual cycle.

Removal of the IUD often does not require pain relief; local anesthesia will be required when removing or replacing hormonal IUDs. The doctor fixes the cervix with a gynecological speculum, and then using special tool(forceps) grabs the threads of the spiral and carefully pulls out the device, while gently stretching the cervix.

Usually this procedure goes without difficulty, the woman experiences less pain than when inserting a spiral. But there are situations when the spiral cannot be pulled out so easily, then the doctor widens the cervical canal and makes it easier to remove the IUD. You may also encounter the problem of broken threads, then the doctor inserts a special hook through the cervix, with the help of which the foreign body is removed from the uterine cavity.

But there are situations when the doctor simply does not detect the spiral threads. The question arises: is there a spiral in the uterus at all? If so, where is she? To do this, the woman is offered an ultrasound of the pelvic organs, and, if necessary, radiography. Sometimes there are cases when the spiral is located outside the uterine cavity (due to perforation of its wall), then laparoscopic surgery is urgently needed to remove the foreign body.

Replacing the spiral intrauterine contraception can be performed immediately after removal of the old IUD; 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;
It is better to carry out the procedure during menstruation;
removing the IUD during or before ovulation increases the risk of pregnancy;
before replacing the IUD, it is necessary to use other methods of contraception (condom, oral contraceptives or spermicides) 7 days in advance to prevent an unwanted pregnancy.

Possible side effects

The intrauterine device is a modern, convenient and effective method of contraception. But this 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 experience intolerance this method and the development of side effects, some of which can have a very negative impact on health and lead to severe pathologies. Reducing the risk of developing these side effects will help by choosing the type of IUD that is suitable for this woman, a detailed assessment of contraindications for its insertion, 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

"Nulliparous cervix";
irritation of the autonomic nervous system;
increased emotionality of a woman;
The size of the intrauterine device does not correspond to the size of the uterus.

Side effect	Reasons for development	How often does it occur?	Treatment of adverse reactions
Pain in the lower abdomen immediately after insertion of the IUD	Often.	Anesthesia local anesthetics cervix; correct selection of spiral sizes.
Loss of the IUD from the uterine cavity or expulsion	Violation of IUD installation technique; incorrect selection of spiral size; Features of a woman - foreign body immunity.	Often.	Adhere to all rules of technique for inserting and selecting the size of the IUD; After expulsion, it is possible to replace the spiral with another one.
Painful and heavy periods	the first months after insertion of an IUD with copper are a normal reaction; non-infectious inflammation as a reaction to a foreign body; allergic reaction to copper; inflammation of the ovaries - adnexitis.	Up to 15%.	Removing the IUD and replacing the IUD with another type of contraception; replacing the copper IUD with a hormonal intrauterine system, in which heavy menstruation does not arise; prescribing antispasmodics (for example, No-shpa) and non-steroidal anti-inflammatory drugs (ibuprofen, indomethacin, nimesulide, etc.) or antibiotics.
Inflammation of the genital organs (colpitis, endometritis, salpingitis, adnexitis): unusual discharge from the vagina, often with an unpleasant odor; itching and burning in the vaginal area; possible spotting in the middle of the menstrual cycle; nagging pain lower abdomen and lumbar region; menstrual irregularities; increased body temperature and general malaise.	The spiral was installed for chronic inflammatory diseases of the genitourinary system; the IUD does not protect against sexually transmitted diseases, but increases the risk of the spread of sexually transmitted diseases from the vagina to the uterus and appendages; non-infectious inflammation that develops as a reaction to a foreign body increases the risk infectious inflammation caused by bacteria and fungi normally contained in bacterial microflora vagina.	Up to 1% of cases	Removing the spiral; prescription of anti-inflammatory and antibacterial therapy, according to the results of laboratory diagnostics.
Severe uterine bleeding	Damage (perforation) of the walls of the uterus by the IUD during its installation or operation; presence of uterine fibroids.	Very rarely	Removing the spiral urgently; emergency medical care.
Anemia: pale skin; changes in blood tests; weakness.	Uterine bleeding; long and heavy periods for more than 6 cycles.	Very rarely.	Individually, it is possible to remove the IUD or replace it with a hormonal IUD; iron supplements (Aktiferrin, Totema and others), vitamins and nutritional correction.
Development of fibroids	Damage to the endometrium during insertion or use of the IUD;	Rarely.	Removal of the IUD or replacement with a hormonal IUD; taking hormonal contraceptives.
Risk of ectopic pregnancy	The inflammatory process, which can be facilitated by the IUD, in some cases leads to obstruction of the fallopian tubes; one of the effects of the spiral is contraction and spasm of the smooth muscles of the fallopian tubes, which can cause a pathological pregnancy.	1:1000	Surgical treatment, removal of the fallopian tube.
Pain during intercourse, difficulty achieving orgasm.	Inflammatory process in the genitourinary system; incorrect position and/or size of the device in the uterus; allergic reaction to the components of the spiral; damage to the walls of the uterus; ovarian cysts.	Up to 2%.	Removal of the IUD or replacement with a hormonal IUD.
Onset of pregnancy	The intrauterine device is not a 100% effective method.	From 2 to 15%.	Individual approach.
Perforation (puncture) of the uterine walls: sharp pain in the lower abdomen; uterine bleeding; deterioration general condition, up to loss of consciousness.	Damage to the walls of the uterus during insertion, operation and removal of the device. *Increase the risk of uterine perforation:* early postpartum period; scar on the uterus after cesarean section; abnormalities of the uterus;	Very rarely.	Surgical treatment and emergency medical care.
Ingrowth of the spiral into the wall of the uterus	inflammatory process in the endometrium; using the spiral for more than the recommended period.	Up to 1%.	Removal of the spiral through the cervix using special instruments. Sometimes laparoscopic surgery may be required.
Copper intolerance or Wilson's disease	individual intolerance or allergy to copper.	Extremely rare.	Replacing with another type of contraception or hormonal intrauterine device.

Additional side effects from the use of a hormonal intrauterine system (related to the hormone progestogen):

absence of menstruation (amenorrhea); after removal of the IUD, the menstrual cycle is restored;
functional ovarian cysts ( benign formations), will be required hormone therapy estrogen hormones;

Intrauterine device (IUD): composition, action, indications, possible negative consequences of use - video

Intrauterine device (IUD): mechanism of action, dangerous complications (therapist's opinion) - video

How can pregnancy proceed with an intrauterine device?

Basic principles of managing pregnancy with the IUD:

1. Difficulties arise with diagnosing pregnancy; the woman is confident in her contraception. And menstrual irregularities with an IUD are not uncommon; this 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 consult a doctor at the slightest deviations, changes or hints of pregnancy.
2. If a woman wishes, a medical abortion can be performed.
3. The IUD is not an indication for medical termination of pregnancy. The choice is up to the woman, because in most cases, pregnancy with the IUD proceeds normally and without complications. But still the doctor must evaluate possible risks pregnancy and may recommend terminating it.
4. The IUD can be removed during pregnancy. The copper coil is often not removed as it does not affect the development of the fetus. The hormonal IUD will release hormones throughout pregnancy that can lead to fetal developmental abnormalities. The gynecologist can remove the IUD 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 fetal ultrasound is necessary.

Possible risks of pregnancy with an intrauterine device:

High risk of ectopic pregnancy; ultrasound monitoring is required.
Such a pregnancy can end in miscarriage at an early stage, which is associated with the effect of the coil on the endometrium, to which the fertilized egg is attached.
The IUD can cause intrauterine infection of the fetus, as well as intrauterine growth retardation and pregnancy loss.
High risk of fetal malformations during pregnancy with hormonal IUD.

How to choose a good intrauterine device? Which spiral is better?

intrauterine contraceptive device

“Which IUD should I choose, copper or hormonal?” Here a woman needs to choose between efficiency and possible adverse reactions. The hormonal spiral has more possible side effects associated with gestagen, but they are temporary and stop after a few months. And the contraceptive effect of using such a device is much higher. If a woman has fibroids, then the hormonal IUD is a method of not only contraception, but also treatment. A copper IUD with silver and, especially, gold has higher efficiency than a conventional copper device, and the risk of side effects is lower; this is a kind of middle ground between a hormonal and a copper IUD.

“How much does an intrauterine device cost?” For many women, the issue of cost-effectiveness is of great importance and determines the choice of a spiral. Copper IUDs are much cheaper than hormonal systems. Also, spirals with silver and gold have a high cost.

“Which coil is used the longest?” Spirals with silver and gold can be used the longest, up to 7-10 years or more. Hormonal IUDs are usually used for no more than 5 years.

"Which spiral will not affect next pregnancies?" Any IUD can lead to problems with future pregnancies, including ectopic pregnancy and infertility due to inflammatory process. The risk of developing an ectopic pregnancy during IUD use is higher with hormonal IUDs due to the action of progestogen. Copper IUDs pose a greater risk of complications such as inflammation of the uterus and appendages. When an IUD is removed, ectopic pregnancy often occurs after the use of copper IUDs.

“Which coil is painless?” During installation and removal of the coil, the woman experiences some pain. But this should not fundamentally affect the choice of an IUD. When the hormonal system is introduced, 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.

Review of various modern intrauterine devices: Juno, Mirena, Goldlily, Multiload, Vector extra, spirals with gold and silver

Name

Description

Validity period

Often from conversations between friends or in queues antenatal clinic you can hear stories about intrauterine devices, various reviews of them and impressions about this contraceptive. But what is it and what does it do? Will this affect a woman’s hormonal background, her ability to someday become a mother and, of course, will she be able to protect her from certain diseases? Is this method reliable for preventing unwanted pregnancy and are there any differences between them?

Let's try to understand these issues, consider 6 popular intrauterine devices and find out what the differences between them are. Which spiral to choose?

What is an IUD (intrauterine device)?

- this is one of the effective means contraception, which is often used by women who have given birth, who most often have a permanent partner and are not ready for at the moment back to motherhood.

Like any other type of contraception, spirals vary in their composition, type, period of use and other parameters.

Classification

There are 2 groups of spirals:

hormonal;
non-hormonal.

Both perform the same task - protection from unwanted pregnancy. But some of them have additional properties. For example, they are often used in gynecological practice as a way to treat certain diseases, and non-hormonal IUDs with the addition of silver or gold have a bactericidal effect and protect the female reproductive system from unwanted infections.

There are 3 generations of spirals:

1st generation

An IUD without any metal or hormone, consisting only of medical grade plastic.
Their contraceptive effect is achieved only through the mechanical impossibility of attaching the fertilized egg to the endometrium.
Often cause complications (infectious diseases, ectopic pregnancy and prolapse of the IUD - expulsion).

1st generation IUDs are no longer used because more reliable and effective IUDs exist.

2nd generation

IUDs containing metal. That is, these are spirals that also consist of medical plastic, but have a contraceptive effect due to additional components - copper, silver, gold.
Metals act not only on female body, but also on male factor– spermatozoa, and thereby reduce the risk of unplanned pregnancy.

3rd generation

Hormonal IUDs, which at this stage are used as therapeutic and contraceptive agents.

Intrauterine devices have different shapes:

T-shaped;
round or semicircular;
in the form of an umbrella;
horseshoe-shaped (semi-oval).

Each spiral has its own advantages and disadvantages and is selected individually depending on the characteristics of a particular woman’s body.

All spirals have the same principle of action - protection against unwanted pregnancy.

So, how does the IUD help prevent conception?

All spirals consist of medical plastic, which rarely causes allergic reaction in women. But such cases do occur. For this reason, you need to carefully monitor your sensations and monitor the body’s reaction after installing the spiral.

In addition to medical plastic, modern spirals include:

metals (silver, copper, gold);
hormones.

Hormonal IUD

This type of IUD releases a certain amount of a hormone that affects not only the female body, but also reduces the activity of sperm. The spiral does not affect male potency and on men's health! Only on sperm that have already entered the woman’s reproductive tract. The only noticeable disadvantage that intrauterine devices can bring to a man is the feeling of the antennae of the device during sexual intercourse. This issue can be easily resolved: you need to come to see a doctor, and the gynecologist will simply shorten the interfering tendrils of the spiral.

The hormone in the spiral affects the maturation and release of eggs by a woman’s ovaries and does not have a destructive effect on the hormonal balance as a whole.

The very presence of the IUD in the uterus prevents the attachment of the fertilized egg and, accordingly, pregnancy does not occur. This is a mechanical factor in preventing pregnancy. The spiral also causes local reaction, which has a detrimental effect on sperm, inhibiting and destroying them.

Hormonal IUDs affect many women's diseases(, etc.) and are recommended for use by gynecologists for the treatment of the latter.

Non-hormonal IUD

As for IUDs containing metals, such designs, in addition to the mechanical factor of pregnancy protection inherent in all spirals, have a detrimental effect on the male factor. For example:

Copper, oxidizing the environment, inhibits the movement of sperm that enter the uterine cavity and damages them.
Silver and gold increase the shelf life of spirals and have a beneficial effect on local immunity, protecting a woman from inflammatory diseases of the pelvic organs.

All types of spirals have a stimulating effect on fallopian tubes and enhance their peristalsis. While the fertilized egg is rapidly moving into the uterine cavity, the endometrium does not have time to prepare to accept a new life, and as a result, the embryo ends up in an unfavorable environment that is not suitable for further development.

To summarize, we can identify the links of fertilization that are influenced by any spiral:

On the male factor (inhibitory and spermicidal effect).
For the maturation and release of the egg from the ovaries.
For the delivery of the egg and fertilized egg through the fallopian tubes.
Attaching the fertilized egg to the endometrium.
A local reaction that causes the release of enzymes that are harmful to sperm.

Who can get an intrauterine device?

The desire of the woman herself at this stage of life not to become a mother (provided that there is already a history of childbirth).
Frequent pregnancies with other types of contraception (if they are used incorrectly or are not taken carefully).
Protection against unwanted pregnancy during lactation (breastfeeding).
In order to save money. IUDs are installed for several years, which allows a woman not to worry about other types of contraception (oral contraceptives, condoms).

Important! IUDs do not protect against STIs (sexually transmitted infections)! It is recommended to use a contraceptive if you have a regular sexual partner ( low risk transfers venereal diseases). It should also be mentioned that IUDs are used in women who have given birth and are not recommended for contraception in young nulliparous girls.

Method of setting up a spiral

The spiral is installed both during menstruation and immediately in the first days after it, since at this time it is more likely. In addition, the cervix is slightly open during this period, which makes it easier for the device to enter the uterine cavity and cause minimal discomfort to the woman.

Before installing the spiral, the doctor conducts tests for the presence of inflammatory diseases and, if necessary, prescribes anti-inflammatory therapy. This reduces the risk of complications and the IUD falling out in the future. The process itself takes place only in a gynecologist’s office, under aseptic conditions.

If a woman decides, she should wait some time (about 6 weeks) for the uterus to return to its previous state. The fact is that during pregnancy the uterus overstretches, and after childbirth it gradually returns to its previous size. This process is called uterine involution. In order to avoid complications after installing the IUD, gynecologists recommend waiting until the end of involution.

It is not recommended to place an intrauterine device immediately after an abortion. The patient should be monitored for complications and various inflammatory diseases that could provoke an abortion. As soon as the obstetrician-gynecologist is convinced that the woman is completely healthy, the IUD can be placed in the uterine cavity.

The instructions for some IUDs contain instructions about inserting a contraceptive immediately after an abortion. This issue should be resolved individually with an experienced doctor and follow his advice in this matter.

Review of intrauterine devices: the most popular means

There are a huge number of intrauterine contraceptive devices on the market, which have different shapes, compositions, terms of use and, of course, price ranges. They all have their advantages and disadvantages.

So, let's look at the most commonly used and popular spirals:

Spiral Multiload (Multiload CU-375)

This is a copper wire spiral that has a T-shape. It is not hormonal. The metal affects spermatozoa, causing their death and the impossibility of further fertilization.

The shelf life of the spiral is 4 years. After this period, the spiral must not be used under any circumstances!

Rod length – 35 mm. This is a standard length; the spiral has no other variations in size. It is suitable for women whose uterine cavity, after measuring the size of the uterus with a probe, is between 6 and 9 cm long.

Among the features of the spiral, it should be noted that its use is prohibited in the following situations:

if you have an existing allergy to copper;
in the first 3 months after an abortion;
during the period of breastfeeding.

If a woman has been taking immunosuppressants for a long time to treat another pathology, the IUD is not suitable, and another method of contraception should be selected.

It should be noted that the presence of copper in the contraceptive will not affect total quantity copper in the body.

The price range is around 2.5-3 thousand rubles.

Spiral Copper (Copper TCu 380A)

Just like the previous spiral, it contains copper. Spiral dimensions – vertical – 36 mm, horizontal – 32 mm. A feature of this spiral is a greater release of copper into the uterine cavity, which causes a stronger local reaction.

Duration of use – 5-6 years.

Another tip: After installation, you should lie on the couch in the doctor's office. IN in rare cases after insertion of the IUD, a decrease in pulse rate and clouding of consciousness are observed.

All other properties are the same as those of the Multiload spiral.

The price fluctuates around 2 thousand rubles

Spiral Goldlily

It contains both copper and one of the noble metals - gold. Gold covers the copper surface, protecting it from early oxidation and corrosion. By creating a potential difference, additional protection against unwanted pregnancy is created. Gold has a powerful bactericidal effect and prevents the occurrence of inflammatory diseases of the pelvic organs.

Another advantage of the contraceptive is the availability of several sizes. Every woman will be able to choose exactly the option that she needs.

The period of use is 7 years.

A significant disadvantage is the price. Due to the presence of gold, the cost of an intrauterine contraceptive is about 4-5 thousand rubles.

Spiral Juno Bio-T with Silver (Ag)

Another spiral in the line modern means contraception. The instructions offer the following indications for the use of the spiral (except for the woman’s desire):

Treatment and prevention of Asherman's syndrome (formation of adhesions in the uterine cavity).
For post-coital protection (can be administered within 3-4 days after unprotected intercourse).

It contains copper and silver, which increases the service life up to 7 years. Silver prevents early and rapid oxidation of copper, which gives the spiral a longer-term effect.

One more thing useful quality silver – bactericidal effect. Juno protects the woman’s body from inflammatory diseases and other infectious complications associated with the presence of the spiral in the uterine cavity.

Juno works on the same principle as other spirals, influencing all links in the chain to prevent unwanted pregnancy. The price of this product is also attractive - about 400-500 rubles.

Spiral Nova T

T-shaped coil containing copper and silver (copper wire with silver in the core). As in Juno, in the Nova T spiral, silver prevents early fragmentation of copper. But the difference is the period of use - Nova T should be changed every 5 years. No specific features were identified for other mechanisms of action.

The price is about 1500-2000 rubles.

Mirena spiral

One of the most common means of intrauterine contraception is hormonal system. This product contains a synthetic gestagen - levonorgestrel. It is released per day in a certain required quantity, which is sufficient to perform two functions - contraceptive and therapeutic. That is why this spiral is often recommended for women with gynecological diseases(fibroids, endometriosis, etc.).

Mirena inhibits ovulation and prevents the formation of a fertilized egg, which increases its contraceptive effect. The Pearl index of the hormonal intrauterine system is 0.1-0.5, while for conventional IUDs it reaches 3.

Important aspects:

The IUD does not affect hormonal levels.
Not contraindicated in women with metal allergies.
Approved for use during breastfeeding.
It is a 3rd generation spiral.

The shelf life of Mirena is 5 years. Further use is not recommended due to the depletion of the hormone reserves in the IUD and the increased possibility of developing infectious diseases of the pelvic organs.

This contraceptive has a high cost - about 10-12 thousand rubles.

Dear girls and women! Remember that for an accurate and correct selection of the spiral, you must consult a doctor, because every female body is unique and inimitable!