Safety - IUD does not have a systemic effect, that is, except for the uterus, it does not affect any other organs and body systems.
Ease of use - the insertion of IUD does not require the consent of the sexual partner and making adjustments to the sex life of the couple.
Economic benefit - the cost of purchasing a contraceptive is not comparable with the cost of hormonal contraceptives which are necessary to protect against pregnancy for a long time.
Disadvantages of intrauterine contraception: '> contraception: They are relative, if not minimal. Before the insertion of IUD, it is necessary to undergo an examination, but it must precede the choice of any method of protection against pregnancy, with the exception of barrier and physiological methods.
When using IUD, the duration of menstruation and the amount of menstrual discharge may increase, so if menstruation is initially abundant and long, then it is better to refuse the use of IUD.
When using IUD, its spontaneous expulsion from the uterus may happen. The issue is solved by the selection of the IUD of other form and of different size.
The presence of IUD in the uterus facilitates the penetration of infection into the upper parts of reproductive system, so for women with multiple sexual partners and at high risk of infection with sexually transmitted infections, it is better to refuse the use of intrauterine contraception.
During the use of IUD, it is necessary to undergo a preventive examination every six months to monitor the position of IUD in the uterus and to detect the infections of genital organs. This fact can hardly be considered a drawback of intrauterine contraception; rather, it obliges a woman to look after her health.
When is the use of IUD contraindicated?
Confirmed or implied pregnancy.
The insertion of IUD is not a method of abortion, so before you install an IUD, you need to be sure that there is no embryo in the uterus or outside it. Based on this, menstruation is considered the best time for IUD insertion, although theoretically, in case of absence of pregnancy IUD can be inserted at any day of menstrual cycle.
Malignant tumors of genital organs.
IUD can provoke tumor recurrence, if there was any.
Acute inflammatory processes of pelvic organs.
IUD supports inflammation and may contribute to the development of complications.
The presence of sexually transmitted diseases.
IUD predisposes to the spread of infection in the upper sections of genital tracts.
Bleeding of unknown etiology from genital tracts, the appearance of spotting in the middle of the cycle, excessive and prolonged menstruation.
Abnormal development of the uterus.
Uterine myoma of more than 8 weeks.
IUDs can promote tumor growth.
Endometriosis of any localization.
IUDs increase the risk of dissemination of endometriosis.
Allergy to copper and silver.
Most modern IUDs contain inclusions of copper and silver. In case of intolerance of these metals, gold IUDs should be preferred.
Anemia with hemoglobin level below 90 g/l, blood diseases accompanied by the blood-clotting disorder. In the presence of IUD, menstrual blood loss increases, and this can aggravate the course of the disease. Attention! Intrauterine contraception can be used for nulliparous women, but only with strict consideration of other contraindications and the absence of possibility to use other means of protection.
The presence of an IUD in the uterus increases the risk of ectopic pregnancy, so the use of the IUD is not recommended in case of predetermined impaired patency of the fallopian tubes, including the case of presence of ectopic pregnancy in the past medical history. How to choose an IUD? IUD Yunona – European quality and availability.
At the moment more than fifty types of IUDs have been developed and produced in the world, but essentially most of them are identical to each other. A rigorous analysis of world experience of intrauterine contraception and daily tracking of new products in this area allowed the specialists of CJSC "Medical enterprise Simurg" (Belarus) to create a whole line of intrauterine contraceptives that meet the needs of women and modern medicine.
IUDs “Yunona” have a European quality certificate (MUV, Austria).
For the high quality of IUDs “Yunona” enterprise “Simurg” was awarded the United States International Prize “Torch of Birmingham” (1996) and Spanish prize “BID” (1999).
In comparison with the foreign ones IUDs, contraceptives “Yunona” have lower cost due to the absence of customs costs and affordable cost policy of the manufacturing enterprise.
Differentiated approach to intrauterine contraception
Before one buys an IUD at the pharmacy one must consult a gynecologist and undergo an examination in order to rule out the contraindications for the use of intrauterine contraception. Given the fact that it is most convenient to insert an IUD during menstruation, it is better to plan a visit to the doctor during the first half of menstrual cycle. The minimum examination before the insertion includes:
Analysis of past history data.
General and gynecological examination.
Microbiological analysis of smears for flora.
Cytological analysis of cervix uteri and cervical canal scrapings.
General analysis of blood and urine.
Ultrasound of genital organs. Based on the analysis of the data obtained during the examination, taking into account the age of the woman, her reproductive plans for the future, the number and outcomes of previous pregnancies and deliveries, the experience of using IUDs, if any, and the expected period of intrauterine contraceptive use, the doctor suggests one or another intrauterine contraceptive. A wide range of IUDs "Yunona" allows to choose a contraceptive individually for each woman.
For women who need long-term protection from pregnancy, it is recommended to use the IUD with a maximum life time - silver-containing “Yunona Bio-T Ag” with a life time of 7-8 years and gold IUD “Yunona Gold” and other gold-containing IUDs with a life time of 9 years.
If the protection against pregnancy between the births is necessary, copper IUD “Yunona Bio-T” which serves 4–5 years, will suit well.
Nulliparous women need a small IUD, and the choice turns to the circle-shaped intrauterine device “Yunona Bio-T” №1. Pluriparous women and women in whom cervical insufficiency was found during pregnancy, are recommended to use circle-shaped IUD “Yunona Bio-T” №2. It is also suitable for women with ruptures of cervix uteri.
Circle-shaped IUDs "Yunona" are the best choice for insertion immediately after medical, instrumental abortion and abortion by vacuum aspiration method. In this case for nulliparous women it is better to choose the circle-shaped IUD “Yunona Bio-T” №1, and for parous women it is better to choose the circle-shaped IUD “Yunona Bio-T” № 2.
In case of presence of chronic inflammatory diseases of pelvic organs, is used IUD “Yunona Bio-T Super” covered with propolis. Propolis provides protection against inflammation during the period of adaptation to IUD.
Intrauterine contraceptive can be inserted on the 3-4 day after sexual intercourse, in this case it prevents pregnancy. For this purpose, for nulliparous women it is better to use circle-shaped IUDs “Yunona Bio-T” №1, and for parous women “Yunona Bio-T” or circle-shaped contraceptive “Yunona Bio-T” №2.
You’ve decided to insert an IUD – When can this be done?
Traditionally, the insertion of IUD is coincided with the menstruation. The optimum time for the insertion of IUD is the day when menstrual flow begins to decrease, usually it is the 3-4 day of menstruation. This approach often makes it difficult to use intrauterine contraception, so doctors should consider other possible options. Strictly speaking, it is possible to install an IUD at any day of menstrual cycle in case of confidence in the absence of pregnancy. If menstruation came on time, did not differ from the normal one, after it there were no sexual intercourses, and ultrasound data confirm the absence of pregnancy in the uterus, then one can have IUD installed. The best time is the period from 4th to 19th day of the cycle.
The IUD can be inserted immediately after an abortion, regardless of the method by which the pregnancy was terminated.
The IUD can be inserted within the first two days after normal delivery or after 5-6 weeks, regardless of whether the menstrual cycle has recovered or not.
After a Cesarean section the IUD can be installed in 3-4 months.
After the endured inflammatory process of genital organs, the IUD can be inserted only after the completion of the full course of rehabilitation, that is, after 6-8 months.
In case of necessity to replace the IUD with the expiring period of use or to replace the IUD that has moved from its place, a new IUD can be inserted immediately after the extraction of the old one.
To prevent pregnancy the IUD is inserted 3-4 days after unprotected sexual intercourse.
How the IUD is inserted: methods, sensations, actions.
The insertion of IUD is an outpatient medical procedure that does not require hospitalization. Most often it is carried out by a gynecologist in the conditions of female counseling clinic.
After the examination and selection of IUD the doctor prescribes the day of carrying out of the procedure.
The procedure of insertion of IUD is almost painless. The difficulties are most often associated with the emotional state of a woman. In order to avoid pain during the IUD insertion, 30 minutes before the insertion of the IUD, a woman can take an ordinary anesthetic drug and during the procedure it is necessary to completely relax the muscles of the thighs, perineum and abdomen.
In case of high pain sensitivity, fear, and an unstable emotional state, pain relief may be required - it is better to notify your doctor immediately. During the insertion of the IUD, paracervical anesthesia is used in case of which the anesthetic agent is injected with a syringe into the tissue surrounding cervix uteri. The effect develops in 2-5 minutes, after which the doctor proceeds to the insertion of the IUD.
After a gynecological examination and anesthesia, the doctor fixes cervix uteri with forceps, checks the depth of the uterus with a probe, and inserts the IUD with the help of a guide tube. The cervix uteri is released from the forceps and is treated with antiseptic solution. The procedure can be considered completed. From start to finish, the insertion of an IUD takes on the average 5 minutes.
After the insertion of the IUD, painful sensations are possible, they are connected with uterine contraction and the body's attempts to "get rid" of a foreign body. During this period, for the purpose of pain relief, you can take any non-steroidal anti-inflammatory agent or a simple analgetic.
No matter how thoroughly was carried out the treatment of the operative field, instruments and hands of the doctor, during the insertion of the IUD, a certain amount of microbes is always brought inside the uterus. With the preventive purpose after the insertion of the IUD are prescribed broad-spectrum antibiotics. The course of treatment in the absence of symptoms of inflammation is usually 3 days.
In order to prevent infection and expulsion of the IUD from the uterus, it is necessary to refrain during 8-10 days from sexual activity, physical activity, sports, visiting the pool, bath and sauna.
Attention! Even in case of good health, in 10 days after the insertion of the IUD, it is recommended to visit the doctor in order to monitor the position of the IUD in the uterus and for early detection of complications.
Life with the IUD: the rules of intrauterine contraception.
The period of adaptation to the IUD lasts on the average 3 months. Immediately after the insertion of the IUD the menstrual flow becomes more abundant. After the cessation of menstruation, insignificant, often spotting, bloody discharge from the genital tract during three menstrual cycles is possible. It should be noted that in the background of using the IUD, menstruation becomes more abundant and long - this is normal.
Small pains in the lower abdomen during the period of adaptation to the IUD resemble menstrual ones by nature and usually do not require the use of painkillers.
Intrauterine contraception does not require the adherence to a special hygiene regimen.
It is allowed to visit bath, pool, to swim in open water, massage and physiotherapy procedures.
During the first year of use of intrauterine contraception it is recommended to visit the doctor in 1, 3, 6 months after the insertion of IUD. In the future in case of good health the visits to the doctor should be planned once a year. If abnormalities occur in the state of health, contact the doctor immediately without delay.
Cases when you need to see a doctor urgently:
severe and/or prolonged abdominal pain,
pain during sexual intercourse,
blood-tinged discharge in the middle of the menstrual cycle,
excessive and prolonged menstruation accompanied by malaise and dizziness,
unusual mucous or purulent discharge from genital tracts,
unusual discharge from the genital tracts.
It is necessary to monitor the period of use of IUD and when it ends to remove the contraceptive. In case of a wish to use intrauterine contraception in the future, when you remove the obsolete IUD, you can install a new one.
Attention! If desired the IUD can be removed at any day of menstrual cycle, but the optimum time for this are the most “abundant” days of menstruation.
The procedure of extraction of IUD is simple and painless. The doctor removes the IUD from the uterus by pulling by the cervical threads. In this case, the IUD "folds" and easily slips out of the uterus.
Attention! Despite its apparent simplicity, in order to avoid the complications, it is forbidden to remove the IUD by yourself.
The IUD does not suppress ovarian function, therefore the restoration of fertility happens quickly regardless of the period of use of intrauterine contraception. Doctors advise to plan pregnancy not earlier than one month after the removal of the IUD - this time is necessary for the full restoration of reproductive system.
Preliminary examination, differentiated approach to the choice of the IUD model, the professionalism of the doctor who inserts the contraceptive, prophylactic use of antibiotics during the first days after the insertion of the IUD contribute to the rapid adaptation of a woman to the IUD. Nevertheless, as with the use of other methods of protection against pregnancy, complications are possible with intrauterine contraception.
The most common cause of uterine pregnancy is the displacement of the IUD and its partial expulsion. The delay of menstruation should be the reason to consult a doctor.
According to the statistics, half of pregnancies that occurred on the background of intrauterine contraception are interrupted spontaneously at early stages or end by preterm labor. In addition, the presence of IUDs increases the risk of infectious complications. That is why the doctors recommend removing the IUD and terminating pregnancy.
It is extremely difficult to remove the IUD from the uterus without disturbing the pregnancy. There is a high risk of injury to the embryo, which will either lead to its death, or will cause the formation of abnormalities.
Alternatively, one can leave an IUD in the uterus and keep the pregnancy. It should be remembered that copper ions included in the IUD, can disturb the development of the fetus. If pregnancy can be brought to delivery, the IUD is excreted with the placenta or is removed after the birth of the fetus with the help of the instruments.
The presence of IUD increases the risk of ectopic pregnancy. This is due to a change in the vermicular motion of the fallopian tubes and the impaired movement of the fertilized egg in the direction of the uterus.
In order to reduce the risk of ectopic pregnancy, it is recommended to use the IUDs containing copper.
It is necessary to stop the use of the IUD in case of presence of a chronic inflammatory process of uterine appendages and violation of the patency of the fallopian tubes. It is risky to use the IUD if there is a history of ectopic pregnancy.
Spontaneous expulsion of the IUD
Due to the contraction of the uterus immediately after the IUD insertion and during the subsequent menstruations, the IUD can move into the cervical canal and fall into the vagina, the doctors call this complication IUD expulsion.
The frequency of expulsion is influenced by the individual structural features of genital organs of a woman, the presence of cervix uteri tears, the number of previous deliveries, the initial position of the IUD in the uterus, that is, the correctness of its orientation. It is noted that inert IUDs are "rejected" more often than the medicated ones containing copper, silver or gold.
The lengthening of cervical thread, the presence of hard IUD stem at the entrance to the cervical canal, pain during sexual intercourse and blood-tinted discharge after it point to the partial expulsion of IUD. Ultrasound confirms the diagnosis of IUD expulsion.
Lowered IUD is to be removed. In case of a wish to continue intrauterine contraception, the IUD of another model can be inserted immediately after the extraction of the fallen out one.
Inflammatory diseases of uterus and its appendages
Endometritis and adnexitis are serious complications of intrauterine contraception. Most often it is due to the presence of hidden infections, sexually transmitted diseases and chronic inflammation of genital organs, which were not diagnosed before the insertion of the IUD.
If inflammatory diseases of pelvic organs occur, IUD extraction and a course of anti-inflammatory therapy are indicated. Intrauterine contraception can be used 6-12 months after the end of treatment.
During use of IUD, especially during the first three months, the menstruations can be abundant and long. However, the loss of more than 80 ml of blood during one menstruation is regarded as pathology, menorrhagia which can lead to anemia, accompanied by weakness, decreased working capacity, dizziness, nausea, visual impairment.
The criteria for deciding whether to remove the IUD in case of uterine bleeding are the results of blood test, in particular, hemoglobin and hematocrit indices. If the bleeding disturbs a woman for more than 3 months and anemia develops, it is advisable to remove the contraceptive.
Pain in the lower abdomen over the pubis immediately after the insertion of the IUD and during the next three menstruations is acceptable. It is associated with the "irritation" of the uterus and its periodic contraction.
Taking conventional analgetics and non-steroidal anti-inflammatory drugs relieves the condition in case of minor pain sensations. Severe pain in the abdomen immediately after the insertion of the IUD may indicate a wrong position of the contraceptive or that its size is too large. Ultrasound examination clarifies the situation. If the assumptions are confirmed, the IUD should be removed. Immediately after this, it is possible to insert another contraceptive, if necessary, of smaller size than the previous one.
The perforation of uterus, that is, its damage during the insertion of IUD is a rare complication. The accurate assessment of the anatomical and physiological characteristics of a woman’s body, high professional level of the doctor, the accurate performance of the IUD insertion technique prevent from injury.
The symptom of uterine perforation is the pain that spreads throughout the lower abdomen, the tension of the anterior abdominal wall, dizziness, nausea, weakness and the absence of IUD threads in the vagina. The appearance of such symptoms is the reason for emergency visit to the doctor.
In case if the uterus is completely perforated, the contraceptive is removed during laparoscopy or laparotomy. In case of partial perforation of the uterus hysteroscopy is indicated.
At the beginning of the XIX century appeared pessaries - special diaphragms which were inserted into the vagina with the aim of supporting the genital organs. Their "side" contraceptive effect was noticed by the scientists and served as the basis for creating a similar device, but for the insertion into the uterus. The euphoria about the invention did not last long. The “contraceptive” was intended for self-use, infections were constantly carried into the uterus, and this was the cause of a huge number of serious inflammatory complications. As a result medical community rejected their development. At the beginning of the 20th century, the first intrauterine devices appeared. They consisted of the loops of filaments made from small cattle intestines. The material quickly decayed and therefore was soon replaced by silk. Thus in 1909 thanks to Richter R. the first intrauterine contraceptive appeared - a ring of silk threads which was completely inserted into the uterus. In 1923 Pust modified Richter R.'s ring having attached a catgut's “tail” to it, thus facilitating the removal of the contraceptive, but even in this form the IUD did not become popular - the infectious minuses of the contraception brought its advantages to nought. In 1929 German scientist Ernst Grafenberg developed and proposed the use of a silver circle-shaped contraceptive, it was much better than its predecessors, but it had one major drawback - it was deformed during the uterine contractions and it fell out of it during the menstruation.
In 1934 thanks to the Japanese scientist Ota the ring gained support elements, but even this did not save the invention, it was subjected to harsh criticism and was excluded from general use. Despite the opposition of the medical community, Richter-Ota ring has found its place in gynecology. Its cheapness, a small number of side effects of silver contraceptive and lack of alternative equally reliable methods of protection against pregnancy have made the contraceptive popular among the doctors and women. The science of intrauterine contraception began to develop by leaps and bounds. In 1958 the first plastic (inert) IUD appeared - Lippes loop. All subsequent inventions differed from it only in form and had rather large sizes which became the cause of uterine bleeding. Moreover, every fifth woman who used an inert IUD became pregnant within a year. This result did not satisfy either the doctors or the patients themselves. In 1968 the contraceptive properties of copper were discovered, and it became an integral component of all IUDs. Inert plastic spirals lost their positions and were later excluded from the list of recommended ones. Silver was added to the IUDs in order to protect copper from destruction and to enhance the protective properties of IUD, many contraceptives with copper braiding have silver core. In 2001, a new stage in the development of intrauterine contraception began. The intrauterine device has become a hormonal system containing gestogens - analogues of female sexual progesterone. The IUDs "learned" not only to prevent pregnancy, but also to treat a number of gynecological diseases.