Most women nowadays intrauterine spiral (BIS) prefer a method of contraception such as insertion. And not surprisingly, the contraceptive effect of the IUD reaches 98 percent, its presence is almost imperceptible, and in most cases it is safe. However, before deciding to install a BIS, you should consult with your doctor, who will recommend a specific type of intrauterine device, as well as determine the possible contraindications for its use.

What is an IUD?

The intrauterine sprial is a small device made of plastic that fits the size of the uterus. The surface of the intrauterine contraceptive is coated with a metal (copper, silver or gold), which not only protects against infection, but also enhances the contraceptive effect.

There are many forms of spirals. The first of these tools is the Lipps petal, the appearance of which is reminiscent of a spiral (in the form of a double “S”). But the Lipps tool size was large enough and had a number of drawbacks. Today, the letter "T", the number "7", rings, ovals, spirals are created. For example, the Multiload intrauterine spiral, which is popular today, is in the form of a horseshoe, which provides additional fixation at the expense of the side walls of the uterus due to the thorny ridges.

The mechanism of action of the intrauterine device

BIS begins to “work” immediately after insertion into the uterine cavity, i.e., it prevents an unplanned pregnancy. The contraceptive effect of the intrauterine device is based on several mechanisms:

• Abortive effect. When a foreign body (BIS) enters the uterine cavity, its muscle tone increases and this prevents the fertilized egg from implanting the cell. In addition, the spiral increases the peristalsis of the fallopian tubes, resulting in the fertilized egg cell reaching the uterus when the ednometrium is not ready for its attachment. In the case of implants, the pregnancy is terminated at an early stage according to the type of miscarriage.
• Mechanism of aseptic inflammation. Once the BIS is installed, leukocytes begin to enter the uterine cavity, looking at the spiral as a foreign body. Leukocyte infiltration of the endometrium prevents implantation of the egg. In addition, leukocytes, macrophages and histiocytes enhance sphagocytosis of sperm, thereby increasing the contraceptive effect of BIS.
• Enzymatic disorders. BIS alters the amount of enzymes in the endometrium and creates conditions that negatively affect sperm, egg cell survival.
• Movement of prostaglandins. Once BIS is established, biologically active substances - prostaglandins - begin to be synthesized intensively, a substance that affects many stages of reproduction.
• Inhibition of ovulation. The established BiS affects the hypothalamic-pituitary system and complicates the production of gonadotropins, correspondingly to the formation of sex hormones, resulting in pre-ovulation.
• Inhibition of sperm migration into the cervical canal. The ends of the spiral strands make it difficult for the sperm to enter the uterine canal. When the Mirena hormonal coil is inserted (levonorgestrel stores), the cervical mucus thickens in the uterine canal.

Spiral placement conditions and inspections

Before the introduction of BIS, the woman must undergo the necessary examination:

• Collect anamnesis to identify possible contraindications;
• Gynecological examination to determine the location and size of the uterus;
• Bacterioscopic examination of discharge from the vagina, cervix or urethra;
• Clinical urine and blood tests;
• Blood tests for HIV infection, syphilis, and hepatitis B;
• UT examination of the small pelvic organs to exclude inflammatory diseases of the uterus and uterus.

After examination, BIS is introduced on days 3-4 of the menstrual cycle. First, the cervical canal opens slightly during menstruation, which makes it easier to insert the IUD. Second, menstrual blood serves as a shock absorber and reduces the risk of injury to the uterine walls and cervix. Third, menstruation confirms the absence of pregnancy.

Instructions against spiral insertion

It should be noted that the installation of the spiral has a number of contraindications:

• Presence of chronic and acute inflammatory diseases of the genitals;
• Presence of uterine tumors (fibroids, cancer) and endometriosis of the pelvic organs;
• Cervical dysplasia of any degree;
• Anemia of any genesis;
• Dysfunctional uterine bleeding;
• Chronic endocrine diseases (thyroid disease, diabetes);
• Pregnancy;
• Abnormalities of the uterus and its cervix (scar deformity, ectropion).

Advantages of intrauterine spiral

BIS has a number of advantages that have made it popular:

• Reliable contraceptive effect (98%);
• Long-term effects (3 to 10 years);
• Economic benefits;
• It is not necessary to take birth control pills, which is especially handy for forgetfulness;
• Mirena hormonal coils are used for the treatment of small uterine fibroids and grade 1 - 2 genital endometriosis;
• Does not require daily monitoring;
• Does not affect sex;
• Reproductive function (being able to conceive) is restored immediately after BIS removal;
• An ideal contraceptive for young mothers.

Disadvantages of the intrauterine device

Despite all the advantages, the method of intrauterine contraception also has its disadvantages. The following side effects may occur:

• Enhancing and / or prolonging menstruation;
• Pain during menstruation;
• Hemorrhage between periods;
• Spontaneous fall of BIS (expulsion);
• Perforation of the uterus during insertion of BIS or during implantation;
• Requires one permanent sexual partner;
• Spiral insertion is not recommended for infertile women;
• Increases the risk of ectopic pregnancy;
• Increases the risk of inflammatory diseases of the lower pelvic organs;
• Requires monthly independent monitoring;
• Reduces endometrial fullness, which reduces the chances of pregnancy.