The intrauterine contraceptive device (IUD)

September 5, 2011

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Intrauterine devices   first mentioned in 1909, when Richter was able to describe in detail provided in the form of a ring device, which in those years was made from silkworm gut usual. Although the first in the history of the Navy was known in ancient times, consider such devices at this time is not necessary. Currently there are various forms of intrauterine contraceptives, including " umbrella "," loop " "T" Accessories in the form spiral   or in the form of IUD rings .

For the production of IUDs are now using a variety of innovative materials, which include plastic . silver   and copper . Most often in our time in the domestic and global gynecology used device Sorreg-T 380A , Which contains copper. Intrauterine contraceptives are the most pressing in China, where such devices are now the main method of contraception. Among the most commonly used forms of the IUD to be noted ring without thread With a curl, which is made of stainless copper. This form of the ring is gradually replacing the previously popular Ring Mach Performed with two symmetrical swirls.

According to statistics, currently the Navy around the world uses 85 million women, more than 60 million is attributable to China. This method of protection against unintended pregnancy is now in second place, and in the first place there is still a voluntary surgical sterilization . In the XXI century the most pressing are made of copper intrauterine device, called collectively Sorreg-T 380A. These Navy should include modern modifications such as Multiload . C-380- Slimilin . Sorry r T 200 . Nova T . Lippes loop   and T C-380Ag And agents containing progestin .

IUD contraceptive capabilities, mainly based on the special effects on female egg They have an effect on the migration of sperm On Implantation   and processes of fertilization And directly with the   uterus . Unfortunately, the exact mechanism of action of IUDs is not fully understood by scientists, and is not set yet. It is believed that such contraceptive effect on the uterus and cause capacity reduction as well as the change in activity. Perhaps their use results in the development aseptic inflammatory nature , Wherein the enzyme system alters the activity of the endometrium, and peristalsis   tubal ligation is accelerated. Therefore, the migration of sperm from which the fertilization   female egg, varies considerably, they quickly get into the uterus and then die before reaching their goal.

By studying the properties and different putative mechanisms of action of modern uterine contraceptive, it may be noted the possible impact of the following:

• on sperm and slowing their migration Fallopian tubes   from the woman's vagina;
• in the fertilized egg, thus accelerating its subsequent transition into the uterus through the fallopian tubes;
• on fertilization   - Significant inhibition process fertilize an egg;
• implantation - the subsequent death blastocysts   a reaction force in the presence of a foreign body in the uterus and a significant development of inflammatory processes;
• the impact of possible abortifacient IUD because of rejection already fertilized egg from the endometrium;
• endometrial effect reduction activity carbonic anhydrase , and alkaline phosphatase . This is achieved by entering into a chemical reaction of copper, from which are made intrauterine devices.

Important conditions when selecting IUDs are not only their shape and size, the level of progestins   in spiral and copper, as well as the age of the woman , The amount of her previous pregnancies or childbirth. If medicated IUDs used correctly, the frequency of unintended pregnancy hovered at 0, 1-1, 5%, and for a typical non-medicinal use of intrauterine devices, this indicator rises to the level of 2-3%. Among the women in older age, as a rule, the Navy had less effective as performance indicators directly linked to the age of the woman. Statistics show that the least effective are IUDs made in the form of a ring with a copper content, but a means of Navy Sorry r T 380A has a minimum frequency of unintended pregnancy.

Pregnancy rates can be minimized by using the following means:

• Navy, including in its membership copper or a progestin pregesteron;
• Navy, which have a large surface area;
• Navy with minor expulsion rates ;
• intrauterine devices introduced completely and settling at the bottom of the uterus;
• funds in which the full or partial expulsion is detected in time.

Non-contraceptive properties   intrauterine devices:

• Navy progestin can reduce the intensity dysmenorrhea   and menstrual bleeding ;
• IUDs are often used for the prevention and treatment Asherman's syndrome   - Adhesions occurring in the uterus.

Types of intrauterine devices

By type of IUD is neutral Lippes Loop Which is divided into four types depending on the size. They are sold in pharmacies or in sterile packaging, or in inexpensive packets requiring subsequent sterilization in a special antiseptic solution containing benzalkonium . As a rule, the Lippes loop embedded in the uterine cavity by means of the insertion of the rod - a special medical instrument.

Modern IUD ring shaped stainless steel characterized by the absence of one curl filaments. This intrauterine device is most often used in China, with a diameter of 18-24 mm curls. First, with the help of the mother probe should determine the length of the internal cavity of the uterus, and then to determine the necessary size of the ring.

The most common view is now the Navy is Coopper-T 380A, manufactured in a sterile package. It is a copper wire, wound on a plastic rod vertical. Coopper-T 380A inserted into the inner cavity of the uterus using a special wire, and this type of IUD in the case of the right of establishment and the lack of negative effects can not pull over a five year period.

Means Sorreg T-200 is designed for contraception for a period of four years, it is produced in a sterile package and is most commonly used in Mexico and China. This type of IUD is inserted into the uterus minimized with the use of a special conductor.

This kind of IUD as Sorrer -7, sold in modern sterile packaging, and the conductor is already included in the sale. In this case, the IUD is introduced into the uterine space by the "withdrawal" or "push" in the middle of the uterus. In disclosing it after I can often hear a click, and only after that the conductor is removed.

Variety Navy Multiload®-375 and 250 are sold already inserted in the guide, and the construction itself is in a sterile package. This intrauterine device is available in three sizes and is administered by retraction .

Medical IUD Progestasert-T containing progesterone   produced in a sterile package, progesterone hormone itself is gradually released after entry into intrauterine cavity from the bottom of the thumbnail of an intrauterine device with a constant speed. This type of IUD is easily inserted into the uterus way of withdrawal.

Nova-T - a kind of IUD, made in the form of the letter "T". It is characterized by containing levonorgestrel, which is released after entering from the lower portion of the intrauterine device with a constant speed.

Contraindications of IUD use

Navy It can not be used   in the following cases:

• if too high a risk of infection various infections   and subsequent sexual transmission;
• women suffering from various inflammatory diseases of the pelvic organs, as well as post-abortion or post-partum endometritis ;
• acute purulent cervicitis At Chlamydia   or gonorrhea ;
• pregnant women, and persons who may be suspected pregnancy.

Thus intrauterine devices can be used as postcoital contraceptive   within five days elapsed after unprotected intercourse. However, WWII prohibited from using women who have been diagnosed endometrial cancer , Vaginal bleeding occur pathological character, as well as those that have been identified uterine cancer .

Selecting the Navy should be especially careful to women suffering leykoreey without cervicitis   or severe vaginal infection   in step relapse infectious purulent cervicitis . Also, IUDs are not recommended for childless women at increased risk of contracting sexually transmitted infectious diseases. Another relative contraindication for the use of the IUD - Presence AIDS   or other diseases that cause the immune system in an unstable state, and disease anemia Although the Navy, including progestins, can significantly reduce menstrual blood loss. Intrauterine devices are not recommended for women with painful or heavy menstrual periods, small in size of the uterus, cervical stenosis sufferers, as well as those who have already had one ectopic pregnancy .

Before the introduction of intrauterine devices is desirable to make a gynecological examination, which may reveal contraindications of IUD use such as abnormal structure of the uterus or the presence of biomes .

The principles of introducing intrauterine devices

If a pregnancy is excluded, the IUD can be administered at any time during the menstrual cycle. In cases where the pregnancy is suspected, it is advisable to wait for the onset of the next menstrual cycle. The most common intrauterine devices are introduced into the woman's uterus at the 3-8 days, in the beginning of the menstrual cycle or after a certain period after an abortion. After birth, it is recommended to wait a few months, and only then enter the IUD.

Navy is administered in the following situations: in the absence of pregnancy:

• In the first ten minutes after birth occurred since then entered the Navy already risky due to the contraction of the uterus and there is a significant risk of expulsion
• Six months after delivery, if you exclude a new pregnancy, a woman all the time or to refuse sexual acts, or used in contacts condom Or woman to enjoy vaginal spermicide
• Immediately after making an abortion, if he did earlier than 12 weeks after conception the fetus if an artificial legal or spontaneous abortion is not characterized by complications
• On any day of the menstrual period if the pregnancy is completely eliminated, and the woman before this ever use any contraceptives

IUD insertion, and antibiotic prophylaxis

Currently antibiotics   prophylactic appointed in cases where women are at greater risk of contracting infections that are sexually transmitted. If appointed by the antibiotic, you should consider the following factors:

• The woman in this period should not hurt communicable diseases of acute and have no contraindications to the use of antibiotics and IUD
• Recommended internal reception Doxycycline
• During the period of breast-feeding women are encouraged to take erythromycin

As a rule, intrauterine devices introduced immediately after physiological birth, if they are passed without complications, and uterine contractions are normal in nature, with the risk of uterine bleeding should be absent. After the release of the placenta IUD has consistently entered manually, their introduction is a convenient and safe method, with the risk of infection does not occur. To prevent the development of inflammatory complications, it is necessary to strictly observe the rules of asepsis to which the mandatory use of long sterile gloves.

This method of input Navy has the side effect is overestimated the frequency of expulsion of intrauterine devices. The probability of occurrence of expulsion rate in the copper-containing IUDs is significantly lower than that using the Lippes loop, therefore further explanations relate only to funds sorry r T 380A.

The probability of expulsion   decreases in the following cases:

• If the IUD are introduced into the uterus during the first ten minutes after placenta ;
• you need to manually release the uterus from the accumulated blood clots in it;
• IUDs should be set manually to howl into the uterus;
• IUD must be positioned at the bottom of the uterus, high in its cavity;
• Navy must enter an experienced doctor;
• you must enter the intravenous medication that causes uterine contractions.

If the thread Sorry r T 380A administered immediately after birth, they are encouraged to leave directly into the uterine cavity. If a woman a month after their introduction can not palpate   independently, the position of the Navy here Sorry r T 380A is determined by sensing the intrauterine cavity. Keep in mind that within a month after the recent birth of a new offensive by the fact of pregnancy is considered unlikely. If the thread Navy during sensing can be palpated, the physician can easily remove them quickly from the endometrial cavity, and subsequently - from the cervix. In all other cases, intrauterine devices, which confirmed the presence of probing, it is already possible to leave in the uterus without any fear.

Many women immediately after the intrauterine device mark nausea   or significant pain It is advisable to come to the medical clinic with her husband or partner who may accompany the procedure after a woman home.

After the introduction of uterine funds necessary to check the position of the threads before you came to leave the doctor's office. Learn how to determine the length of the filaments, and they are of the external os of the cervix usually perform two centimeters. If palpation already entered the Navy, you can feel the plastic part of them or the implementation of palpation is impossible, significantly increases the risk of unwanted pregnancy. Threads are advised to check regularly for a few months after entering the Navy in the uterine cavity, and the detection of violations of their position until the next recommended treatment to the doctor to use additional contraception.

Do not forget about the possibility of development of various inflammation As well as the risk of infection. When the pain in the abdomen, fever, various vaginal discharge, immediately consult a specialist. Remember that these inflammatory diseases - a direct path to infertility   or chronic pelvic pain.

Be sure to follow all the changes and menstrual disturbances in the menstrual cycle in a timely manner, please contact a gynecologist at the slightest anxiety due to health violations. Pay attention to symptoms such as the appearance of the vagina heavy mucous   or bleeding , Increased pain during menstruation, the occurrence of menstrual bleeding . Remember that the IUD can be removed at any time, just enough to see a doctor. Do not forget that the unpleasant symptoms when using this method of birth control appear, usually in the first two or three months after the introduction of an intrauterine device, and then many women they are.

Do not attempt remove the IUD yourself As well as a safe for you to extract intrauterine contraceptive is possible only and only an experienced doctor in a sterile clinical environment. Always monitor displays the following:

• menoschesis   - This fact may indicate the occurrence of pregnancy;

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