RIA was applied for the first time in the world by Richter in 1909. Today, the most commonly used method to prevent pregnancy is the insertion of an IUD. Intrauterine devices are popularly called spirals. The spiral is a reversible birth control method with long-lasting protection. Spirals are plastic medical devices containing mostly copper that are large enough to fit inside the uterus. Spirals containing Cu are used only for family planning purposes. In addition, there are also spirals containing hormones. These spirals are mainly used to reduce uterine bleeding, but they also have a family planning effect.
To briefly mention the IUD (spiral) types; There are two types of spirals most used.
1-Copper RIA (Spiral): TCu 380 A, Multiload (MLCu 250 and 375) and Nova T (TCu 200 Ag and 380). Ag)
TCu 380 A : It resembles the letter T in shape. In addition to the 314 mm² copper wrapped in the body section, there are two copper tapes of 33 mm² each on both arms. Its protection continues for 10 years.
Multiload (MLCu 250 and 375): It consists of a vertical body and two horseshoe-shaped arms with spiny protrusions on this body. There are 250 or 375 mm2 copper is wound. It has 3-5 years of protection depending on the amount of copper it contains.
Nova T (TCu 200 Ag and 380 Ag):It resembles the letter T in shape. 200 or 380 mm2 copper wire stabilized with a silver core is wrapped in the body part. It has 5 years of protection.
2-Hormone IUDs (Spiral): There are LevoNova and Mirena containing Progestasert and levonorgestrol (LNGg 20) as progesterone preparations in the body.
In its T-shaped body there is a cylinder containing 52 mg of levonorgestrel. It protects for 5 years by releasing 20 micrograms of levonorgestrel per day.
When does the protection of the spiral begin and when does it end?
Protection begins as soon as the spiral is inserted. As soon as the spiral is withdrawn.
Who can use the spiral?
**For women who have completed the number of children or have at least one child, especially if they do not want to use a hormonal system.
**For women who are breastfeeding.
**For women who cannot use birth control pills or hormone-containing methods due to smoking, advanced age or some other reasons.
**After unprotected intercourse for emergency protection purposes. If the spiral is inserted in the early period, it can prevent the pregnancy from settling in the uterus.
Who cannot have the spiral inserted?
**The spiral is not inserted into women who have never had children.
**Abnormal bleeding of unknown cause.
**If there is a known pregnancy or suspicion of pregnancy.
**If there is a sexually transmitted disease.
** If there is a recent uterine infection or if there is an active genital infection.
**When there is a curtain in the uterus and there is cervical insufficiency.
**Women who are allergic to copper.
**Women with a genetic disease called Wilson syndrome, which causes copper accumulation in the body.
**When the Pap smear result is abnormal.
**When cervical erosion is diagnosed.
**In those with bleeding and coagulation disorders.
**It may not be placed in the uterus with myomas, depending on their location and size.
**In the presence of a malignant tumor.
When can the spiral be worn?
The spiral is worn on days when the menstrual period decreases in quantity. There are two reasons why it is worn during menstruation; Firstly, the menstrual period is proof that the woman is not pregnant. The second is that the cervix opens during the menstrual period and the spiral can be inserted more easily.
After normal birth, the spiral can be inserted within the first 48 hours or 40 days later. Since there is no sexual intercourse for the first 40 days after normal birth, there is no need to wait for menstruation.
The spiral can be inserted immediately after the intervention after miscarriage and curettage.
How does the spiral application work?
Spiral application is very easy. There is no need for anesthesia during the application, but sometimes light anesthesia can be applied upon the patient's request.
The patient is laid on the gynecological table. The vagina and cervix are cleaned with antiseptic solutions. The spiral, which is decided together with the patient, is placed into the uterus using the appropriate method. The threads of the spiral are cut so that they hang slightly from the cervix. spiral rope It is necessary for it to be removed from the uterus easily.
During the use of the spiral, situations in which a doctor should be consulted urgently:
**Abnormal vaginal bleeding
**Menstrual delay
**Severe groin pain, sudden cramps
**Unexplained fever and chills seizures
** Foul-smelling discharge, foul-smelling menstruation and feeling of odor after intercourse.
**Feeling of the spiral by the partner during sexual intercourse (normally the spiral is never felt. If it is felt, it is most likely that the spiral has slipped out of place).
Situations to be considered after the spiral is inserted:
**Temporary pain and cramps may be observed immediately after the spiral is inserted. Painkillers can be used.
**Since slippage in the spiral is most common in the first month, the first check should be checked gynecologically in the 1st month, then in the 6th month, and then once a year, even if there are no complaints.
**As the cervix is more open during menstrual periods, movements that will increase intra-abdominal pressure should be avoided (such as straining, lifting heavy loads, excessive coughing).
**There is no need to use prophylactic antibiotics after the spiral is inserted. However, personal hygiene should be taken into consideration.
How does the spiral (IUD) prevent pregnancy?
The copper content of the spiral has a lethal effect on sperm. In addition, the inflammatory condition created by the spiral in the uterus prevents the pregnancy from settling in the uterus. Spirals containing progesterone have the power to prevent ovulation. Mirena, which contains progesterone, thickens cervical mucus. In this way, it prevents the passage of sperm.
What is the success rate of the spiral in protecting against pregnancy?
No birth control method provides 100% protection. The spiral is considered a very effective and reliable birth control method. The risk of becoming pregnant within 1 year is almost 1 - 3%.
Can pregnancy occur while using the spiral?
Yes, there is a risk of becoming pregnant while using the spiral. Pregnancy while using a spiral often occurs as a result of the spiral falling or sliding downwards. lyre. However, sometimes pregnancy can occur when the Spiral is in the desired place in the uterus. In this case, if the pregnancy is to continue, the spiral must be removed immediately. Because if the spiral remains in the uterus, it may cause infection and septic shock.
However, removing the spiral may cause the pregnancy to miscarry. If the pregnancy is desired to be terminated, then the curettage method can be used. In cases where the pregnancy progresses, it is not possible to remove the spiral. In this case, pregnancy can continue with the spiral. In this case, it does not cause any anomaly in the baby as it is thought.
Does the use of spiral cause a predisposition to ectopic pregnancy?
In women who become pregnant while using spiral, the resulting pregnancy is an ectopic pregnancy. The probability of having an IUD is higher than in women who do not use a spiral. This rate is even higher when using a hormonal spiral.
Does the spiral cause infertility?
The use of spiral increases the risk of genital infection. Therefore, infections such as chlamydia and gonorrhea (gonorrhea), especially those affecting the tubes and ovaries, can cause adhesions and cause loss of normal tissue structure, resulting in infertility.
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