The spiral, also Intrauterinpessar, is one of the most widely used contraceptives in addition to pill and condoms worldwide. The 2.5 to 3.5 cm spiral is inserted into the woman's uterus. While the first models of intrauterine devices had the shape of a spiral and were thus eponymous, today's copper spiral is usually T-shaped, made of plastic and has a sheathed with copper wire shank. Sometimes a gold plate is incorporated, which makes the spiral better visible on the ultrasound. Contraception with the spiral is considered very safe and can remain in the body for five years if well tolerated.
Spiral: effect and function
Exactly how the spiral works is not known in detail, experts assume several mechanisms that prevent it:
- Copper ions released into the uterus have a toxic and inhibitory effect on the sperm. They lose their orientation ability, durability and flexibility.
- The spiral is a foreign body and thus causes inflammation in the uterine lining, which is harmless, however, because it is not triggered by viruses or bacteria. The inflammatory cells can directly break down sperm; at the same time an implantation is prevented by changing the uterine lining. In an emergency, therefore, sometimes "the spiral afterwards" (similar to the "morning after pill") is used.
- The transport of egg and sperm is hampered by influenced function of the fallopian tubes.
- Spiral: insertion only by gynecologist
Insert spiral - remove spiral
The insertion of the spiral always takes place in a gynecological practice. For this purpose, a special sleeve is used, which facilitates the insertion through the cervix into the uterus. Since the cervix is slightly open during menstruation and pregnancy can usually be ruled out, the gynecologist will use the coil during the last days of the period.
The spiral is precisely placed with the help of ultrasound; also in this way the situation is controlled at regular intervals. In addition, the women can check the position of the spiral even by means of control strings, which can be felt like the thread of a tampon.
The insertion of the spiral does not last long but usually causes a pulling or pain. Especially young women whose uterus is still growing, feel the insertion of the spiral as unpleasant. Maybe a painkiller is recommended here. In rare cases injury may occur when inserting the coil.
Spiral: side effects and safety
The copper spiral became a short time after its development in disrepute, as a specific model led by design flaws to severe inflammation. The modern spirals also harbor an increased risk of infection in the first months after insertion. Inflammations of the pelvic area occur more often in young women. The risk is increased by frequent sexual intercourse with changing partners. The thread of the spiral makes it easier for germs to rise, which in the worst case can even lead to infertility.
Also, with young women and girls as well as women who have not yet born a child, the risk is higher that the spiral is ejected. In addition, it can lead to bleeding disorders such as spotting, bleeding or a generally increased and also longer menstrual period. In this case, it may be advisable to have the seat of the spiral checked. In addition, the spiral often causes an increased outflow.
The risk of ectopic pregnancy is also slightly increased in the case of spiraling prevention. If a woman becomes pregnant despite the spiral, she must have it removed. Here is the 20 percent risk of miscarriage, which is still higher if not removed.
Spiral: prevention suitable for everyone?
Spiral contraception is not suitable for everyone due to the above-mentioned disadvantages. In general, the use of another method of contraception is recommended for the following groups:
- Young women and girls who have not yet had a baby or whose womb is still growing
- Women with cycle and menstrual disorders
- Blood clotting disorders and anemia
- Inflammation and (suspected) malignant diseases in the uterus and genitals
For the following conditions, inserting the coil should only be used after careful consideration of the risks with the physician:
- Benign fibroids of the uterus
- kidney disease
- Diabetes mellitus
- Treatments that require the use of diminishing effects on the immune system
In contrast, the spiral is suitable for the following persons:
- Women who already have children and have completed family planning
- Women who can not take hormonal contraceptives or who do not want to forego a natural cycle
- Women who do not want to think about contraception over a period of several years
The advantages of the spiral are mainly that the user can not commit any handling errors (most common reason for pregnancy despite contraception) and not how to forget about the pill. Women who already have children usually get along with the spiral.
Spiral: cost and price
The costs of the spiral must be borne by the patients themselves, except for women up to the age of 20 and women entitled to social welfare. The costs for the spiral amount to between 25 and 40 euros, depending on the model. In addition, the physician calculates an amount between 80 and 130 Euros for inserting the spiral.
The first ultrasound examination to check the position takes place four to six weeks after the onset of the spiral and is taken over by the health insurance. The further check-ups, which are due every six months, must be paid by the patient herself. As a rule, the spiral thus allows a more cost-effective form of contraception than the pill, if it is used for a period of at least three years.