Contraception: copper IUD
The copper IUD is a hormone-free contraceptive that the gynecologist uses in the uterus. It can stay there for several years and reliably protect against pregnancy
T-shaped copper spiral
© Your Photo Today / A1PIX
Right-angled T-shaped and with a two and a half to three and a half centimeter long plastic rod around which a fine copper wire is wound, a T with slightly curved side arms, a horseshoe-shaped oval with barbs, a plastic frame in the shape of a 7, each with copper wire around the Carrier rod: This is what copper spirals look like.
At the lower end they have two control or retrieval threads made of non-absorbable plastic. Normally, the doctor pulls the coil out again with the help of the threads at the appropriate time. Until then, the woman can regularly feel the thread herself and thus check the presence of the spiral.
Copper spiral: many models
The coil is also called the intrauterine coil; intrauterine means in the womb. Some doctors prefer to speak of an intrauterine device (IUD). There are the different shapes described above in different sizes and different metal alloys, made entirely of copper or copper with gold or silver content. Gold or silver are said to improve durability, and silver is also supposed to protect against pathogens.
How does the copper spiral work?
The copper content is decisive for the preventive effect. The steadily released copper ions inhibit the sperm and shorten their lifespan. The copper changes the mucus in the cervix and the secretions from the uterus and fallopian tubes. Possibly still active sperm reach the egg cell more poorly, and this, if exceptionally fertilized, cannot implant itself. Contraceptive protection is provided immediately after insertion.
And what is the copper chain?
The copper chain is a further development of the copper spiral. Since it has no rigid framework, it is very flexible (frameless IUD) and adapts to the shape of the uterus. It consists of several copper links that are strung like pearls on a surgical thread. Its upper end is anchored in the vault of the uterine wall. Insertion and removal - the ingrown end of the chain is detached again - are carried out by specialized doctors. The copper chain can also be used for women with fibroids, for example.
Hormones: contraception with or without? Let us advise you in detail
© Banana Stock / RYF
Insertion of the coil, controls
A woman should first seek precise advice from her gynecologist about which method of contraception is best for her, what the benefits and possible risks are. Before the insertion, the gynecologist examines the woman physically. It excludes changes that speak against the insertion of the IUD, for example pregnancy, an inflammation in the genital area or a change in the uterus. If everything fits, the woman confirms in writing that she has been adequately informed and that she wants the contraceptive measure.
The copper IUD is best placed in the uterus during or at the end of the menstrual period. The cervix is then somewhat dilated and pregnancy is unlikely. If necessary, the woman can be given a pain reliever beforehand.
After insertion, the doctor shortens the retrieval sutures appropriately, they then protrude about two centimeters into the upper vagina. He uses ultrasound to check the position of the spiral. He also explains to the woman how she can feel the retrieval threads herself.
Four to six weeks later or after the first menstrual period that follows, the doctor will check that everything is okay. An ultrasound examination shows whether the coil is correctly positioned. The statutory health insurance companies usually pay for this first check-up.
The later controls take place about every six months, in the case of special features at any time earlier.
Advantages of the copper spiral
The copper coil is suitable for women of all ages. The natural monthly cycle is retained. The copper IUD provides long-term and hormone-free prevention. Side effects that can occur with hormone preparations do not occur with the IUD. Depending on the model, it can normally remain in the uterus for three to five years or longer, up to a maximum of ten years. After removing the IUD, pregnancy is possible in the next cycle.
The copper IUD is also well suited for contraception during breastfeeding, and doctors insert it six to eight weeks after delivery at the earliest. Before the uterus has regressed, there is too great a risk of the coil being expelled or the uterus injured.
Application errors are as good as impossible with the IUD. During the time when the IUD remains in the body, women do not have to think about contraception.
Disadvantages of the copper spiral
Temporary abdominal pain or back pain are possible in the first few days after insertion. Menstrual bleeding can be heavier, longer and more painful. The coil can also be ejected unnoticed with the bleeding. It is therefore important that the user feels the withdrawal thread regularly after her period.
If the symptoms are severe or persistent, including bleeding, unusual discharge or fever, the woman should see the gynecologist. It could be a sign of infection. Perhaps the IUD is no longer correct and the safety of contraception is impaired.
The risk of a fallopian tube or ectopic pregnancy is slightly higher. However, pregnancies under the IUD, which is one of the safe contraceptive methods, only rarely occur.
A sign of pregnancy can be that you miss your period. If severe abdominal pain sets in, there may be a pregnancy outside the uterus. The symptoms here, however, are different and differently pronounced. Abdominal pain can also have many causes. In any case, menstrual disorders and other abdominal complaints should always be clarified by a gynecologist, especially if they have occurred under the IUD.
Contraindications to the copper coil
Clearly: pregnancy and IUDs - they don't go well together. Pregnancy is an exclusion criterion. If it occurs with the IUD in place, the doctor will usually advocate removing the IUD, even if this may lead to a miscarriage. The risk of complications in pregnancy, such as infection or miscarriage, is higher if the IUD remains in the uterus.
The copper IUD is also not suitable for women with changes in the uterus, such as myomas or a malignant disease. Even if there is an increased risk of infection for sexually transmitted diseases, a tendency to heavy bleeding, abdominal inflammation or after previous ectopic pregnancies, the IUD is ruled out as a method of contraception.
Blood clotting disorders or disorders of the copper metabolism (copper storage disease) are further contraindications, as is an allergy to a component of the IUD.
Diabetes mellitus, kidney disease, or certain drug treatments, such as blood-thinning or immune-suppressing drugs, are situations in which the doctor will carefully examine whether an IUD is an option.
If all else fails: spiral afterwards
After unprotected sexual intercourse or contraceptive failure, the copper IUD, as well as the copper chain (see above), can be used within five days to prevent pregnancy as an emergency. More on this in the article "Emergency contraception".
The IUD only protects against pregnancy. To avoid contracting sexually transmitted diseases, condoms should be used.
As with any method of contraception, it is strongly recommended that you keep the suggested appointments with your doctor.
For women up to the age of 20 who have statutory health insurance or are entitled to social assistance, the responsible cost bearer pays for the IUD and for inserting it. To be on the safe side, you should ask your doctor, health insurance company or a counseling center for family planning, pregnancy and questions about contraception beforehand.
Pearl index: copper spiral: 0.9 to 3 (or lower, about 0.4 to 1), depending on the copper content; Copper chain: 0.1 to 0.5