Spiral: contraception without hormones

Spiral: contraception without hormones

The IUD, also known as an intrauterine device, is one of the most widely used contraceptives in the world, alongside the pill and condom. The coil, which is 2.5 to 3.5 cm in size, is inserted into the woman’s uterus. While the first models of intrauterine devices had the shape of a spiral and thus gave it its name, today’s copper spiral is usually T-shaped, consists of plastic and has a shaft wrapped with copper wire. Sometimes, a gold plate is also incorporated, which makes the spiral easier to recognize on the ultrasound. Contraception with the spiral is considered safe and can remain in the body for five years if well tolerated.

Spiral: effect and function

How exactly the spiral works is not known in detail; experts assume that several mechanisms cause contraception:

  • Copper ions released into the uterus have a toxic and inhibitory effect on sperm. In this way, they lose their ability to orientate themselves, their lifespan and their mobility.
  • The IUD is a foreign body and thus causes inflammation in the lining of the uterus, which is not dangerous because viruses or bacteria do not cause it. The inflammatory cells can degrade sperm directly; at the same time, implantation is prevented by changing the lining of the uterus. In emergencies, the “morning after” (similar to the “morning after pill”) is sometimes used.
  • The impaired functioning of the fallopian tubes impedes the transport of eggs and sperm.
  • IUD: Insertion only by a gynaecologist


Insert spiral – remove spiral.

The spiral is always inserted in gynaecological practice. A unique sleeve, which facilitates insertion through the cervix into the uterus, is used for this purpose. Since the cervix is ​​slightly dilated during menstrual bleeding and pregnancy can usually be ruled out, the gynaecologist will insert the IUD during the last days of the period.

The spiral is precisely placed with the help of ultrasound; the situation is also checked at regular intervals. The women can also check the position of the spiral themselves using control lines that can be felt like the thread of a tampon.

The spiral insertion does not take long but usually causes a pulling or pain. Young women, in particular, whose uteruss is still growing, find the insertion of the spiral uncomfortable. A painkiller may be advisable here. In rare cases, injuries can occur when inserting the spiral.

IUD: side effects and safety

Shortly after its development, the copper spiral came into disrepute because a specific model led to severe inflammation due to design errors. The modern spirals also harbour an increased risk of infection in the first few months after insertion. Inflammation of the pelvic area is more common initially, especially in young women. The risk is increased by frequent sexual intercourse with changing partners. Germs can rise more easily via the spiral thread, which, in the worst case, can even lead to infertility.

Young women and girls, as well as women who have not yet given birth, are also at greater risk of the IUD being expelled. In addition, there can be bleeding disorders such as spotting, bleeding between periods or a generally increased and longer menstrual period. In this case, it may be advisable to check the spiral’s fit. In addition, the spiral often causes increased discharge.

The risk of an ectopic pregnancy is also slightly increased when using a spiral contraceptive. If a woman becomes pregnant despite having an IUD, she must have it removed. There is a 20 per cent risk of miscarriage here, but this is even higher if it is not removed.


Spiral: Is contraception suitable for everyone?

IUD contraception is not for everyone due to the disadvantages mentioned above. In general, the use of another method of contraception is recommended for the following groups of people:

  • Young women and girls who have not yet had a child or whose uterus is still growing
  • Women with cycle and menstrual disorders
  • bleeding disorders and anaemia
  • Inflammation and (suspected) malignant diseases in the area of ​​the uterus and genitals

In the case of the following diseases, the insertion of the spiral should only be used after careful consideration of the risks with the doctor:

On the other hand, the spiral is suitable for the following people:

  • Women who already have children and have finished planning a family
  • Women who cannot take hormonal contraceptives or do not want to go without a natural cycle
  • Women who do not want to worry about contraception for several years

The main advantages of the spiral are that the user cannot make any handling errors (the most common reason for pregnancy despite contraception) and cannot forget the pill, for example. Women who already have children usually get along with the spiral.

Spiral: cost and price

The costs of the spiral are to be borne by the patients themselves, except for women up to the age of 20 and for women entitled to social assistance. Depending on the model, the spiral costs between 25 and 40 euros. The doctor charges an additional amount of between 80 and 130 euros for the insertion of the spiral.

The first ultrasound examination to check the situation occurs four to six weeks after the spiral has been inserted and is covered by health insurance. The patient must pay for further check-ups, which are due every six months. As a rule, the spiral thus enables a more cost-effective form of contraception than the pill if it is used for at least three years.


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