How does the contraceptive loop work?
The loop, which lies in the uterus, does not prevent ovulation but rather the implantation of the fertilized egg. There is no effect on hormonal balance. This method of contraception is very safe and has a Pearl-Index nearly similar to the pill. The Pearl Index is a method used to assess the effectiveness of birth control methods. The contraceptive coil is also a perfect solution for women who have not yet had children. The assumption that there are more fallopian tube infections with use of the coil has not been confirmed.
After removal of the coil, fertility is immediately restored.
In what ways do the different types differ? What are advantages/disadvantages?
Copper IUD (Cu-T, Nova-T ® , Multiload ® etc.)
The shaft is coiled by a copper string. Copper prevents the sperms from gaining energy, which leads to a lower fertilization rate. Advantages: about as safe as the pill, cheapest solution, can stay inserted for 3 to 5 years. Disadvantages: bleeding might increase or get more painful. As with all coils, there is no interference with or change in the menstruation cycle. Your body’s own rhythm will not change. In individual cases, this can result in somewhat irregular bleeding or in rare cases, heavy bleeding.
The Gynefix is a hormone free nylon thread on the end of which small copper pearls are fixed. Because the nylon thread is very flexible, it fits itself neatly to the uterus. It should be replaced after 5 years. Advantages: In contrast to other coils, there is less increase of pain during menstruation. Disadvantage: due to uterine contractions, the Gynefix could be expulsed and the contraception lost.
A couple of 2mm copper pearls are strung onto a platinum string. For correct placement, this string lies inside a small insertion tube. When released from the insertion tube, it springs into a coil-form, forming a 3D-structured ball which fills the uterus completely and has contact with the uterine lining. The advantages and disadvantages are the same as with the Gynefix. The copperball is relatively new in Europe and so far no long term studies exist for this particular contraception.
All hormonal spirals are T-shaped similar to the Copper IUD. They are now available in three different sizes with a different release of progesterone which is given locally into the uterus.
They all contain Levonorgestrel (which is a derivate of progesterone) in their shaft. Added functions: The endometrium (lining of the uterus) is hardly or no longer replenished, minimizing or preventing bleeding during menstruation. The hormone thickens the cervical mucus to prevent sperm and bacteria from entering your uterus. Fertilization is rare. There is less salpingitis (inflammation of the fallopian tubes) compared to other sexually active woman.
The Mi… Spiral© is the 5 year coil with the “biggest” hormonal depot compared to the others. You will have no/rare bleeding and pain. No measurable influence of hormones in the body. Disadvantage: no overview of ovarian function as bleedings stop.
The Kyleena© is new (since April 2017) and belongs to the same family. You can leave them for 5 years but the levonorgestrel depot is a little smaller than in the Mi… spiral and you will have poor bleedings. The size of the device is the same as Jaydess. The prize is a Mi… Spiral.
The Jaydess© has the small body as Kyleena and the smallest hormone depot. It distributes less hormones per day, which leads to minimized buildup of the uterus lining. The effect is comparable to the pill's minimization of bleedings. Women with this spiral tend to have their menstruation; however, the flow is less heavy than before. Advantages include a lesser influence on the body physically and the possibility to observe the menstrual cycle. The contraception is safe for up to 3 years.
About 1-2% of women do not tolerate the spiral and extraction of the device is necessary. The expulsion of the spiral is very rare but can sometimes occur (and is included in safety measurements). Thus, an ultrasound control is advised after 6 and 12 months.
Pregnancy is very rare with a spiral. It could lead to ectopic pregnancies, in which case an early diagnosis is crucial. After extraction of the spiral, a uterine pregnancy usually remains intact. There is no higher risk for the embryo and an abortion is not necessary.
Before requesting a spiral, you should thoroughly think about other contraceptive methods which might be better suited to you, such as condoms, the pill etc.