What Is a Progesterone IUD?

A contraceptive ring is a contraceptive device placed in the uterine cavity. Since the devices used in the early stages are mostly circular, it is usually called a contraceptive ring, also called an intrauterine device, or an IUD for short.

IUD

IUD

A contraceptive ring is a contraceptive device placed in the uterine cavity. Since the devices used in the early stages are mostly circular, it is usually called a contraceptive ring, also called an intrauterine device, or an IUD for short.

Usually made of stainless steel, plastic, silicone rubber and other materials, the IUD without medicine is called inert IUD, such as IUD plus progesterone or copper, which can improve the contraceptive effect, it is called with medicine or active Intrauterine devices are one of the types of birth control devices commonly used in China. There are many types of intrauterine contraceptive devices, such as metal single ring, hemp wreath, mixed ring, birth control ring, T-ring and so on.

Chinese name

IUD

Foreign name

Contraceptive Device

Alias

IUD, IUD

Category Name

Intrauterine device and access device

Management category

Class III medical devices

Development of birth control ring

The intrauterine device (IUD), also called the birth control ring ^[1] , was developed in ancient times. According to records, ancient Arabs and Turks put small stones in the camel's womb to prevent the camel from becoming pregnant during a long journey in the desert. In the mid-11th century, Israeli scientist Avicenna reported on the use of contraceptives. In the late 19th century, the use of a metal handle with a handle was used to induce labor in order to correct the position of the uterus, and it also played a role in preventing pregnancy. In fact, these devices do not enter the uterine cavity and are not really functional IUDs.

The first intrauterine device designed for human contraception was Polish physician Richard Richter, who made a circular device from silkworm gut in 1909 and fed it into the uterine cavity with a notched rod. In 1923, K.Pust developed into a cervical and uterine device combined with silkworm gut loops and handles. Although it has been reported clinically, it was later opposed by physicians due to pelvic infection and failed to promote it.

For the first time, the IUD was promoted and improved by Emst Grafenberg, Germany. He improved the star-shaped IUD made from silkworm gut and silver wire into an alloy ring, that is, a Grignard ring.

After 1920, Grignard rings became popular in Germany. In 1925, Japan's Ota designed a wheel-shaped plastic ring. In 1934, the Ota ring applied gold and gold-coated silver rings, and its effect was said to be higher than that of the Grignard ring.

In 1957 Oppenheimer reported on 329 women in Israel, and Ishihama reported on the clinical trial results of 18,594 cases in 149 hospitals in Japan, with failure rates of 2.5% and 1.7%, respectively. And there are no obvious complications, which cause people's attention.

In 1962, the Population Council established the Cooperative Statistical Plan (CSP), which carried out an extensive evaluation of various IUDs. The second IUD international conference was held in 1964 to study and analyze various IUDs. International assessments were performed on 27,000 placed women and more than 39,000 users.

The third IUD International Conference was held in Cairo in 1974. The plastic IUD was used as a carrier to add metals, hormones, and anti-bleeding drugs, which was called the second-generation active IUD.

The Fourth International Conference on IUDs was held in New York in 1994 to evaluate the performance of IUDs commonly used and newly studied in various countries, as well as the results of large-scale, multicenter comparative studies. According to their pregnancy rates, the current active IUDs are divided into three categories: the first category has a pregnancy rate of 2% to 3% one year after placement; the second category has a pregnancy rate of 1% to 2%; the third category has a pregnancy rate 1%. It is recommended to promote the third category.

Domestic research in recent years has focused on the mechanism of IUD bleeding side effects and long-term safety research. In the study of new IUDs for preventing IUD bleeding, it was shown that adding indomethacin to copper-bearing IUDs can significantly reduce bleeding after implantation and improve the clinical use effect. New products with indomethacin, copper IUD, and memory alloy IUD were available from 2001 to 2002.

According to the data of the Fourth International Conference on IUD, the total number of people applying IUD in the world has exceeded 100 million, while China accounts for more than 80 million, and about 40% of the measures adopted by women of childbearing age. ^[2]

How the birth control ring works

1. The copper ions in the copper intrauterine birth control ring increase the aseptic inflammatory response of the endometrium and interfere with the enzyme system activity necessary for implantation, which is not conducive to the implantation of fertilized eggs and blastocyst development.

2. Copper ions may also change the biochemical characteristics of cervical mucus, affect the sperm's activity and capacity, and further enhance the contraceptive effect. Copper ions can also kill sperm and fertilized eggs directly.

3. The role of prostaglandins: The long-term stimulation of the birth control ring causes the endometrium to produce prostaglandins. On the one hand, prostaglandins can increase uterine contraction and fallopian tube peristalsis, and promote fertilized eggs with insufficient development and division degree to be sent to the uterine cavity in advance and affect the implantation.

4. A large number of prostaglandins can strengthen the effect of estrogen, so that the decidual response of the endometrium during pregnancy is suppressed, which is not conducive to implantation of fertilized eggs.

5. Ring energy can interfere with the normal cycle change of the endometrium, which is not conducive to implantation; it can also affect the transport or capacitation of sperm. IUDs containing high doses of levonorgestrel may also inhibit ovulation, change cervical mucus properties, and are not conducive to sperm penetration.

The mechanism of human pregnancy is that a woman's ovaries release eggs, the eggs are fertilized at the ampulla of the fallopian tubes, and then develop into embryos (mulberry embryos) in the fallopian tubes, which are then implanted into the uterus and implanted. And contraception is to block any of these steps.

The contraceptive principle of the intrauterine contraceptive device (IUD) is: When an embryo wants to implant in the womb, the constantly moving IUD scrapes the uterine wall, causing aseptic inflammation of the uterus, making the embryo unable to function properly The bed conceives, which causes miscarriage to achieve contraceptive purposes. The essence of intrauterine contraceptive device (IUD) is a long-term gentle curettage abortion, which is the first choice for Chinese women after marriage.

Common types of birth control rings

IUDs without drugs are called inert IUDs, such as IUDs with progesterone or copper, which can improve the contraceptive effect. They are called medicated or active IUDs.

Inert IUD: Made of stainless steel wire or plastic, silicone, such as metal single ring, twist ring and stainless steel palace ring.

Copper intrauterine device: It is the most widely used type of active intrauterine device, which uses copper to kill sperm or fertilized eggs to enhance the contraceptive effect.

Intrauterine device that releases progesterone: The progesterone contained in the intrauterine device is slowly and constantly released into the uterine cavity, which improves the contraceptive effect and can significantly reduce bleeding.

Intrauterine device that releases hemostatic drugs: It can effectively control the increase in menstrual flow after the intrauterine device is placed.

The foreign body of the IUD can cause asexual inflammation of the endometrium, which affects the implantation of fertilized eggs. In addition to the above-mentioned effects of the washed IUD, in addition to the above-mentioned effects of the copper-containing IUD, the copper-containing IUD releases copper ions and has a killing effect on sperm and embryo.

Intrauterine devices containing progesterone can release a small amount of progesterone into the uterine cavity for a long time, which causes the endometrium to shrink, which is not conducive to implantation of fertilized eggs. These two effects make the contraceptive effect of active intrauterine devices even stronger.

How to use birth control ring

The method of using the vaginal contraceptive ring is very simple. On the fifth day of menstrual cramps, the first-time user can place it in the deepest part of the vagina (the posterior fornix of the vagina).

The front and back walls of the vagina are usually closed, so the vaginal contraceptive ring is generally not easy to prolapse in the deep part of the vagina, but the user should go to the hospital for regular inspections, and learn to check and correct the position of the ring themselves under the guidance of medical staff.

Because the ring is small and deep in the vagina, there is no obvious foreign body sensation in the same room, and it has no effect on sexual life.

If there is any influence, the ring can be taken out during sexual intercourse, and then inserted after sexual intercourse, which does not affect the contraceptive effect.

It is best to place the IUD 3 to 7 days after menstruation is clean. If the ring is taken after the abortion, the depth of the uterine cavity should be well controlled, preferably less than 10 cm. The lactation ring should be released more than 3 months after delivery, and 6 months after cesarean delivery. If you have a spontaneous abortion, it should be appropriate to recover more than one normal menstruation. In China, the intrauterine device with copper is used as the clinically preferred contraceptive ring. After the contraceptive ring is placed in the uterine cavity, the body and endometrium have a process of adaptation. Some people may experience side effects such as increased leucorrhea, bloody leucorrhea, increased menstrual flow, abnormal menstrual cycles, and lower abdominal discomfort after the ring is released. Most of these symptoms disappear naturally within 3 months to 6 months, and have little effect on the body. However, severe complications such as uterine perforation, ectopic pregnancy, intrauterine device ectopic, infection (endometritis, accessories, etc.) can be caused by inadequate aseptic operation, unskilled technology, improper placement or rough movement. Inflammation, etc.), irregular bleeding and menstrual disorders can cause infertility. After the contraceptive ring is placed, it will quickly act as a contraceptive, and the contraceptive effect disappears immediately after removal. According to clinical observations, many women get pregnant again soon after taking the ring. Therefore, if there is a pregnancy plan, the contraceptive ring should be removed in time. In addition to the serious complications mentioned above, it generally does not cause infertility. If there are no side effects and complications, the metal IUD can be placed for 8 to 10 years, the plastic IUD can be placed for 3 to 5 years, and the IUD with medicine can be placed for 1 year. After taking out, replace the new IUD.

Advantages of birth control ring

Because the vagina is closed before and after than usual, the vaginal contraceptive ring is generally not easy to prolapse in the deep part of the vagina. The ring is small in volume and deep in the vagina. There is no obvious foreign body sensation in the same room, and it has little effect on sexual life.

Although the IUD in the uterine cavity does not interfere with follicular development and mature ovulation, nor does it completely prevent sperm-egg binding, but due to the mechanical and / or drug release of the IUD in the uterine cavity, it prevents the implantation of fertilized eggs from being affected. . Through histological, histochemical, and biochemical examination of the endometrium, it is believed that the IUD can change the body fluid environment in the uterine cavity, and increase the activities of the endonuclease, acid phosphatase, and alkaline phosphatase, thereby affecting Growth, development and implantation of fertilized eggs.

IUDs have a good contraceptive effect and have a long validity period. Non-fertile women who have given birth or are willing to use this method for contraception can use it. Of course, using this method of contraception is not 100% insurance, and pregnant women with rings are more common clinically.

There are many types of IUDs, and doctors will choose the appropriate model based on the size of a woman's cervix.

Does not inhibit ovulation and does not affect the female endocrine system, thus avoiding the adverse reactions of general drug contraception. No major harm to the body, long-term contraception.

Does not affect sexual life: Many people like to bring a set when they are in the same room, but they do not have that high sexual interest and are very troublesome. Seriously affected the life between husband and wife.

Does not affect women's fertility: If you want a baby, just remove the ring and it will not affect the body.

Contraindications to birth control

Acute pelvic inflammatory disease, acute vaginitis, severe cervical erosion, excessive menstrual bleeding or irregular bleeding, uterine fibroids, and narrow neck opening; women with severe systemic diseases should not put on the ring, otherwise it will cause inflammation and menstruation. The amount increases.

The following conditions are not suitable for use:

1. Severe systemic conditions such as heart failure, severe anemia, bleeding disorders, and the acute stages of various diseases.

2. Reproductive organ inflammation, pollution, such as vaginitis, severe cervical erosion, and acute and chronic pelvic inflammatory disease.

3. Frequent or excessive menstruation and irregular bleeding.

4. Cervix is too loose, severe old cervical laceration, severe uterine prolapse.

Birth control ring adverse reactions

Some women may experience adverse reactions after placing a birth control ring.

1. Bleeding

   The increase in fibrinolytic enzyme activity by the birth control ring is the main cause of bleeding, and 6-aminoacetic acid can reduce bleeding. A small amount of irregular vaginal bleeding does not require treatment; if the amount of bleeding is large, drugs can be used to stop bleeding. If the treatment fails, the ring can be removed. Those with prolonged bleeding need anti-infective treatment.

2. Backache, abdominal fall

   It may be caused by too large or low birth control ring, causing contractions. You can try antispasmodics first. If it doesn't work, you can choose a new ring.

3. infection

   A few can cause ascending infections due to inadequate disinfection or aseptic manipulation. After the occurrence, the ring should be taken first, and then treated accordingly.

4. IUD incarceration

   Individual developmental devices can be embedded between the uterine muscle walls. The shallower can still be pulled out with the ring hook; the deeper, the cervix must be dilated to size 6-7, then the ring is brought to the cervix, and the loop wire is cut straight with two hemostats and then pulled out. Operation should be slow and gentle. If necessary, it can be hooked under the guidance of B-ultrasound to reduce the blindness of operation. The ring is deeply embedded, and even those who have penetrated the pelvic wall out of the palace wall should be removed by laparotomy or laparoscopy.

5. IUD falls off

   Mostly occur in the first year of the band, especially during the first 3 months of menstruation. The natural fall of the IUD is related to the ring being too large, too small, not placed on the bottom of the uterine cavity, poor quality of production materials, insufficient support, loose uterine cavity of the subject, excessive labor intensity or excessive menstruation. Therefore, follow-up observation should be taken in the first year after the ring is released.

6. Pregnancy with ring

   Pregnancy with a ring may be caused by improper ring selection and placement. You should be aborted and a new ring selected. ^[3]

Birth control side effects

1. Uterine perforation: The mechanism of uterine perforation caused by the upper ring is not clear. It is generally believed that it may be caused by improper uterine size or improper doctor's operation. In addition, when a woman is exercising violently, the birth control ring in the body is sharp due to its sharp shape, and it may also cause damage to the uterus due to physical inertia. Unexplained uterine contraction may also cause the uterine ring to squeeze and cause uterine perforation.

2. Damage to other organs: In a few cases, intrauterine devices can enter the abdominal cavity after perforating the uterus, which can cause ectopic IUDs. IUDs may be located differently in the bladder, pelvis, and mesentery.

3. Excessive menstrual flow: Some IUDs contain copper ions, which have cytotoxic and hemolytic effects, resulting in excessive menstrual flow and bleeding without clotting, which is normal.

4. Ectopic pregnancy: If the embryo is implanted in the fallopian tube and does not reach the uterus, the result is an ectopic pregnancy. The contraceptive principle of the IUD is to change the environment in the womb and cause abortion. It only plays a local role in the womb, so it can only prevent normal pregnancy in the womb, but not ectopic pregnancy.

5. Fibrotic lesions: IUDs are essentially foreign bodies in the human body. And foreign bodies in the human body can cause mechanical damage to local tissues, chronic inflammation, and fibrotic lesions, which is already medical common sense. 10 to 12 years after the ring, fibrotic lesions will occur in the endometrium.

Birth control ring precautions

1. Take appropriate rest ^[4] to avoid excessive physical labor. Generally, you should rest for 1-2 days after putting on the ring. Do not do heavy physical work within a week, so as not to cause the ring to fall off and bleeding.

2. Pay attention to hygiene and avoid infection. After placing the ring, the vulva should be cleaned daily and kept clean. Do not take a bath in the basin for 2 weeks. Do not share the room for 2 weeks to avoid infection.

3. Pay attention to the bleeding of the yin (yin) tract and the shedding of the ring. If you find that the yin (yin) tract bleeds more than twice the usual menstrual blood volume or the bleeding time is longer, the changes in the menstrual cycle should be checked at the hospital. During the first 3 months, pay attention to whether the ring has fallen off.

4. Periodic inspection. Generally, the first inspection after the release is after the first menstruation after the release, the second is within 3-6 months after the release, and the third inspection is a review of 12 months after the release , And review once a year thereafter.

5. Possible side reactions after ring release. If the menstrual flow significantly increases after the ring is placed, the menstrual period is significantly prolonged or there is often a small amount of bleeding, and there is severe back pain and abdominal pain, these are abnormal phenomena and should be checked at the hospital.

6. Pay attention to nutrition. After putting on the ring, you should pay attention to diet conditioning, and appropriately increase nutrition, especially eat some foods rich in iron, such as lean meat, liver, pork loin, eggs and other foods. Fresh fruits are generally conditioned by the diet mentioned above, which can effectively prevent physical energy consumption caused to the human body due to side effects after ring release.

Although the operation of putting the ring is simple and safe, it is a surgical operation after all. To avoid infection, sexual intercourse must be prohibited for 3 days before the operation and within two weeks after the operation. Pay attention to vaginal hygiene. Do not take a bath after putting the ring to avoid causing uterine cavity. infection. Should pay attention to rest for 1-2 days after surgery, do not do heavy physical labor and heavy exercise activities within a week, because the uterine cervix is loose after the ring is placed, the ring is easy to fall off.

Correct understanding of birth control ring

The birth control ring can achieve contraceptive purposes without affecting sexual life. It is easy to take, safe and effective, and has slight adverse reactions, which has become an important measure for women's postpartum contraception.

Birth control ring

Women with loose uterine mouth and heavy menstrual flow may fall off during the menstrual cycle. Therefore, when using the toilet during menstruation, pay attention to whether the ring falls out with blood. Generally, in the first month after the ring is released, go to the hospital for inspection once the menstruation is clean, and then check again after 3 months. It can be reviewed once every 1-2 years. Within 3 months after the ring is released, especially during the menstrual period, you should pay more attention to whether the ring is detached. If you find that the ring is detached, take other contraceptive measures in time, and wait to return to the hospital after the next menstruation.

Does the birth control ring induce cancer?

The widespread use of clinical practice in China has only begun in the 1960s. Some people do not have a correct understanding of birth control rings, and they are always afraid that long-term rings will induce uterine tumors. This worry is unnecessary. Some people have taken the endometrium for pathological examinations of women with different years of rings, and found that most of them are normal, and may have mild local inflammatory pathological changes, and this change will not have any adverse effects on the human body. No cancer was found.

Life expectancy of birth control ring

Studies have shown that: stainless steel metal rings can be placed for 15-20 years; silicone, plastic or other types of birth control rings can be placed for 5-7 years. After placing the ring, if you have obvious discomfort, you need to remove or replace the ring, or you can remove the ring when you plan to become pregnant. 3 to 7 days after the menstruation is clean, take the ring, the precautions after removing the ring are the same as the ring. Postmenopausal women stop ovulating and will not be pregnant anymore, so there is no need to prevent pregnancy anymore. Rings can be taken, usually 6 months to 3 years after menopause. Premature ring removal, because of menopausal instability, can be pregnant again, too late, atrophy of the uterus, it will cause difficulty in ring removal.

Birth control ring time

The intrauterine device is placed in the uterine cavity of women of childbearing age, and the purpose of contraception is achieved through mechanical stimulation and chemical interference, which does not avoid the adverse reactions of general drug contraception.

8 golden times for Sheung Wan

1. Placement during the menstrual cycle: It is generally suitable to place it within 3-7 days after menstruation is clean, because the chance of pregnancy within this time is very small; and the endometrium is a proliferative period, the endometrium is thin, and the chance of causing injury and bleeding after placement less. Foreign countries also choose to place it during menstruation, so the possibility of pregnancy before the device can be ruled out, and the cervix is loose, easy to operate, and the psychological burden of uterine bleeding after placement can be avoided.

2. Immediate placement after induced abortion: Immediately placed after induced abortion or forceps and curettage, at this time the cervix is loose, and secondary surgery can be avoided. Some studies have shown no increase in complications of infection and bleeding compared with placement during the menstrual cycle, and pregnancy and shedding rates are similar. However, it must be ensured that the contents of the uterine cavity are completely removed, there is not much bleeding, and the uterus is contracted before placement. If there is irregular vaginal bleeding before surgery. More bleeding during the operation, poor uterine contraction or suspicious uterine cavity contents are not completely removed, then wait for the next menstruation before release.

3. Placement after induction of mid-term pregnancy: Immediately after mid-pregnancy during non-vaginal surgery, such as abdominal puncture of amniotic cavity rivanol for labor induction, after fetal delivery, during uterine surgery. The placement of IUDs after induction of labor in the second trimester of pregnancy generally has a high shedding rate, even 5 to 10 times higher than that of early abortion. Therefore, if there is a possibility of residual tissue in the uterine cavity, there may be a potential infection and water sac or other Drugs should not be placed by vaginal induction.

4. Those who are amenorrhea at 42 days postpartum and lactation, except for pregnancy and good uterine contraction recovery, lochia clean for more than 5 days, and no uterine cavity or perineal infection, can be placed with an IUD to reduce lactation pregnancy. However, the factor uterine muscle layer is brittle and thin, so care must be taken to prevent perforation.

5. Caesarean section should be placed half a year later.

6. The IUD has expired without any symptoms and can be replaced immediately after removal.

7. The placenta is placed immediately after delivery and at the time of cesarean delivery. Its advantages are that the delivery and placement of the IUD are completed at the same time to avoid secondary surgery; the disadvantage is the high rate of shedding. Such as broken water for more than 12 hours, delayed labor, vaginal operations such as surgical births, hand placenta, etc., are likely to cause infection, it is not appropriate to place an IUD. Suspicious placenta remains, it is best not to place an IUD because of the possibility of bleeding. For classical cesarean section, the factor incision is located in the uterine body. The IUD is easy to incarcerate from the incision or penetrate the uterine wall into the abdominal cavity. Generally, it is not placed;

8. After the intercourse (after intercourse). Women who are concerned about pregnancy after intercourse because they have not taken contraception or have an accident (such as a broken condom) and are planning to take long-acting birth control can place a copper-containing active contraceptive device within 72 hours.

Although there are many kinds of placement time mentioned above, it is usually placed most often within 3 to 7 days of menstrual cleanness.

Birth after birth control

After the birth control ring was removed, its effect of interfering with sperm and egg binding disappeared, and the endometrium returned to normal. Studies have confirmed that 75% of women can conceive within 6 months of ring removal; 90% of women can conceive within 1 year after ring removal. Moreover, after the ring was conceived, there was no effect on fetal development. However, in order to repair the endometrium well, after taking the ring, other methods should be used for contraception for 1-3 months before pregnancy.

What to do about birth control pregnancy

Cause of pregnancy

1. The placement is not allowed. For example, if the birth control ring is not placed on the uterine floor, it cannot play a contraceptive role.

2. After the ring was placed, physical labor in the squatting position or sexual life caused the birth control ring to shift and fall off, resulting in failure of contraception.

3. Suffering from diabetes, hyperglycemia, increased body fluid acidity, and corrosion of metal rings affect contraception.

4. The ring was left for too long and was not replaced in time, and the endometrium was exfoliated and menstrual scouring month after month, resulting in ring dislocation or downward movement.

5. Improper model selection, such as a larger uterus and a smaller ring model, will cause the ring to shift or fall off in the uterus and fail to play a contraceptive role.

Previously, it was thought that pregnancy with a ring has no effect on the fetus and will not cause fetal malformations. At this time, it is not necessary to terminate the pregnancy and remove the ring. The ring can be discharged with the placenta after the fetus is delivered. In recent years, it has been found that the chance of ectopic pregnancy with ring pregnancy is slightly higher than that under normal circumstances.

Choice of birth control device

Do you know which IUD is suitable for you?

Assorted birth control rings

For most healthy women of childbearing age, copper-containing T "rings" or neoplastic 380 "rings" are preferred. The T "ring" is inexpensive and has a precise contraceptive effect. The ring body consists of a plastic stent and copper wire. Due to the large copper content of this "ring", the plastic stent is less flexible, so the side effects of postoperative bleeding and abdominal pain are slightly more. Those who cannot adapt to the T "ring" can try the new body 380 "ring". The ring is affordable, imported from Germany, and has excellent technology. The polyethylene stent is soft and has good compliance, which reduces the irritation of the palace wall. Its adverse effects after surgery are small and users can accept it.

IUD contraception has a certain failure rate, and this failure is mostly caused by "out-of-loop", that is, the IUD is discharged from the uterine cavity by itself. And "out-of-loop" is mostly related to user's cervical slack, so such women should choose a contraceptive device carefully. You can try the mother ring, which is V-shaped, consistent with the shape of the uterine cavity, the stent is a memory alloy, has good compliance and is not easy to deform, and the two ends are copper particles, which is not easy to fall off. Another feature of this ring is that there is no tail wire, so it reduces the incidence of reproductive tract infections and sexual discomfort. Of course, the lowest ring-breaking rate is the Gini ring imported from Belgium, which looks like a miniature chain and consists of six copper sleeves made of polypropylene surgical sutures. Because the entire ring body has no stent, its shape is relatively free and can change with the uterine cavity. At the same time, one end of the ring is embedded in the muscular layer of the uterine wall, so the dropout rate is low.

In addition, some women usually have more menstrual flow, but they want to use an intrauterine device. What should I do? It is best to choose a medicated IUD. The IUD is imported from Germany, and its shape is the same as the new body 380 "ring", except that the longitudinal wall is surrounded by a medicated (contraceptive) cylinder. Once the IUD is placed in the uterine cavity, The medicine will be slowly released in small doses, and it only acts on the inside of the uterine cavity and has no effect on the whole system. While significantly reducing the amount of menstrual blood, it also avoids the adverse reactions of general contraceptives. Because the whole ring does not contain copper, women who are allergic to metals can also try it.

In short, there are many types of contraceptive devices. Women and friends must be informed before "Sheung Wan", and strive to choose a ring that suits them so as to avoid unnecessary trouble.

The birth control ring has been used as the main method of contraception for more than 30 years, and it is a "safe", "effective", simple, and economical reversible birth control method declared by family planning. However, there are many women who are deeply concerned about the use of birth control rings. Below are some of the topics that readers are most concerned about.

Will the birth control ring be inserted into the uterus and cannot be taken out?

Many women are worried whether the birth control ring will be embedded in the uterine muscle wall for so long. In fact, such concerns are superfluous. This is because the birth control ring is placed in the uterus and is not attached to the uterine muscle wall. The endometrium undergoes periodic changes of shedding, bleeding, drainage and regeneration once a month, so that the birth control ring will not be fixed on the endometrium, nor will it grow in the myometrium. Therefore, it will not Will be embedded in the womb.

Stainless steel metal rings can be placed for 15-20 years; silicone, plastic or other types of birth control rings containing copper can be placed for 5-7 years. Some experts in China took the endometrium for pathological examination at the same time as taking the ring, and compared with those who did not release the ring, and found that there is no difference between the two. Therefore, if there is no other discomfort after Sheung Wan, there is no need to worry.

Are birth control contraceptives foolproof?

After Xiao Zhang went to the ring, her menstrual flow began to increase and her menstrual period prolonged. This time, more than ten days after her menstrual period, she went to the hospital for an ultrasound examination and found that her birth control ring was gone and she was pregnant. Xiao Zhang was puzzled: Now that the birth control ring has been put in, how can it fall off?

The birth control ring is lost because the birth control ring does not match the size and shape of the uterine cavity, and the support of the material is insufficient. In addition, as far as the uterus is concerned, the birth control ring is a foreign body. The rejection function of the uterus keeps the uterine muscles staying in an attempt to squeeze out the birth control ring. At this time, backache, abdominal pain, increased leucorrhea, and increased menstrual flow may occur. Therefore, in the first few months after the birth control ring is placed, the birth control ring is most likely to fall off. As time goes on, the uterus and birth control ring will be "peaceful." The longer the birth control is released, the less likely it is to fall off.

The birth control ring will cause pregnancy, so will the ring be pregnant? Xiao Zeng has been wearing a ring for seven or eight years. This time, she went to the hospital to check for irregular menstruation. The doctor checked her and told her that she was pregnant. She couldn't believe that the ring would still be pregnant. The reason for the pregnancy with a ring may be: the position of the birth control ring in the uterine cavity is low, close to the cervix, and it can not inhibit the implantation and development of fertilized eggs; It is suitable, or the birth control ring has been deformed, and the contraceptive effect has been lost. The endometrium cannot respond to the birth control ring, and the contraceptive effect cannot be achieved.

What are the circumstances of birth control ring

1. Those who release the ring for more than 5-10 years and require a new ring.

2. Patients with irregular vaginal bleeding or other symptoms that fail to treat. People with more vaginal bleeding or infections should take the ring in time.

3. Hope to have children.

4. One year after sterilization. Menopause for six months

5. For the above, it is recommended to take the ring.

6. Side effects are serious, those who switch to contraceptive methods.

7. Those with a ring pregnancy can be removed during abortion.

Birth control ring

Before taking the ring

An X-ray or B-ultrasound should be performed before taking the ring. The ring with the tail wire can ask the doctor to open the vaginal opening to see if there is nylon wire outside the uterine mouth to confirm that the ring is in the uterine cavity before taking the ring. . The best time to get the ring is within 3-7 days after menstruation is clean. This will reduce bleeding.

After taking the ring

1. Take proper rest within 2 weeks after taking the ring, do not do heavy physical activity, and eat nutritious food. Pay attention to the vulva cleanliness, ban bath and intercourse for 2 weeks.

2. On the day after ring removal, there may be mild lower abdominal discomfort, low back pain, or a small amount of vaginal bleeding. If the amount of vaginal bleeding after surgery exceeds the amount of menstruation, or the bleeding continues to be unclean after half a month, or the abdominal pain is severe, etc., please return to the hospital immediately.

3. Take appropriate anti-infective and hemostatic drugs after surgery

Birth Control Factors

Want to have a child before taking out the birth control ring?

After the birth control ring is placed in the uterine cavity, due to its special local effect, the endometrium can have a wonderful non-bacterial inflammatory response, which interferes with the combination of sperm and eggs, and the fertilized egg implants and develops in the endometrium. Grow to achieve contraceptive purposes. Of course, it ca nt be fixed after being ringed. When Xiao Li was preparing to perform abdominal MRI, the imaging doctor asked her to go to the gynecology department to remove the birth control ring before doing an MRI to prevent metal objects from affecting the image quality. In addition, because of some complications due to the upper ring, you can consider removing the ring after conservative treatment is ineffective; when the ring is used or menopause, you should remove the ring in time.

The purpose of putting the ring is for contraception. Since the menopause is not needed, it is not necessary to leave the ring in the body. Besides, when placing the ring, the doctor puts the appropriate type of birth control ring according to the size of the uterine cavity. After menopause, ovarian function declines, estrogen levels decrease, reproductive organs begin to shrink, the uterine cavity shrinks, and the cervix tightens, but the birth control ring does not become smaller. If it is not removed in time, it will cause difficulty in removing the ring. Therefore, menopausal women should remove the ring in time, there is no need to leave the foreign body (birth control ring) in the body.

Can the ring only be X-rayed?

X-ray image of birth control ring

Monitoring the situation of the birth control ring through perspective can make the birth control ring work better. This point line can meet the requirements and the price is cheap. Therefore, the traditional transparent ring mostly uses X-rays. So, is it possible to use only X-rays for the transparent ring? After Zhang had an irregular menstrual period with a ring, the doctor advised her to have a B-ultrasound to see the condition of the birth control ring. Xiao Zhang held the doctor to open the B-ultrasound, with a doubt in his face. I heard the sisters said that the through-holes are all X-rays. The doctor explained that the ultrasound can also check the birth control ring in the body, and some rings are not developed under the X-ray. Xiao Zhang also did not know what ring he was wearing. In addition, according to the ultrasound, he can also understand the uterus by the way And its attachments. Xiao Zhang heard the explanation and went to check cheerfully.

In recent years, more and more people have proposed to use ultrasound instead of X-ray examinations for three reasons: one is that X-rays have some radiation damage to the human body, so it should not be performed for a long time multiple times; the other is the size and shape of the human uterus The difference is very large, X-ray fluoroscopy cannot accurately determine the position of the ring and the adjacent relationship between the ring and the uterus, and this point has the advantage of ultrasound. Third, with the development of high technology, many emerged that cannot pass through the X-ray. The birth control ring, which causes the birth control ring to develop during X-ray fluoroscopy. For this reason, fluoroscopy is gradually being replaced by ultrasound.

Birth control ring medical research

"Study on Endometrial Morphology of TCU220C IUD for a Long Time":

100 women randomly selected to place TCu220CIUD for 5 to 12 years were in the IUD group ... The endometrium at 1 cm outside the indentation was basically normal, and the lesions were all limited to the indentation. Inflammation was found in all cases, mainly lymphocyte infiltration. The depth is 0.91 to 1.20 mm. There are cases of endometrial atrophy, 25% of those with IUD 5 years and <10 years, with a range of 0.81mm2; 71% with 10-12 years, with a range of 1.50mm2. Endometrial fibrosis was found in 18% of patients aged 5 years and less than 10 years, with a range of 1.87mm2; all patients with fibrosis in 10-12 years had a range of 2.04mm2. No hyperplasia and malignancy were seen in the IUD group. Hemorrhage and necrosis were observed in patients who had been placed for 10-12 years.

"Application of Hysteroscopy in Difficulty in Removing IUD":

1 case of intrauterine metal contraceptive device incarcerated 2/3 myometrium and rusted, and the 0.3 cm fracture was not completely removed

"Bladder Perforation Caused by IUD":

Intrauterine device (IUD) penetrates the anterior wall of the uterus completely or partially in the upper part of the cervix or inside the cervix, and in a few cases continues to penetrate the bladder forward. This rare complication is usually not diagnosed early.

"Using Hysteroscopy to Diagnose and Manage Difficult-to-Remove IUDs":

Of the 35 patients, 27 had IUDs or fragments in the uterine cavity (1 of which was a stainless steel IUD just placed on the submucosal fibroid pedicle, 1 had the IUD completely broken, and 1 had a broken T Most of the IUDs were embedded in the uterine wall), and no IUD was found in 8 cases (4 of them were removed by laparotomy, and the other 4 were estimated to fall off without treatment). Of the 27 cases, 19 cases were removed with crab claw forceps under hysteroscopy, 2 cases were removed with microhook, and 6 cases were removed with long curved vascular forceps.

"Six cases of severe contraceptive shock in female contraception":

From 1973 to 1978 in Jinzhou, 6 cases of severe septic shock occurred during birth control surgery, 4 died, and 2 cases were cured. There were 1 case of perforation of the upper ring, 1 case of perforation of the uterine ring (death), 2 cases of perforation of the ring uterus and simultaneous bowel injury (1 case of death), and 2 cases of septic shock with mid-term induction of labor in the hydrostatic sac.

"B-ultrasound diagnosis of a double-uterus pregnancy with a ring"

The patient had a pregnancy history of three times before the pregnancy. The patient reported that the first time was an "O" ring two years ago. After pregnancy, the ring was considered unreliable and changed to a "T" ring. Two pregnancies with a ring, she still has a "T" ring. The patient often checks the condition of the contraceptive device because she is worried about the pregnancy with a ring. No abnormalities are found each time.

"A Case Report of Contraceptive Circulation into the Rectal Womb":

It was discovered in February 76 that the pregnancy with a ring was performed in a hospital for abortion and the ring was taken. But after completing the abortion, the ring was not successfully obtained, and he went to a hospital on March 4th. See through: ring in the pelvic cavity.

"Clinical analysis of 24 cases of ectopic pregnancy with IUD":

Hallat et al. Reported that from 1953 to 1975, the incidence of ectopic pregnancy among women with devices was 9.85%, of which the incidence rose to 15.46% in the 17 months from 1974 to 1975 when a large number of IUDs were promoted. In recent years, there are reports in the literature that the increased incidence of ectopic pregnancy may be related to the widespread use of IUDs. As we all know, ectopic pregnancy is acute, and if not handled in time, shock can occur and endanger life. Therefore, there must be a high degree of vigilance on the combination of IUD and ectopic pregnancy. This article discusses the 24 cases of intrauterine birth control combined with ectopic pregnancy in the hospital in recent years.

"A Case of Gini's Birth Control Anomaly in the Ileum":

Discussion: IUD ectopic uterus perforation caused by improper manipulation and rough and excessive force. The IUD enters the abdominal cavity from the perforation. There are also incorrect placement of the IUD, which damages the uterine muscle wall, especially the Gini IUD. The structure is mainly made of 6 imports. A copper sleeve with a purity of 5mm and a diameter of 2.2him is connected in series on a non-biodegradable polypropylene wire. The surface area of the copper sleeve is 330 millimeters. One end of the surgical line has a ring-shaped nodule for fixing. When placing, gently push the push rod to fix the knot to the myometrium of the uterus. If the knot penetrates the myometrium during placement, the IUD will gradually enter the abdominal cavity due to the contraction of the uterus.

"One case of severe adverse reactions caused by Aimu MCu functional IUD"

On the first day after surgery, I did not feel any special discomfort. On the second day, I felt nauseous and my appetite decreased. No special treatment was performed. On the third day, I felt back pain, lower abdomen, swelling with frequent urination, and slightly swollen face. Taking anti-infectives and other drugs, no obvious improvement; on the fourth day, the above symptoms were significantly worsened, and the size of the stool could not be resolved, the face was swollen, dizziness could not stand, and was rushed to the hospital ... The second is related to copper poisoning. Its main table is Nausea, vomiting, abdominal pain, diarrhea, fever, chills, hemolytic anemia, jaundice, blood proteinuria, and severe myalgia, etc.

"One case of uterine perforation caused by intrauterine device":

Female, 45 years old. Due to lower abdominal pain, bloating, and backache for more than half a year. Needle-like pain when bending over or squatting

"Study on the mechanism of intrauterine device-induced uterine perforation with pigs and dogs":

(Foreign Medicine. Family Planning Volume)

Intrauterine devices (IUD_s) have been used for many years and have been widely accepted. There have been some reports of side effects of IUD_s in recent years, but the uterine perforation caused by IUD_s seems to have nothing to do with these side effects. Because IUD_s is widely used, the authors believe that it is necessary to explore the mechanism leading to uterine perforation. Five healthy sows weighing about 120 kg and nine healthy dogs weighing about 30 kg were used in the experiment. Open the abdomen under general anesthesia and place the IUD.

"One Case of Uterine Perforation Caused by Rupture of IUD":

The patient was 32 years old, and was admitted to the hospital on March 9, 2005 because of having an IUD for 8 years, menstrual disorders for more than 3 months, and lumbosacral pain for more than 10 days. ...... I felt pain in the lumbosacral region more than 10 days ago, it was unbearable, and I could not engage in manual labor.

Medical literature related to ring pregnancy (also called belt pregnancy): "Clinical preliminary analysis of 198 cases of belt pregnancy":

Nine hundred and ninety-eight pregnant women who underwent negative pressure aspiration in the family planning clinic of the hospital from January to June 2007 ... 69 cases of apparent pregnancy with IUD down in this group, accounting for 34.84%; those with normal IUD position Of the 129 cases, there were 27 cases with obvious indwelling time and 102 cases without obvious cause. Pregnant women with a device are 22 to 48 years old. Among them, 140 cases were under 35 years of age. Accounting for 70.70%. The IUD retention time for pregnant women with a device is 3 months to 20 years. Among them, 104 cases of IUD stayed within 5 years, accounting for 52.52%.

"Clinical analysis of 162 cases of pregnancy with device":

The types of IUDs, placement time, and ultrasound performance of 162 cases of pregnancy with device were discussed. Results The causes of pregnancy with a device were as follows: The abnormal position of IUD accounted for 62.97% (102/162), of which 90 cases (55.56%) of IUD moved down, 9 cases (5.56%) of incarceration, and 3 cases (1.85%) of ring inversion. The position of IUD was normal (with unknown reasons), accounting for 24.69% (40/162). Over 12.25% of the storage life (20/162).

"Related Factors Affecting Pregnancy with Device and Prevention":

The clinical data of 150 patients with pregnancy diagnosed in this hospital were analyzed. Results: The incidence of uterine pregnancy was 1.44%; related factors of uterine pregnancy: younger age, history of motherhood, breastfeeding or abortion, ring placement within 3 years, multiple ring placement, inert IUD, less precaution, History of cesarean section. CONCLUSION: The incidence of pregnancy with devices is high

"Cause Analysis of Pregnancy with Devices":

The hospital diagnosed and treated 228 cases of pregnancy with a device from January 2003 to March 2005. The above cases are now further analyzed and discussed. 1 Clinical data: Among 228 pregnant patients with a device, the age ranged from 23 to 47 years, with an average age of 35 years. 166 were placed IUD during postpartum lactation, 38 were placed during abortion, and 14 were placed again after removal of the device. . One hundred and seventy-six cases had one pregnancy with a device, and 52 cases had more than two pregnancy with a device.

"Analysis of 226 cases of pregnancy with device":

Retrospective analysis of 226 cases of organised pregnancy among 1,832 cases of early pregnancy termination from 1994 to 2002

"Analysis of 272 cases of IUD with device pregnancy":

The author often encounters pregnant patients with a device in clinical work. This article analyzes 272 of them

"Clinical analysis of 208 cases of pregnancy with device":

Analysis of the causes of 208 cases of pregnancy with a device in the hospital from January 2000 to December 2001 is as follows ... From January 2000 to December 2001, a total of 208 cases of abortion with a device in the hospital were performed, with an average age of 31.7. (23 to 44) years old, 6 to 10 weeks of gestation, 49 cases of scarred uterus.

"Exploration of the causes of pregnancy with a device":

Device pregnancy is considered to be the main indicator of IUD failure. In order to understand whether the pregnancy with a device is related to the abnormal position of the IUD, we observed the position of the IUD in the uterine cavity and the relationship between the IUD and the position of the fetal sac. Results The position of IUD in 106 pregnant women with organs, except one case of IUD was normal in uterine cavity, 87 cases moved down and severely moved down, accounting for 82%.

"Analysis and prevention of 314 cases of pregnancy with device":

The analysis of the causes of 314 cases of pregnant patients with device treated in the past 2 years is reported as follows, and corresponding preventive measures are proposed. 1 Clinical data The pregnant women with this device were confirmed by B-ultrasound and surgery. The average age was 30.5 years (22 to 45 years), 5 to 13 weeks of gestation, 1 to 4 parities, and 56 cases of scarred uterus. Placement time was 126 cases in 5 years, 101 cases in 5 to 10 years, and 87 cases in 10 years. There were 85 cases after device placement, 203 cases during lactation, and 26 cases after abortion.

"Clinical analysis of 256 cases of pregnancy with device":

This article analyzes 256 cases of pregnancy with a device. General information: 256 cases of pregnancy with a device were collected in the outpatient department of the hospital from July 2002 to August 2003, all of which were confirmed by B-ultrasound as having an IUD.

"B-ultrasound analysis of 260 pregnant women with a device":

This article analyzes the uterus of 260 cases of pregnant women with a device. Materials and Methods 260 pregnant women with device were from the station outpatients from June 1994 to December 1996, aged 21 to 42 years old, with an average of 25.6 years old. The IUD placement time was from February to 12 years.