The hormone spiral, also known as the Intrauterine System (IUS), is an approximately three-centimeter-wide, mostly T-shaped plastic body, which is inserted into the uterus like the conventional spiral. While contraception in the latter is ensured, inter alia, by the copper ions released, the hormone coil releases a small amount of the synthetically produced hormone levonorgestrel to the body. The hormonal spiral is one of the safest contraceptive methods. The risk of unwanted pregnancy despite hormone spiral corresponds approximately to that of sterilization.
Hormone spiral: effect
Contraception is given from the first day of use and over a period of up to five years. Unlike the pill, the hormone spiral delivers the hormone locally, meaning only very small amounts enter the circulation.
The hormonal spiral has contraceptive effects in several ways:
- The yellow-body hormone levonorgestrel thickens the mucus in the cervix. Permeability to sperm is thus made more difficult.
- The yet passing sperm are inhibited by the hormone in their activity.
- It comes to influence up to the suppression of ovulation and Eireifung.
- The lining of the womb changes, making it difficult for a fertilized egg to nest.
Use hormonal spiral
The insertion of the hormone spiral is similar to that of the copper spiral. First of all, a gynecological examination is carried out to exclude possible diseases and to discuss risks. The size of the uterus is also measured in order to facilitate the determination of the optimal position of the hormonal spiral.
With a special applicator, the hormone spiral is introduced into the uterus after the genital area has been sterilized.
The threads attached to the hormonal spiral are self-checking and are later used for removal. The doctor cuts the threads to a practical length. Since the onset of the hormonal spiral can cause a slight pulling up to greater pain, patients should discuss in advance with the doctor whether anesthesia is useful or is desired.
Hormone spiral: side effects not insignificant
The hormone spiral approved in Germany since 1996 can cause a number of side effects. Therefore, physicians must inform in detail about the hormonal spiral. Since 2007, physicians are also obliged to provide information about the use of the hormonal spiral and its side effects to interested patients.
If a woman chooses the hormonal spiral, she must give written consent and confirmation of potential risks prior to insertion. Adverse events (frequency prevalent during the first six months of the adjustment phase) include:
- Cycle Disorders: Irregular or no menstrual bleeding (or even bleeding)
- Pain: headache, migraine, abdominal pain, tenderness or pain in the chest, back pain
- Rash, itching, eczema, acne (in some cases also negative effects on the hair, also increased body hair can occur)
- Nervousness, mood swings and depressive moods, loss of libido
- Weight gain, water retention in the tissue
- Ovarian cysts (usually benign)
- Possible increased risk of breast cancer and thrombosis (roughly equivalent to combined oral contraceptives)
- Inflammations: pelvic area, uterus, cervical mucus, vaginal mucosa and labia minora
Hormone spiral also in young women and breastfeeding?
The hormone spiral is a very common contraceptive method in Germany and especially popular among women who
- already born once or several times
- want to prevent in the long term
- do not tolerate estrogen in certain contraceptives
- have a very strong menstrual period
In countries such as the US or Sweden, hormone coils are also a common method of contraception in young, childless women. In Germany, however, many gynecologists advise against a hormonal spiral in the mentioned group of people. The reason for this is not the now refuted risk of infection, but the pain that can arise both during insertion and when pulling the coil and the other mentioned side effects.
Meanwhile, there are extra small hormonal spirals, so that they can be an option for young women without children. A detailed consultation and education by the gynecologist is recommended in any case.
Even during lactation, a hormone spiral can be used because it has no effect on milk production and the child. However, the onset should take six to eight weeks after birth, when the uterus has completely regressed.
Hormone spiral: cost and price
The costs for the hormonal spiral are only assumed for women up to the age of 20 and for women entitled to social assistance. If you want to use the hormonal spiral, you should be sure that contraception is desired over a longer period of time. The initially relatively high cost of hormone spiral from a price up to 400 euros, however, pay off in comparison to the pill after the planned period of five years.
The semi-annual ultrasound checks to check the correct position of the hormone spiral are not paid by the health insurance company - except for the first after four to six weeks.
Since the hormonal spiral is also used for the treatment of menstrual cramps and for the treatment of very heavy menstrual bleeding, the costs for the spiral in this case are covered by the health insurance - provided that the hormonal spiral is prescribed for this reason alone.
Remove hormone spiral
After five years, the effectiveness of the hormones decreases and the contraception becomes more uncertain. Women who now want a child can become pregnant again in the next cycle after removing the hormonal spiral. If you still want to stay in contraception with the hormonal spiral, you can use a new hormone spiral immediately after removing the old one.
The change should be made during the menstrual period; In women who no longer menstruate, the hormonal spiral can be changed at any time. More than half of all women who use the hormone spiral for the second time have no menstrual period at all. In a direct change of the hormonal spiral, the side effects of the adjustment phase remain off.