Mirena IUD - Dr. Zatik János nőgyógyász

Mirena IUD

The hormon free IUD and IUD with progestogen IUS-IntraUterine System (Mirena, Jaydess, Skyla, Levosert, Donasert) Insertion and removal  of IUDs at Szent Anna Surgery Debrecen Hungary. The hormonal and non hormonal  IUD is inserted in a similar procedure .Can only be inserted by a qualified gynecologist. Before the insertion, a pelvic examination and ultrasound, PAP test  is performed ,to examine the size and position of the uterus. Sometimes it  is also recommended that patients be tested for gonorrhea and chlamydia prior to insertion.During the insertion, the vagina is held open with a cusco speculum, the same device is used during a pap test smear.  A special instrument is used to steady the cervix, the length of the uterus is measured for proper insertion by ultrasound and a probe.The IUD is placed using a narrow plastic tube through the the cervix into the uterine cavity. short length of monofilament plastic/nylon string hangs down from the cervix into the vagina. The string allows physicians and patients to check to ensure the IUD is still in place and enables easy removal of the device A moderate cramping can occur during the procedure, which generally takes  ten minutes or less. Removal of the device should also be performed by a qualified gynecologist. After removal, fertility will return to previous levels relatively quickly. The procedure is similar to the insertion.A clinical  study found that the majority of participants returned to fertility within two to four months. At Szent Anna Surgery Debrecen Hungary  we insert or remove  the IUDs with local anestesia,in 15-20 minutes. You  do not need to go at a hospital, or no need  deep anestesia.We have the best methods and  We have the greatest experience and equipments on insertion and removing of IUDs without pain. We have  several types of IUD. Before we  choose th ebest type of device for you we make a thorough consultation when  you can see the IUDs and you can ask your questions. Dr Zatik János MD. PhD gynecologist has the greatest experience and qualifications to insert and remove the IUDs.     Types of IUD The intrauterine device, or IUD, is a plastic or metal birth control device (Size:30 mm )  that is placed inside the uterus by a gynecologist for a long time 5-7 years. There are two basic  types of IUDs in use. Hormonal IUDs-: Intrauterine System IUS: Brand name:Mirena,Jaydess,Levosert which contains levonorgestrel, a type of progestogen Hormon free IUDs (non hormonal)  Brand names: Multiload, Mona Lisa, Lilly gold, Lilly silver, Copper T, TCu 300) We have a long experience with progesteron IUD-s too:From 1976-1990 the name of IUD with progesteron was Progestasert and from 1990 we have the Mirena. Non-hormonal IUDs: For copper IUDs, the metal itself seems to exert a spermicidal effect. The copper also affects the lining of the uterus by not allowing a fertilized egg to implant, and it stimulates the production of prostaglandins, chemicals that affect the hormones needed to support a pregnancy. Hormonal IUDs: prevent pregnancy by releasing the hormone progestin, which thickens the cervical mucus, acting as a barrier to prevent sperm from entering the uterus. This type of IUD also affects the lining of the uterus to prevent a fertilized egg from being implanted, should fertilization occur The cylinder of the device contains the hormone and is coated with a membrane that regulates the release of levonorgestrel.Mirena releases the hormone at an initial rate of 20 micrograms per day and declines to a rate of 14 micrograms after 5 years, which is still in the range of clinical effectiveness. Skyla releases 14 micrograms per day and declines to 5 micrograms per day after 3 years  Jaydess releases 6 micrograms per day and lasts for 3 yearsIn comparison, oral contraceptives can contain 150-300 micrograms of levonorgestrel. The hormonal IUD releases the levonorgestrel directly into the uterus, as such its effects are mostly paracrine rather than systemic. Most of the hormone stays inside the uterus, and only a small amount is absorbed into the rest of the body.Blood levels of levonorgestrel in Mirena users are one-tenth those found in users of levonorgestrel-only pills. Effect of hormonal iUDs Cervical mucus thickens,Sperm's survival and ability to penetrate the egg is inhibited,Endometrium is suppressed,In some women, ovulation is inhibited. Numerous studies have demonstrated that IUDs primarily prevent fertilization, not implantation Contraindications of the IUD Uterine abnormality. History of pelvic inflammatory disease within the past 3 months, ectopic pregnancy, venereal disease, pelvic surgery, vaginitis, cervicitis, postpartum endometritis, septic abortion, uterine or cervical malignancy. Abnormal vaginal bleeding. Multiple sexual partners for patient or partner. Immunosuppression. Genital actinomycosis. Retained IUD. Pregnancy. Have, or may have, breast cancer,Have severe liver disease Adverse Reactions:  Women who use the non hormonal IUD-s (Copper T) may experience side effects. Heavy menstrual bleeding ,dysmenorrhea If heavy menstrual bleeding occurs regularly, anemia is possible Menstrual cramps Higher risk to infections(PID pelvic infection, tubo-ovarian damage endometritis, tuboovarian abscess). Infertility, , Uterine or cervical perforation Ectopic pregnancy Non hormonal IUDs are preventing pregnancy 98% and  Mirena is 99,9% preventing pregnancy Advantages of hormonal IUDs Long-acting reversible contraceptive method with high effectivity and low hormone intake(equal to one contaceptive pill  in every 75 days ) No need to remember to take any daily action Fewer menstrual cramps Periods are usually lighter or none at all (amenorrhea) No proven effect on weight        Reduces the risk of endometrial cancer It can be used while breastfeeding Cheepest method for longer time Ability to become pregnant returns quickly when removed In addition to birth control, hormonal IUD are used for prevention and treatment of menorrhagia (heavy periods),Endometriosis and chronic pelvic pain,Adenomyosis and Dysmenorrhea,Anemia, In several  cases, a hormonal IUD may prevent a need for a hysterectomy.[   Disadvantages Hormonal IUDs No STD protection High price at the insertion Irregular periods and spotting between periods often occurs after insertion, but this usually improves after 3 to 6 months. Periods  causes menstrual irregularity, Cramping or backache can occur at insertion and Moderate discomfort during insertion procedure Commomly reported increase in acne at the first time after the insertion Expulsion: Sometimes the IUD can slip out of the uterus.If this happens a woman is not protected from pregnancy Perforation: Very rarely, the IUD can be pushed through the wall of the uterus during insertion. Risk of perforation is mostly determined by the skill of the gynecologist . Infection: The insertion of the IUD does have a small risk of pelvic inflammatory disease (PID). Concurrent infection with gonorrhea or chlamydia at the time of insertion increases the risk of pelvic inflammatory disease.If PID does occur, it will most likely happen within 20 days of insertion. The device itself does not increase the risk of infection, buti f you have heavy pain or fever after the insertion pleas make a consultation. Ovarian Cysts: Enlarged follicles (ovarian cysts) have been diagnosed in about 10% of the subjects using a hormonal IUD. Most of these follicles are asymptomatic, although some may be accompanied by pelvic pain or dyspareunia. In most cases the enlarged follicles disappear spontaneously after two to three months. Surgical intervention is not usually required