Identify the contraceptive shown:
C. Lippe’s Loop
D. Vaginal ring
Ans:C. Lippe’s Loop.
Intrauterine Contraceptive Devices
First generation IUDs:
- The non-mediacted or inert IUDs are referred to as first generation IUDs.
- They appeared in different shapes and sizes – loops, spirals, coils, rings, and bows.
- The lippes loop is the best known and commonly used device in the developing countries.
Second generation IUDs:
- The copper IUDs comprise the second generation
- Copper -7
- Copper T-200
- Cu-T-220 C
- Cu-T-380 A or Ag :The Cu-T 380A is approved for use for 10 years.
- Nova T
- The numbers included in the names of the devices refer to the surface area (in sq. mm) of the copper on the device.
- Nova T and Cu-T-380 Ag are distinguished by a silver core over which is wrapped the copper wire.
Third generation IUDs-
- Hormone-releasing IUDs are the third generation IUDs.
- The most widely used hormonal device is progestasert, which is a T-shaped device filled with 38 mg of progesterone, the natural hormone. The hormone is released slowly in the uterus at the rate of 65 mcg daily.
- Another hormonal device LNG-20 (Mirena) is a T-shaped IUD releasing 20 mcg of levonorgestrel (a potent synthetic steroid); it has a low pregnancy rate (0.2 per 100 women) and less number of ectopic pregnancies.
Mechanism of actions of IUDs:
- Induce a foreign – body reaction that results in chronic inflammatory reaction –> cellular and biochemical changes in the endometrium and uterine fluids. These changes impair the viability of the gamete and thus reduce its chances of fertilization rather than its implantation.
- Prevent fertilization primarily by interfering with the ability of sperm to survive and to ascend the fallopion tubes, where fertilization occurs.
- Effectively interrupts the reproductive process of implantation “.
- In medicated IUDs, copper enchances the cellular response in the endometrium. By altering the biochemical composition of cervical mucus, copper ions may affect sperm motility, capaciation and survival.
- Hormone – releasing devices increase the viscosity of cervical mucus and thereby prevent sperm from entering the cervix. They also maintain high level of progesterone in the endometrium and thus, relatively low levels of estrogen, thereby sustaining an endometrium unfavourable to implantation.
Side effects and complications of IUDs
- Bleeding : Most common
- Pain :Second major side effect
- Pelvic infection : PID,Pregnancy
- Uterine perforation
- Ectopic pregnancy