ParaGard is a T-shaped device that is inserted into the uterine cavity to prevent pregnancy.
Indications for use
- prevention of unwanted pregnancy;
- parous women;
- usage for medical purposes in women with fibroids, endometriosis, adenomyosis, premenstrual syndrome.
Mechanism of action
The contraceptive effect of ParaGard is achieved due to copper properties. This device has a high safety profile and can be installed for up to 12 years. In addition, copper-containing intrauterine devices are effectively used as emergency contraception.
Its actions include the following specifications:
- changes in the endometrium and the inability for a fertilized egg to attach to the uterine walls. It is essentially a kind of micro-abortion, so the moral aspect often does not allow women to take advantage of this contraception type.
- copper devices affect spermatozoa, reduce their motor activity and interfere with movement in the uterine area.
- strengthen the tubes’ peristalsis. It increases the speed of egg passage and ensures entry into the uterine cavity without fertilization.
- copper-containing spirals reduce the activity of spermatozoa and prevent implantation of the fetal egg.
Mode of application and dosage
ParaGard is introduced for a period of 3 to 5 years. It is established on the 3-4th day of the menstrual cycle when the cervix is slightly open. Sexual life is allowed for 8-10 days from the establishment of this device. The effectiveness of this IUD is quite high due to the usage of various mechanisms of action – about 90%.
- Hypersensitivity to the copper;
- Malignant tumors of the cervix;
- Cervical disease (erosion, dysplasia, cervicitis);
- Uterine bleeding of unknown etiology;
- Ectopic pregnancy in anamnesis;
- Inflammatory diseases of the uterus and appendages.
For the conditions listed below, ParaGard should be used with caution after consultation with a specialist:
- congenital heart disease or heart valve disease (due to the risk of developing septic endocarditis);
You with a doctor should discuss the reasonability of removing the system in the presence or the first occurrence of any of the following side effects:
- migraine, focal migraine with asymmetric loss of vision or other symptoms indicative of transient ischemia of the brain;
- unusually severe headache;
- severe arterial hypertension;
- severe circulatory disorders, including stroke and myocardial infarction.
It is a common case if during the first months a woman has violations related to menstrual bleeding. The number of days during which menstrual bleeding and spotting may occur may increase. In addition, bleeding can become more abundant. Within a short period of time after the IUD installation, you may experience abdominal pain. Prolonged pain and heavy bleeding may indicate partial expulsion of the IUD.
In this case, the IUD needs to be removed and the new one installed in the correct position. Pregnancy, which develops in case of failure of this method of contraception, can be ectopic. During the use of the IUD, inflammatory diseases of the pelvic organs are possible.
After ParaGard installation, cases of sepsis have been reported (a very serious systemic infection, which can be fatal).
The risk of uterine perforation is elevated in women with breastfeeding and in women who have had an IUD installation up to 36 weeks after delivery.
After penetrating the IUD, some women may experience pain and dizziness. If after a half-hour it does not pass when you are in the supine position, there is a risk the IUD is installed incorrectly. A survey should be conducted and, if necessary, the IUD should be removed. In connection with the use, skin allergic reactions are possible.
Pharmaceutical inducers of enzymes, especially biological catalysts from the cytochrome P 450 system, which take part in the metabolic drugs’ degeneration such as anticonvulsants and others, enhances the biochemical conversion of progestins. However, their effect on the ParaGard effectiveness is not significant, since the main point of implementation of the therapeutic capabilities of the intrauterine device is the local effect on the endometrium.
ParaGard and pregnancy
During ParaGard use, pregnancy is unlikely. However, if you become pregnant with an IUD in the uterine cavity and wish to remain pregnant, the IUD is recommended to be removed. If the IUD is not removed, there is a risk of miscarriage or premature birth. The course of pregnancy should be carefully monitored. There is no evidence of developmental defects in cases where the pregnancy started and continued right up until the birth while the IUD was in the uterine cavity. If the IUD cannot be removed carefully, the issue of the reasonability of abortion may be considered. If you wish to keep a pregnancy and the IUD cannot be removed, talk to your doctor, who will tell you in more details about further actions. In particular, you should immediately consult a doctor with convulsive pain in the abdomen in combination with fever.
Although an ectopic pregnancy can occur with ParaGard use, the existing data do not indicate a higher overall risk of ectopic pregnancy in women using IUDs than women who do not use any method of contraception.
Nevertheless, a woman who becomes pregnant while using the IUD needs a thorough examination. Women with an ectopic pregnancy, a postoperative cervical or cervical infection in the past are at a higher risk of ectopic pregnancy. The possibility of an ectopic pregnancy should be considered when delaying the onset of menstruation, poor menstrual bleeding and lower abdominal pain.
ParaGard can be easily removed by a doctor, after which pregnancy is possible. Removal of the IUD is usually painless. After ParaGard is removed, fertility returns to a normal state.
If pregnancy is undesirable, the IUD should be removed during menstrual bleeding. Sexual intercourse during the week before the removal of the IUD in the middle of the cycle can lead to the pregnancy. For this reason, a different method of contraception should be used for several days before and after the removal of the IUD.