Contraception

Contraception – good to know

Love, lust and sexuality – but with controlled family planning. That is what modern women want. However, most conceptive methods have side effects that damage the sensitive organism in the long term. For example, a higher risk of developing cancer has been proven associated with taking the birth control pill[1]. This is because synthetic hormones suppress the body’s natural hormone system and impact it negatively in the long term. In addition, hormonal contraceptives are also significant robbers of vitamins and nutrients: there is an increased need for micronutrients such as the B vitamins B2, B6 and B12 as well as for folic acid, vitamins C and E, zinc and manganese.

[1] J Med Assoc Thai. 2004 Oct;87 Suppl 3:S167-8. Menopause. 2010 Sep-Oct;17(5):1040-7. Clin Exp Obstet Gynecol. 2011;38(3):225-7. Ginekol Pol. 2014 Dec;85(12):944-9.

This gives rise to a number of diseases and/or symptoms, such as increased skin pigmentation, eczema, hair loss (alopecia), liver diseases, cardiovascular diseases, water retention in tissue (oedema), migraine, depression, weight gain and many more.

Which forms of contraception work reliably without a negative impact on the organism?

Contraceptives without synthetic hormones include the copper coil, the gold coil, the copper ball and the copper chain, all of them intra-uterine devices (IUD). The devices are located inside the uterus; the copper ions they emit have a lethal effect on sperms. The IUDs are effective for up to 5 years. If you plan to become pregnant, they can be removed at any time, thus restoring fertility.

The copper IUDs have a Pearl Index of 0.3-0.8, meaning that of 1000 women using this method for 1 year, only 3-8 will become pregnant despite this contraception. They are thus regarded as very safe. For comparison: The Pearl Index for the pill is 0.1-0.9. Contraception with synthetic hormones (pill, hormonal coil, vaginal ring, hormonal implant, hormonal patch) often results subsequently in heavier periods, period pain and PMS (pre-menstrual syndrome), because of the suppression of the natural hormone balance, particularly of progesterone. These symptoms can appear after discontinuation of synthetic contraception, but are rarely associated with the hormone-free IUD. However, a well controlled bioidentical hormone therapy or a plant-based remedy can restore hormonal balance naturally.

Unfortunately, the coil is often associated with higher risk of infection; however, this depends on the sexual behaviour of the user. Only the use of a condom can protect against infections; this is particularly important for multiple sexual partners.

Copper coil, gold coil, copper ball, copper chain – IUDs

(IUD = intra-uterine device, a device or object located in the womb)

History of the coil

It is said that the idea of intra-uterine contraception originated in the Orient.
Arabian and Turkish camel driver used to insert small stones into the wombs of camel cows to avoid offspring while on their travels.

The first coil, known as the “Gräfenberg ring”, had been invented by Berlin physician Ernst Gräfenberg (1881-1957). He also gave his name to the famous G-spot (short for “Gräfenberg spot”).

How the hormone-free coil works

Copper coil – copper ball – gold coil – copper chain

The emitted copper ions cause

  • disruption to the sperm-egg interaction (known as the micro-galvanic effect)
  • impairment of sperm mobility
  • sperms to die.

The copper coil, the copper chain, the copper ball and also the gold coil have a dual effect: The copper is constantly released in small quantities into the uterus, thus

  • causing the structure of the lining of the uterus to change thus preventing the implantation of a fertilized egg. This sperm-egg interaction is also referred to as a micro-galvanic effect;
  • limiting the mobility and survival time of sperms, as sperm enzymes die thanks to the copper ions. No fertilization thus takes place.

The quantities of copper released by the hormone-free coil are minute and pose no risk to the user.

The average amount of copper ingested with food is considerably larger. The

lining of the womb is less reactive than areas of skin on the body’s surface. Nevertheless, it is advisable to have an allergy test to copper performed by a dermatologist prior to fitting an IUD. After more than 40 years, no negative impacts of the copper IUD have been noted.

What the various devices look like

The copper coil and the gold coil are actually T-shaped biocompatible plastic carrier.

The flexible wire of the copper ball is made up from the memory shape alloy nitinol coated with a white polymer coating that is studded with 17 copper pearls. With the aid of the flexible carrier thread, the insertion tube is introduced to the uterus. The device then coils up into a copper ball.

What is the difference between the copper coil, the gold coil, the copper ball and the copper chain?

All four IUDs have the same effect through copper ions.

The only differences are in material and technique.

  • The copper coil – also known as Flexi T, is the least costly of all four IUDs and also the one most frequently used. Thanks to its flexible arms, positioning is quick and uncomplicated and thus the most painless method.
  • The gold coil is in the medium price category; in Dr Farmini’s view, it retains its position better than the copper coil, because its T-shape is a bit more robust. The probability of the coil slipping out is thus lower than for the Flexi T copper coil. In the gold coil, a fine copper wire is wound around a gold core. Here, too, the contraceptive effect is solely due to the copper ions. The gold protects the copper from corrosion, thus ensuring a better durability of the device.
  • The copper ball, together with the copper chain the most expensive option, is the latest development in the market of hormone-free contraception. Thanks to its ball shape and particularly its shape memory, it ensures a good fit inside the uterus. Thanks to its high-tech design, injuries and irritations to the lining of the uterus are avoided. The robust little copper balls do not require additional metals for stabilization. However, the copper ball is not suitable for women with a nickel allergy, because nickel is one of the components of the nitinol thread.
  • The copper chain – Four to six copper sleeves are threaded onto a fine surgical plastic wire. The individual copper links are stabilized with the first and the last copper sleeve, as their are squeezed onto the wire.

Each IUD has a fine removal string made from polyamide which is used to take it out.

Advantages and disadvantages of hormone-free IUDs

Copper coil – gold coil – copper ball – copper chain

Advantages

  • Long-lasting contraception
  • Can also be used while breastfeeding
  • Contraception remains ensured even with illness such as gastrointestinal disorders.
  • Uncomplicated, because the coil, unlike the pill, cannot be forgotten.
  • The most cost-effective contraception, because it remains effective for up to 5 years.
  • No negative effect on libido or bone metabolism.
    • Fertility is restored once the IUD is removed.
    • No weight gain
    • Highly effective (Pearl Index: 0.3-3), i.e. very safe
    • Also possible for young women who have not given birth
  • No micro-nutrient deficiency
  • No suppression of the body’s own hormone system

Disadvantages

  • The intolerance rate is approx. 5 percent.
  • The IUD can slip out of place.
  • It is not suitable for women with Wilson’s disease, a rare copper excess disorder.
  • There is an increased risk of ectopic pregnancy.
  • For the copper chain, there is a risk of penetration into the abdominal cavity because of its slender form. In that case, it would need to be surgically removed. For that reason, Dr Farmini does not offer this option.
  • IUDs do not protect against sexually transmitted diseases (STDs).

* The possibility of a pregnancy cannot be completely ruled out, despite contraception.

Insertion of the hormone-free IUD

With pain relief, the IUD can be fitted at any time. The insertion process starts by measuring the length of the uterus with a uterine probe in order to select the correct size of IUD.

The selected IUD is then inserted gently. Not including the prior consultation, all of these steps take approx. 10 minutes in total. After the insertion, you have the opportunity to rest in a relaxation room. However, this offer is rarely taken up, as most patients do not feel physically impaired. More information [in German] available from: www.gold-spirale.at and www.gynial.at

Follow-up check

After the first menstrual period, the placement of the IUD is checked in order to ensure its contraceptive effect. We do not charge our patients for the follow-up check and the insertion of a new IUD, should the first one have been found to have slipped. The correct fitting of the IUD should be checked by a gynaecologist once a year. This can be done as part of a routine check-up.

Copper IUD and nickel allergy

Only the copper ball is not recommended for women with a nickel allergy, because its nitinol thread contains nickel. The Flexi T copper coil, the gold coil and the copper chain are nickel-free. Any general practitioner can perform a nickel allergy test any time. It is recommended in case of any uncertainty, if the patient prefers the copper ball.

Emergency contraception – instead of the morning-after pill, the copper IUD for afterwards

Should something have gone wrong (split condom or similar), a copper IUD can be inserted within 5 days after intercourse. In 99 percent of cases, the intrauterine copper devices also provide a safer and healthier alternative emergency contraception than the morning-after pill.

Costs

The costs of an IUD compared to other methods of contraception are the lowest at approx. €5 to €7.50 per month because it lasts for up to five years.

For more information about costs, please click on the “Prices” tab.

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Dr. Armando Farmini - Gynäkologe
Dr. Armando Farmini
Ernest-Thun-Straße 12, 2. Stock
Am Max-Ott-Platz
A - 5020 Salzburg

+43 660 161 4030
office@drfarmini.com