INTRAUTERINE CONTRACEPTION: PROS AND CONS

ISSN: 2582-4686 SJIF 2021-3.261,SJIF 20222.889, 2024-6.875 ResearchBib IF: 9.948 / 2024 VOLUME-5, ISSUE-11 521 INTRAUTERINE CONTRACEPTION: PROS AND CONS MUSAEVA A.F. Gynecologist at the Khorezm branch of the Republican Specialized scientific and practical medical center for mother and child health Matyakubova S.A Director of the Khorezm branch of the Republican SPECIALIZED SCIENTIFIC AND PRACTICAL MEDICAL CENTER FOR MOTHER AND CHILD HEALTH Abstract. The topic of intrauterine contraception remains my relevance on throughout This issue has been a long-standing concern. The importance of this issue stems from the persistent need of the reproductive-age population for birth control, the popularization of information on various birth control methods, and the desire to use safe, effective, and environmentally friendly contraceptive methods. This article examines the use of intrauterine contraceptives, their effects on the endometrium, a woman's reproductive potential, and the positive and negative aspects of their use. The evidence is presented to extraction intrauterine contraceptive. Among them highlight violations menstrual cycle with hypermenorrhea lasting more than 6 months with no effect from nonsteroidal anti-inflammatory drugs, end of use of an intrauterine contraceptive, the woman's desire and needs, desired pregnancy, expulsion, postmenopausal period. Knowledge of all aspects of intrauterine contraception allows the obstetrician-gynecologist Choose the right type of IUD, explain to the woman all the risks of its use, and promptly diagnose and correct any complications that arise. Key words: intrauterine device, complications intrauterine contraception, endometritis, abnormal uterine bleeding. INTRODUCTION. Intrauterine contraception (IUC) is widely used as one of the effective means of ensuring women's reproductive health. This method is a long-term and reliable form of pregnancy prevention and is of great importance in medical practice. The main advantage of the IUC is that it does not require additional regulation of a woman's daily life and provides effective contraceptive protection. At the same time, there are also negative aspects of the IUC, including hormonal changes, risks associated with the surgical procedure, and in some cases, inflammatory processes. This article analyzes the positive and negative aspects of the intrauterine contraceptive device, its impact on reproductive health, and its clinical application. The article examines the effectiveness, safety, and usefulness of the IUC, as well as precautions and possible adverse effects. In this regard, the article aims to provide practical guidelines for maintaining women's health and choosing contraceptive methods. The aim of the work to analyze the data of scientific articles containing current Information on the impact of intrauterine contraceptives on women's health. The main advantages (effectiveness, convenience, reduced risk of repeat pregnancies) and disadvantages (risk of expulsion, possible complications, impact on lactation) are discussed. Intrauterine Contraception (IUD) What is it? ISSN: 2582-4686 SJIF 2021-3.261,SJIF 20222.889, 2024-6.875 ResearchBib IF: 9.948 / 2024 VOLUME-5, ISSUE-11 522 An intrauterine contraceptive is a small T-shaped device that is inserted into the uterus, and there are two main types: Copper IUD: No hormones, effective for up to 10 years. Hormonal (Levonorgestrel) IUD: Releases hormones, effective for 3–8 years. IUDs prevent sperm and egg from meeting, reducing the chance of pregnancy by almost 99%Intrauterine contraception (IUD) is a long-term, highly effective, and reversible method of preventing pregnancy that has many positive aspects. However, it is also associated with some side effects and risks. Positive aspects (advantages) Advantage Details High efficiency Over 99%; annual failure rate 0.2–0.8% Long-term protection 3–10+ years (depending on device type) Reversibility Fertility is restored quickly after removal Ease of use No daily, weekly or monthly reminders required ("set and forget") Cost-effectiver Cheaper than other short-term methods after 3 years Health benefits Hormonal IUD: reduces heavy periods, relieves symptoms of endometriosis and dysmenorrhea Emergency contraception For example, an IUD is the most effective emergency contraception if inserted within 5 days. Negative Sides Disadvantage/Risk Example IUD Hormonal IUD (LNG-IUD) Gormonal IUD (LNGIUD) Increased menstruation Common (up to 67% in the first year) Rare; often menstruation decreases or stops Menstrual pain (dysmenorrhea) In 11–14% of cases 11–14% hollarda Menstrual pain (dysmenorrhea) 2–10% (higher in adolescents and nulliparous women) 2–10% (up to 8% in adolescents) Uterine perforation (perforation) Very rare (1–2/1000) Very rare (1–2/1000) Inflammation (PID) Very rare, mostly within 20 days of installation Very rare, mostly within 20 days of installation Inflammation (PID) The risk increases if pregnancy occurs The risk increases if pregnancy occurs Hormonal side effects No Headache, mood swings, ovarian cysts, rarely acne Hormonal side effects In many people, especially those who have never given birth In many people, especially those who have never given birth Does not protect against JYUI No No ISSN: 2582-4686 SJIF 2021-3.261,SJIF 20222.889, 2024-6.875 ResearchBib IF: 9.948 / 2024 VOLUME-5, ISSUE-11 523 Literature review and methodology According to conducted research, intrauterine contraception use over 100 millions women total peace, And By frequency use she gives in only combined oral contraceptives. Today this reversible method Contraception is one of the leading methods, used by 83 % of married women women reproductive age, near thirds women late reproductive age, A V period perimenopause He is only optimal option [1]. History shows that the first and second generations of intrauterine contraceptive devices (IUDs) were widely used by women all over the world. Initially, R. Richter was proposed insert a ring made of natural silk into the uterine cavity; later, devices were made of precious metals. In second half 20 In the 19th century, polyethylene coils (Lipps loops) and copper-containing intrauterine devices (IUDs) were developed, which were indeed effective as contraceptives; the latter could even be used as emergency contraception. However, the use of these devices often led to complications, especially uterine bleeding, which was the main reason for their abandonment [2]. IUD expulsion occurs in approximately 10% of cases and occurs as a result of contraction of the uterine muscles, often in nulliparous women with small uterine sizes. Partial expulsion increases the risk of pregnancy. If conception occurs, removal of the IUD without damaging the fertilized egg is possible, although some authors believe that removing the IUD is unnecessary, as the contraceptive is usually located outside the fetal membrane or behind the placenta. After birth, it is expelled along with the placenta; in other cases, it must be removed [6, 11]. Another negative side of using Navy is due to the design features of these devices. From the cervix to the vagina are descending short "antennae" that are necessary for tracking the location of the device. The infectious agent ascends along them by way easily spreads into the uterine cavity. Therefore, only a doctor should perform the installation. And removal devices and initially explain to the woman the importance and special need to comply rules personal hygiene after the procedure [16]. In addition, an imbalance of flora, normally found in all women, is noted: the pH of vaginal secretions increases, preventing the growth of Doderlein bacilli And bifidobacteria, which, in turn, leads to even greater proliferation of opportunistic pathogens microorganisms [6]. To prevent infectious and inflammatory complications, women are recommended to take a course of probiotic preparations to normalize the vaginal microbiome. Women using IUDs are often diagnosed with chronic inflammatory processes of the uterine appendages, which are characterized by a protracted course and, in severe cases, lead to the development of abscesses of the fallopian tubes and ovaries, inflammation of the pelvic peritoneum, and abscesses. Douglasova spaces, genital fistulas. As a result of a constantly recurring inflammatory reaction, sclerosis and dystrophy of the uterine appendages develop, and the risk of infertility increases. The incidence of pelvic infection reaches its peak during the first two weeks after IUD insertion, and there is a clear correlation between the severity of the inflammatory disease and the duration of IUD use [6, 18]. Rare complications associated with IUD use include ectopic pregnancy and device perforation/migration. The incidence of ectopic pregnancy in women with IUDs is slightly higher than in women not using contraception. However, the risk of developing an ectopic pregnancy is low, ranging from 1% to 1.5% during the first year. Suspect an ectopic pregnancy pregnancy at women with Navy enough difficult, especially in the subacute course, since the symptoms can be assessed as side effects of this method of contraception [6]. ISSN: 2582-4686 SJIF 2021-3.261,SJIF 20222.889, 2024-6.875 ResearchBib IF: 9.948 / 2024 VOLUME-5, ISSUE-11 524 If perforated, the IUD damages the uterus and protrudes (fully or partially) beyond its cavity. The likelihood of this complication is quite low—0.1%, but this indicator Maybe may increase depending on the IUD design. Uterine perforation is often discovered accidentally during an examination when the doctor does not find any control threads. However, migration of the device into the free abdominal cavity accompanied by clinic "acute abdomen": cramping pains, bloody discharge, positive symptoms of peritoneal irritation, which requires emergency care. According to research by B. Kassab et al. [cited from 19], out of 165 cases of IUD migration, 45 cases occurred in the omentum, 44 in the sigmoid colon, 8 in the appendix, and significantly less frequently, the device migrates into the small intestine and uterine appendages. A device that migrates from the uterus can cause intestinal obstruction, appendicitis, obstructive nephropathy, and multiple intra-abdominal adhesions [18, 20]. In rare cases, migration of the device into the bladder wall occurs, with the main complaints of women being severe urinary disorder, the presence of blood in the urine, and pain in the suprapubic region [21]. The device may be partially or completely covered with stones, and the degree stone formation varies and does not depend on the duration of stay in the bladder. In the overwhelming majority most In some cases, the IUD can be removed transurethrally. For larger stones, cystotomy or laparoscopic bladder resection is performed. Contact lithotripsy, which crushes the stones and reduces the risk of complications, can be performed beforehand [22, 23, 24]. It is important to remember that the most common problems can be prevented complications A carefully collected medical history of the patient helps, on the basis of which means is being selected V strictly individual in order, Taking into account the size of the uterus, its anatomical features, and plans for future childbearing, the choice of IUD should be made carefully. Adolescent girls and women who have not given birth should be especially mindful of their choice. Due to the small size of the uterus, it is difficult for them to select the appropriate IUD size. As a result, the device descends into the lower isthmic segment of the uterus, which is accompanied by cramping pain and expulsion, which occurs in 20% of cases in primiparous adolescents [25, 26, 27, 28]. Results and discussions Only an experienced obstetrician-gynecologist should perform the installation IUD to reduce the risk of infection and trauma. The cervix and vagina are thoroughly cleaned with antiseptics several times, avoiding contact. probe And tubes introduced devices To walls vagina and speculums. For prophylactic purposes, it is permissible to prescribe antibacterial drugs (semi-synthetic tetracyclines or 1st generation macrolides) [29]. An IUD is inserted With 1st By 7th day menstrual cycle or on any day if the patient denies pregnancy. After an abortion, use Navy Can straightaway same or during the first week, provided there is no infectious or inflammatory process in the pelvic organs. In women immediately after childbirth, the method of choice for contraception is the IUD [30]. The patient must visit the doctor 1-2 months after the procedure to exclude the development of complications. Subsequent follow-up examinations are performed at least once every 6 months: the duration of IUD use is taken into account, and regular cytological examinations are performed. Self-monitoring of the device's presence in the uterine cavity should be performed monthly. If necessary, use barrier contraception, as IUDs are ineffective against sexually transmitted infections [31]. CONCLUSION In summary, it's important to emphasize the rapidly growing relevance of intrauterine ISSN: 2582-4686 SJIF 2021-3.261,SJIF 20222.889, 2024-6.875 ResearchBib IF: 9.948 / 2024 VOLUME-5, ISSUE-11 525 contraceptives. This is due to their high efficacy, affordable price, and proven safety in terms of carcinogenesis. However, a number of side effects persist with their use. Among these, infectious and inflammatory processes in the pelvic organs and uterine bleeding are prominent. Chronic nonspecific endometritis is a common consequence of morphofunctional restructuring of the endometrium. Ectopic pregnancy, uterine perforation, and migration of the device into the free abdominal cavity and pelvic organs occur significantly less frequently. Risk occurrence listed complications proves the need for an individual approach to the selection of an intrauterine contraceptive, which requires care and professionalism on the part of the obstetriciangynecologist. IUD o‘rnatishdan oldin, barcha ijobiy va salbiy tomonlarini, shuningdek, individual sog‘liq holatini hisobga olib, malakali shifokor bilan maslahatlashish zarur. Intrauterine contraception is a long-term, highly effective and reversible method of contraception, recommended as the first choice for many women. Its main advantages are effectiveness, convenience, long-term protection and additional health benefits. However, there are some side effects (menstrual changes, pain, miscarriage, in rare cases complications) and contraindications. An individual approach and consultation with a doctor are important for each woman. LIST LITERATURE: 1. Lyashenko AND. WITH., Pugolovkina D. A. 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