Intrauterine Contraceptive Devices Are Safe But Underused In Developed Countries

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Main Category: Sexual Health / STDs
Also Included In: Women's Health / Gynecology;  Fertility
Article Date: 31 Aug 2007 - 0:00 PDT

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IUDs (intrauterine contraceptive devices) are underused in developed countries even though they are safe and effective for contraception. IUDs are suitable for the majority of women, and offer health benefits beyond contraception, says Sally Rose, Research Fellow, University College, Otago, New Zealand.

You can read about this in this week's issue of the British Medical Journal.

Sally Rose writes that misconceptions about IUDs mean that they are underused in industrial nations.

Unlike other forms of contraception, an IUD's efficacy does not depend on the user's behaviour. The woman's fertility is restored on their removal. IUDs are an excellent alternative to sterilization - something a woman may regret later on.

The write says that some side effects, such as heavy bleeding and pain are common reasons for women discontinuing IUD use. However, with appropriate pain relief they can generally be managed. Despite these benefits, in developed countries IUDs are underused, says that writer.

Nearly half of all IUD users globally are Chinese women. In the UK IUDs are only used by 6% of women, 4.6% in Australia/New Zealand and less than 1% in the USA.

The Dalkon Shield, used in the 1970s, caused pelvic infections that had serious health consequences for many women. Legal action against the manufacturers of Dalkon Shield resulted in a steep decline in the use of IUDs. They were taken off the US market in the 1980s. Current misconceptions are based on outdated information, says the author. People still believe, mistakenly, that modern IUDs cause pelvic inflammatory disease and infertility.

Trials have indicated that there is a slight raised risk during the first 20 days after insertion. However, apart from that, the risk of upper genital tract infection is no different from that experienced by non-IUD users, says the author.

The author recommends testing for Chlamydia and treating it before any insertion. Untreated Chlamydia is a very common cause of pelvic inflammatory infection.

"Editorial: Pain and heavy bleeding with intrauterine contraceptive devices"
BMJ Volume 335 pp 410-11
http://www.bmj.com


Written by: Christian Nordqvist
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