Benefits Of IUD Extend Beyond Contraception Expert Says
Dr. Grimes said that the hormonal IUD is approved for the treatment of heavy menstrual bleeding in more than 80 countries (except the US). The hormonal IUD is also approved in a similar number of countries for protection of the endometrium in women taking estrogen in the menopause, he added.
"Only 2% of women who use contraception in the US choose an IUD, despite the proven safety and effectiveness of this long-term contraception," said Dr. Grimes, vice president of biomedical affairs at Family Health International, Research Triangle Park, NC, and a clinical professor of ob-gyn at the University of North Carolina in Chapel Hill. "Worldwide, however, IUDs are the most widely used reversible contraceptive."
IUDs are an attractive option for many women. The IUD offers similar contraceptive effectiveness as permanent tubal sterilization but it is immediately reversible when removed. Inserting the IUD is a simple office procedure, unlike surgical sterilization which is performed in a hospital.
The IUD is a small, T-shaped plastic device that is inserted into the uterus. There are two types of IUDs approved in the US: the hormonal and the copper IUD. The hormonal IUD releases small amounts of the hormone progestin that prevents pregnancy by preventing fertilization. It is approved for five years of use. The copper IUD releases small amounts of copper into the uterus and prevents pregnancy with similar high effectiveness. It is approved for up to 10 years of use.
IUDs can be appropriate for women who have never been pregnant and those with a history of ectopic pregnancy, according to Dr. Grimes. He added that studies have shown that the risk of pelvic inflammatory disease is negligible and limited to the first month after insertion.
"IUD use among women is associated with a 40% reduction in the risk of endometrial cancer, similar to the cancer protection provided by oral contraceptives, yet many clinicians are not aware of that," said Dr. Grimes. For treating endometriosis, the hormonal IUD is an alternative to leuprolide acetate injections or a 'watch and wait' approach (to see if the pain improves by itself). Another emerging use for the hormonal IUD is treating endometrial hyperplasia, a condition in which there is abnormal overgrowth of the endometrium.
"The IUD is underutilized as a contraceptive in the US," summarized Dr. Grimes. "Research is showing that it has health benefits far beyond preventing pregnancy."
The American College of Obstetricians and Gynecologists is the national medical organization representing over 52,000 members who provide health care for women.
American College of Obstetricians and Gynecologists
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