As a women’s health care provider, I am always pleased to have new contraceptive options to offer my patients. Therefore when the intra-uterine device was under attack, it made me sad to think women would have fewer choices to take control of their reproductive lives. I am happy to report that over the past several years the IUD has made a dramatic comeback.
In the not so distant past, the IUD was close to extinction in America. In the 1960s when Congress was investigating the birth control pill for safety reasons, more and more women were using the IUD. Unfortunately a poorly designed IUD called the Dalkon Shield was introduced in 1970 and was recalled in 1975. It was linked to numerous serious health risks in many of its users. Several IUD users died after miscarriages were followed by severe infection. Women using the Dalkon Shield increased their chances of dying 50 times over women who did not use IUDs. The manufacturer of the Dalkon Shield was sued into bankruptcy. It had a negative effect on the use of all IUDs. Some researchers linked the IUD with serious pelvic infections.
Poor design, use by women in high-risk groups (i.e., women with multiple sexual partners), and failure to remove the IUD in the few women who did become pregnant contributed to the demise of the Dalkon Shield and IUD use in general. Today, women are more rigorously screened, and improved designed and proper protocols for removal have drastically improved the safety of IUD use. Women who use the newer IUDs are actually at less risk of developing infections compared to women who use no contraception.
Currently there are three IUDs on the market in America. They are Mirena, Paraguard, and Progestasert. A health care provider inserts the small device into a woman’s uterus. The procedure is usually done in the office and usually takes just a few minutes. Most of the time it is relatively painless. The IUD has a string that can be felt by the patient and should be checked monthly by the patient to ensure the IUD is in place.
All of the IUDs are very effective. Most recent research suggests that the IUD prevents fertilization by preventing the sperm’s access to the fallopian tube. It does not work by causing an abortion. In fact, one study attempted to flush the uterus and tubes of women with IUDs to recover fertilized eggs and none could be found.
The IUD is also one of the least expensive contraceptives on the market when compared to other forms. While the IUD is more expensive initially, after insertion, there are no ongoing expenses. Once inserted the IUD will prevent pregnancy for 5-10 years depending on the type used.
Advantages of the IUD have led it to be one of the most popular forms of contraception worldwide. Approximately one hundred million women use the IUD worldwide. It is the most popular form of birth control in China, Finland, and Norway.
The IUD can work up to 10 years depending on the type of IUD. It is very convenient. Once in place, there are no pills to take or forget. Trips to the drugstore to refill birth control pills prescription are not necessary. The IUD is 99 percent effective. All IUDs on the market in America are FDA approved. The IUD is almost as effective as permanent sterilization. IUD is reversible. Once the IUD is removed, fertility returns rapidly. And finally, women who are nursing can continue to nurse with an IUD because the IUD does not interfere with milk production.
On the downside, when an IUD is inserted, women have a small risk of developing pelvic infections. The IUD does not prevent a pregnancy outside the uterus. Therefore women with an IUD who do become pregnant have a higher risk of ectopic pregnancy. The IUD does not protect against sexually transmitted diseases. Women should not use an IUD if they have multiple sexual partners. The IUD may become dislodged from the uterus. When dislodged, a woman will no longer be able to feel the string that is attached to the IUD. Risk of the IUD being expelled from the uterus is approximately 5 percent. When any of these circumstances occur, the patient’s health care provider should evaluate her immediately.
I personally have placed hundreds of IUDs. Most women are very happy with their IUD. In a national survey, 98 percent of women using IUD were happy with their choice. As noted, an IUD is not for everyone. If you are interested in an effective, reversible, and safe contraceptive that is convenient, call your health care provider to find out if you are a good candidate for one of the new IUDs.
Dr. Hardy practices obstetrics and gynecology at Atlantic Ob/Gyn with locations in Va. Beach and Chesapeake. Please call 757-463-1234 or visit www.atlanticobgyn.com.