IUD
(INTRAUTERINE DEVICE)
History:
In
the 1970s, the IUD was widely used in the US (10% of all
women using contraception) until problems such as pelvic
infections and deaths led to some devices being taken off
of the market. Modern IUDs are good, safe, long-acting and
cost-effective when used in the right patient populations.
How
it works:
The IUD is a T-shaped device that comes with
one of two active ingredients: copper or progesterone-containing.
It is inserted into the uterus through the vagina by a physician
and remains there for ten or fewer years. A string attached
to the base of the T shape allows easy removal. Intrauterine
devices are believed to work by preventing a sperm from
fertilizing an egg. In the case of the copper IUD, copper
ions in the uterine and tubal fluids are believed to prevent
fertilization of the egg. Studies show that copper IUDs
actually prevent fertilization of an egg and not implantation
of a fertilized egg although theoretically this is possible
(and is the common belief of how they work). The progesterone
IUD works hormonally by preventing ovulation and thickening
the cervical mucus to prevent sperm from entering the uterus.
The copper IUD can be used for up to 10 years; the progesterone
IUD can be used for 1 year.
Who
Should and Should Not Use It:
This method is especially good for women in mutually faithful
relationships, who have had at least one child, and are
interested in reversible, long-term contraception. Women
who are allergic to copper, who have sexual transmitted
diseases (STDs), who have more than one sexual partner,
who have had pelvic infections, who have fibroids or abnormal
uteruses should not use IUDs as the risk of complications
and infections goes up significantly.
Women
who have not yet had children should avoid using IUDs as
there is a higher incidence of certain complications. IUDs
are not recommended for women who are taking steroids, have
HIV or AIDS, have unexplained or abnormal vaginal bleeding,
have cancer of the cervix or uterus or abnormal pap smears.
Women with a history of breast cancer or a suspicious breast
lump should not use the progesterone IUD, and should alert
their doctor to the lump.
Summary of Depo-Provera
| Effectiveness
(Failure Rate) |
COPPER
IUD
Typical
Use: 2 pregnancies per 100 women per year (98% effective)
Perfect
Use:1.5 pregnancies per 100 women per year (98.5%
effective)
Progesterone
IUD
Typical
Use: 8 pregnancies per 1000 per year (99.2% effective)
Perfect
Use: 6 pregnancies per 1000 per year (99.4% effective)
|
| Benefits |
Highly
effective long-term contraception
Protection
for up to 10 years
Ease
of use
Women
who can't use hormone methods can use the copper
IUD with good protection
|
| Risks |
Increased
incidence of PID (pelvic inflammatory disease) which
can lead to infertility and internal scarring
Higher
risk of contracting HIV and other STDs if other protection
not used
2-10%
of users spontaneously expel the IUD from their uteruses
in the first year
Though
risk of pregnancy is lower than most other forms of
contraception, there is a higher risk of ecotopic
pregnancies if one gets pregnant while using an IUD
(ectopic pregnancies are a medical emergency).
Risk
(1/1000) of injury to uterus during insertion of IUD;
commonly insertion causes cramping and discomfort.
|
|
STD
Protection
|
Absolutely
none. (May actually increase risk of contracting HIV
and other STDs.) |
| How
to Get It |
Visit
your doctor or health care provider to see if this is
right for you. A prescription is needed. |
| Cost |
About
$150-200 for the total cost of IUD plus insertion and
exam |
