Separating fact from fiction about IUDs

April 28, 2008 12:00:00 AM PDT
The IUD (intra-uterine device) is the most widely used form of reversible birth control. Dr. Leah Millheiser from Stanford's Obstetrics and Gynecology explains how in recent years, doctors have found other uses and benefits of this device.

The many uses of the IUD
From Dr. Leah Millheiser

1) What is an IUD?

-An IntraUterine Device (or IUC: IntraUterine Contraceptive)

2) Why does the IUD historically have such a bad rap?

-In the 1970s, the Dalkon Shield IUD was associated with septic abortions and pelvic infections and was taken off the market. In the past decade, several modern IUDs have been introduced to the market that are safe and effective. Today, IUDs are the most common form of reversible birth control used around the world.

3) What are the different types of IUDs available in the United States today?

-Mirena: progesterone secreting IUD. Lasts for 5 years Women may experience mood changes, acne, breast tenderness and weight gain due to slight increase of progesterone levels in the circulation

-Paraguard: copper IUD. Lasts for 10 years. No hormone.

4) How does the IUD keep you from getting pregnant?

-Mostly, it prevents fertilization of an egg by a sperm; but also by inhibiting implantation of a fertilized egg and thickening cervical mucus

-Most women using the IUD will continue to ovulate

5) What are the benefits to the IUD?

-They are safe, highly effective, rapidly reversal, and cost-effective

6) Who are appropriate candidates for IUD?

-Any woman at low risk for sexually transmitted diseases

-Desire long-term reversible contraception

-Women in whom estrogen is contraindicated

7) Can women who have never been pregnant or delivered a baby use the IUD?

-Yes

8) When should a women going through menopause remove her IUD?

-After one year of no menstrual periods

9) Are there uses for the IUD other than contraception? -Emergency Contraception: the copper IUD (Paraguard) can be placed within 5 days after unprotected intercourse to prevent pregnancy

-Treatment for heavy menstrual bleeding: the progesterone IUD (Mirena) can be used to decrease heavy menstrual blood flow. Several studies have shown that it is more effective than oral progesterone pills. The IUD should only be placed once other, more serious, causes of the heavy bleeding are ruled out by a clinician. It can be used as an alternative therapy to hysterectomy.

-Menopausal Hormone Therapy: (Mirena) alternative delivery method for progesterone component of combined menopausal hormone replacement therapy. Good for women who cannot tolerate oral progesterone pills. Women experience similar decreases in hot flashes and night sweats when compared to women taking traditional hormone replacement regimens (estrogen and progesterone pills and patches)

-Treatment for Pelvic Pain: small studies show that the Mirena IUD may reduce endometriosis-associated pelvic pain.


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