Items in AFP with MESH term: Intrauterine Devices
ABSTRACT: The intrauterine device (IUD) is an effective contraceptive for many women. The copper-releasing IUD can be used for 10 years before replacement and is a good choice for women who cannot, or choose not to, use hormone-releasing contraceptives. However, some women experience an increase in menstrual blood loss and dysmenorrhea. The progestin-releasing IUD can be used for five years. It may reduce menorrhagia and dysmenorrhea, although some women have increased spotting and bleeding during the first months after insertion. The ideal candidates for IUD use are parous women in stable, monogamous relationships. Pregnancy, unexplained vaginal bleeding, and a lifestyle placing the woman at risk for sexually transmitted diseases are contraindications to IUD use. Insertion of the IUD can take place at any time during the menstrual cycle provided the woman is not pregnant. Before insertion, a bimanual examination and a sounding of the uterus are necessary to determine the uterus position and the depth of the uterine cavity. The IUD is inserted into the uterus according to individual protocols, with the threads cut at a length to allow the patient to check the device's position. Expulsion may occur with both types of IUDs.
ABSTRACT: The intrauterine device, a common form of birth control in the early 1970s, is now avoided by American physicians and women because of concern about complications. This concern is largely the result of the problems reported with use of an intrauterine device that is no longer manufactured. More recent intrauterine devices have an improved design, and reevaluation has shown them to be a safe, efficacious and cost-effective form of birth control. Careful patient selection and preinsertion counseling are crucial to success with the device. Recent studies conclude that the intrauterine device poses no increased risk of pelvic inflammatory disease or infertility when used by appropriately selected patients.
IUDs: Time for a Renaissance - Editorials