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Sunday, March 4, 2012

Intra-uterine Devices (IUDs) are Regaining Popularity in America

Posted by Prahallad Panda on 11:40 AM Comments


Intrauterine device as a method of temporary method of contraception has been very good. Despite its advantages, the popularity went down especially in America due to bad publicity, lawsuits and widespread fears of health hazards in 1970s and 1980s.

English: Mirena IntraUterine System Deutsch: M...
Image via Wikipedia; IUD

Use of oral contraceptive was preferred during the period and since 2002 again the use of IUD is catching up after many researches disproved some of the hazards to which it was wrongly linked.
Among those was the fear of infection, the pelvic inflammatory disease that can lead to infertility was most prevalent. Other misconceptions, fear of getting cancer of cervix or uterus, mis-campaign or some unforeseen/unknown fears with a foreign object like IUD to be in place; perhaps limited its use.
Actual adverse effects associated with its use was sometimes escalated to make it a less preferred choice among the available methods of contraception.
Use of IUDs declined drastically in the 1970s and 1980s when one device, the Dalkon Shield, was linked to severe infections. Poorly designed studies blamed all IUDs for infections that damaged a woman’s tubes and caused infertility. The Dalkon Shield was taken off the market, but later studies that were better designed found that, all other factors being equal, there were no more cases of pelvic inflammatory disease among IUD users than occurred in non-users.
Rather, researchers noted, some women already had sexually transmitted infections like chlamydia and gonorrhoea at the time an IUD was inserted, and the process of insertion carried the infection higher into the reproductive tract. Now physicians know to screen women for such infections and treat any that are present before inserting an IUD.
The number of women in America now using an IUD has more than tripled since 2002 . In the 12 months ending in August 2011, IUDs accounted for 10.4 percent of contraceptives issued by doctors, up from just 1.7 percent in the 12 months ending August 2002, according to data from SDI Health, a health care research firm.
These are some of the facts about the IUD;
  • Pregnancy or IUD failure. Any device or drugs have their own limitations and can not be 100% full proof; and so is the IUD that is associated with 1 in 100 pregnancies in a year with IUD in place. Still, its failure rate is lower in comparison with other methods; about 3 per 100 for the injection of Depo-Provera, about 8 per 100 for the pill and about 15 per 100 for the condom.
  • Ectopic pregnancy, an implantation of of the product of conception in some other place like tubes, rather than the normal place the uterus sometimes occur. This is a true hazard and has to be weighed against the advantages of its use.
  • Infection or pelvic inflammatory disease (PID) can occur, if the person is having infection earlier to the insertion of IUD. Also, infection can be carried into the uterus and up, if proper anti-septic measures has not been taken. Now-a-days, prior infection with agents like chlamydia and other sexually transmitted diseases can be tested and treated adequately before insertion of the device. Insertion of IUD as such is not associated with greater risk of catching infection, if safe sexual practices are being followed; for example one having multiple sexual partners or partners having infection is at the risk of catching infection, which is similar to non-users.
  • Incidence of displacement of the device is not uncommon; that may come out, that is why it is advised to feel the thread attached to the device sometimes to conform that it is in place. It may get into body cavity, if adequate precaution has not been taken by the health care provider during its insertion, or possible perforation has not been detected.
  • Its use does not increase the incidence of cancer of cervix or uterus. Furthermore, IUD use has been found to reduce the risk of developing endometrial cancer. And a new study, published online by The Lancet Oncology in September 2011, strongly suggested that IUD use can protect against cervical cancer as well. Of course, the users should have not already been infected with the human papilloma virus (HPV).
  • Painful menstruation associated with heavy bleeding in some is a reality and can be tackled with some medications at the time of periods.
Given that nearly half of all pregnancies are unplanned, having a contraceptive in can reduce unwanted pregnancies and, consequently, the number of abortions. Not only is the IUD more than 99 percent effective in preventing pregnancy, but insertion of an IUD soon after a woman has unprotected intercourse is often effective as emergency contraception.
Two types of IUDs are available; one that releases tiny amounts of copper; the other that releases localized amounts of a synthetic hormone, the progestin levonorgestrel. IUDs do not disrupt the menstrual cycle and, unlike the pill, they do not prevent ovulation; rather, they interfere with fertilization and implantation.
The copper devices can remain in place for 5, 10 or 12 years, copper stimulates production of fluid in the woman’s reproductive tract that kills sperm. Should an egg become fertilized, copper-induced changes in the uterus prevent implantation.
The hormonal IUD, which can last for five years, prevents pregnancy by thickening the cervical mucus, making it difficult for sperm to get to the fallopian tubes, where fertilization takes place. The hormone also impedes changes in the uterine lining that are needed for implantation of a fertilized egg.
IUDs are best suited for couples in a monogamous relationship. If a woman or her sexual partner has multiple partners, condoms should be consistently used even after an IUD is in place to reduce the risk of sexually transmitted infections.
Therefore, IUDs are neither suitable nor unsuitable for each and every woman, which has to be decided by experienced healthcare provider. And it is also important for women and their partners to be honest about their sexual behavior before an IUD is chosen as a method of contraception.


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