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The IUD Makes a Comeback

The history of the modern, t-shaped, copper intrauterine contraceptive device (IUD) dates from the late 60’s when Dr. Howard Tatum of the U.S. devised the new t-shape. Previous plastic IUD devices had been larger, coil-shaped contraptions with a hard plastic tails making them painful for her, and painful for him.

At about the same time in Peru, Dr. Jaime Cooper determined that adding copper to the filaments of the t-shaped device improved its contraceptive effectiveness. This new design was easier to insert than the old design, had fewer side effects, and was a reliable way to prevent pregnancy.

At about the same time, however, the poorly designed Dalkon Shield was marketed and sold in the U.S. Rather than using a t-design, the Dalkon Shield had a multifilament tail and resulted in a huge rise in safety concerns over pelvic infections and other disturbing side effects. Sales of the device in the U.S. were suspended in June 1974, and it left a public pall over the whole idea of using an IUD for a time.

Nearly forty years on, the pall appears to be lifting. According to the Wall Street Journal, “As of 2010, about 2.1 million U.S. women were using an IUD, the highest level since the early 1980s…. Of women using contraception, about 5% use an IUD, which is still less than the 27% who use the hormonal pill.”

One of the reasons for the rise in popularity of the IUD is its nearly 100% effectiveness, which makes it “20 times more effective than birth control pills, the patch or vaginal ring, according to a 2012 study published in the New England Journal of Medicine.” The IUD virtually eliminates human error.

The IUD Makes a Comeback

The word is also getting out that IUDS are safer and more effective than in the past. Today’s IUDs don’t have multifilament strings, which attract bacteria and infections, and studies show no connection between these new IUDS and pelvic infection or infertility.

Two kinds of IUDS are currently available: Mirena and ParaGard. The Mirena IUD releases a small amount of the hormone progesterone each day. The progesterone acts locally in the uterus to prevent pregnancy, rather than traveling throughout your whole body as it would with a hormonal birth control pill. It contains no estrogen, so it has fewer side effects. With Mirena, users may experience some light irregular bleeding for the first three to six months, but after that initial adjustment period, most women will have periods that are regular, light, short and not painful.

ParaGard prevents pregnancy thanks to a tiny copper filament wrapped around the T. It does not use hormones of any kind and it is the only extremely effective non-hormonal birth control method available. The drawback with ParaGard is that during the first several months of use, many women will have heavier, longer and sometimes crampier periods with this method. Once they are through that initial adjustment, most women’s periods return to normal.

Cost is becoming less of a barrier to use of an IUD now that the Affordable Care Act’s birth-control provision covers the cost not only of the device, but the preliminary consultation and follow-up appointments. And while IUDS have traditionally been used for long-term family planning, Dr. Deborah Nucatola, senior director of medical services for Planned Parenthood said in the WSJ article that the device is also one of “the most effective forms of emergency contraception.”

If an IUD sounds like a good birth control option for you, talk with your AOA physician about your particular health history and determine which IUD option will best suit your lifestyle.

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