New Thinking on IUDs: Safe, Effective Birth Control

A controversial form of contraception known as the IUD--or intrauterine device--may be poised to make a comeback. Dr. Emily Senay has the details.

What's the latest news about IUDs?

For almost 30 years now, we've known that they are a highly effective form of birth control, but concerns over their safety and fears that they might cause infertility have stopped many women from using them.

Now a new study out this morning in the New England Journal of Medicine shows that the copper-coated IUD might not be such a bad idea after all. Researchers found that the risk of pelvic inflammatory disease and infertility for women who never had children is no greater in those who use the IUD compared to those who don't.

This study really goes against the conventional wisdom about the IUD. The researchers categorize the copper IUD as one of the safest, most effective forms of contraception available.

Haven't we heard in the past that IUDs are dangerous?

Intense publicity and litigation surrounding the use of one IUD called the Dalkon Shield made the use of all forms of IUD in this country nearly extinct. It was believed that the Dalkon Shield led to disease and infertility in some women. It was removed from the market, but doctors and women have generally stayed away from all forms of IUDs since. IUD use dropped from about 10% of women using contraception to about 1%.

Does this mean IUDs are safe?

It certainly adds to the growing body of evidence that the devices that are currently available are not associated with problems like those of the Dalkon Shield. Whether or not gynecologists and women accept them widely remains to be seen.

How did they conduct the infertility study if they're not widely used?

The study was conducted in Mexico, where IUDs have always been widely used despite the controversy over them in this country. In fact, it is interesting to note that IUDs worldwide are the most common form of birth control, used by an estimated 100 million women--more than even the pill.

What kinds of IUDs are available now?

There are two brands available. There's the copper form and another one that releases hormones. They both work in different ways to prevent fertilization of the egg by the sperm. The copper form lasts for up to 10 years, and the hormonal for 5 years.

What should women know if they want to consider an IUD?

The most important thing to know is that they do not prevent sexually transmitted diseases, so the ideal candidate for an IUD is a woman who is in a mutually monogamous relationship.

What are the benefits of an IUD over other forms of contraception?

You only have it inserted once, and the contraceptive effects of an IUD are completely reversible once removed. It's also a very cheap form of contraception.
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