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Intrauterine devices. The optimal long-term contraceptive method?
J Reprod Med. 1999 Mar; 44(3):269-74.JR

Abstract

OBJECTIVE

To review selected data on the effectiveness, safety, cost and technical ease of intrauterine device (IUD) use compared with Norplant and surgical sterilization.

STUDY DESIGN

Literature review.

RESULTS

IUDs are highly effective, safe and relatively inexpensive methods of contraception that may offer advantages for some women over other long-term methods, such as sterilization and Norplant. IUDs provide protection against pregnancy comparable to that provided by female sterilization, and they may be more effective than Norplant. IUDs have a long duration of effectiveness: the copper T 380A (TCu380A) is effective for at least 10 years, and the levonorgestrel (LNg) IUD appears to be effective for at least 7. Norplant is effective for only five years. Both types of IUD can disrupt menstrual bleeding patterns, although the patterns of bleeding are different. Copper IUDs often increase blood loss, whereas the LNg IUD, like Norplant, substantially reduces menstrual bleeding. The most important adverse outcome associated with IUD use is higher rates of pelvic inflammatory disease; careful attention to proper insertion techniques can reduce this risk substantially, and LNg IUDs may cause no increase in risk. IUDs, like both sterilization and Norplant, provide no protection against sexually transmitted disease. The TCu380A IUD is extremely cost-effective. There is as yet no public sector price for the LNg IUD, which has not been approved by the U.S. Food and Drug Administration and is not provided by family planning donor organizations. If it can be made available to the public sector at a price substantially less than its present market price, the LNg IUD would be a useful addition to the contraceptive armamentarium for developing countries.

CONCLUSION

Providers, consumers and family planning program managers should begin to see IUDs as potential substitutes for both surgical sterilization and Norplant.

Authors+Show Affiliations

Family Health International, Research Triangle Park, North Carolina 27709, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Review

Language

eng

PubMed ID

10202746

Citation

Fortney, J A., et al. "Intrauterine Devices. the Optimal Long-term Contraceptive Method?" The Journal of Reproductive Medicine, vol. 44, no. 3, 1999, pp. 269-74.
Fortney JA, Feldblum PJ, Raymond EG. Intrauterine devices. The optimal long-term contraceptive method? J Reprod Med. 1999;44(3):269-74.
Fortney, J. A., Feldblum, P. J., & Raymond, E. G. (1999). Intrauterine devices. The optimal long-term contraceptive method? The Journal of Reproductive Medicine, 44(3), 269-74.
Fortney JA, Feldblum PJ, Raymond EG. Intrauterine Devices. the Optimal Long-term Contraceptive Method. J Reprod Med. 1999;44(3):269-74. PubMed PMID: 10202746.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intrauterine devices. The optimal long-term contraceptive method? AU - Fortney,J A, AU - Feldblum,P J, AU - Raymond,E G, PY - 1999/4/15/pubmed PY - 2000/2/19/medline PY - 1999/4/15/entrez KW - Americas KW - Contraception KW - Contraceptive Agents KW - Contraceptive Agents, Female KW - Contraceptive Agents, Progestin KW - Contraceptive Effectiveness KW - Contraceptive Implants KW - Contraceptive Methods KW - Developed Countries KW - Family Planning KW - Health KW - Iud KW - Iud, Copper Releasing KW - Iud, Hormone Releasing KW - Levonorgestrel KW - Literature Review KW - North America KW - North Carolina KW - Northern America KW - Public Health KW - Safety KW - United States SP - 269 EP - 74 JF - The Journal of reproductive medicine JO - J Reprod Med VL - 44 IS - 3 N2 - OBJECTIVE: To review selected data on the effectiveness, safety, cost and technical ease of intrauterine device (IUD) use compared with Norplant and surgical sterilization. STUDY DESIGN: Literature review. RESULTS: IUDs are highly effective, safe and relatively inexpensive methods of contraception that may offer advantages for some women over other long-term methods, such as sterilization and Norplant. IUDs provide protection against pregnancy comparable to that provided by female sterilization, and they may be more effective than Norplant. IUDs have a long duration of effectiveness: the copper T 380A (TCu380A) is effective for at least 10 years, and the levonorgestrel (LNg) IUD appears to be effective for at least 7. Norplant is effective for only five years. Both types of IUD can disrupt menstrual bleeding patterns, although the patterns of bleeding are different. Copper IUDs often increase blood loss, whereas the LNg IUD, like Norplant, substantially reduces menstrual bleeding. The most important adverse outcome associated with IUD use is higher rates of pelvic inflammatory disease; careful attention to proper insertion techniques can reduce this risk substantially, and LNg IUDs may cause no increase in risk. IUDs, like both sterilization and Norplant, provide no protection against sexually transmitted disease. The TCu380A IUD is extremely cost-effective. There is as yet no public sector price for the LNg IUD, which has not been approved by the U.S. Food and Drug Administration and is not provided by family planning donor organizations. If it can be made available to the public sector at a price substantially less than its present market price, the LNg IUD would be a useful addition to the contraceptive armamentarium for developing countries. CONCLUSION: Providers, consumers and family planning program managers should begin to see IUDs as potential substitutes for both surgical sterilization and Norplant. SN - 0024-7758 UR - https://www.unboundmedicine.com/medline/citation/10202746/Intrauterine_devices__The_optimal_long_term_contraceptive_method L2 - https://medlineplus.gov/tuballigation.html DB - PRIME DP - Unbound Medicine ER -