Contraceptives

The very mention of the Dalkon shield contraceptive device sent shudders through the women of America in the 1970’s. At that time, 12 deaths occurred as a result of miscarriage related infections associated with the use of this female contraceptive. Consequently this particular contraceptive was taken off the market in 1975.

Today, that model of contraceptive is widely acknowledged to have had a flawed design, being a multifilament string that served as a channel for infection to a woman’s uterus. Infection could lead to diseases of the pelvic area, infertility and in the worst cases, to the septic miscarriages that first sparked panic.

What is an IUD? An Intra Uterine Device or IUD is a small, plastic or metal/copper device inserted into the uterus that provides years of protection against pregnancy, primarily by interfering with sperm and eggs. For types, use, pros and cons see this easy to follow Handout

Today’s IUDs are one of the most popular types of contraceptive in use and are effective from the time of insertion. Only three IUDs are available in the United States: —the Copper-T 380A (also known as the ParaGard), the Progestasert and a newer one called the Mirena (introduced in the United States in 2001) Effective for a full five years, the Mirena releases a tiny daily amount of levonorgestrel, a hormone similar to progesterone.  A much lower dose of hormone (12mcg) is released via Mirena  than when you take  a ‘low dose’ birth control Pill  and it goes directly to the lining of the womb, rather than through the blood stream, where it may lead to the common progesterone-type side effects
No women have died after an IUD ­related miscarriage since 1977 but if a woman has an STD, such as chlamydia, at the time of the insertion of the IUD or soon after, even with the today’s improved design she may be at a higher risk of miscarriage than a nonuser and she may also tend to get more vaginal infections and inflammation of the cervix (cervicitis) .

Neither copper nor hormonal IUDs will protect you against sexually transmitted diseases so please use a condom and spermicide as ‘backup’ if you have more than one sexual partner.

The scientific consensus is that an IUD is safe - even for single women and women who have never given birth (presuming they do not have an active STI at or near the time of insertion). Insertion for women who have never given birth can be a little more difficult though and sometimes the contraceptive device can be more easily expelled so extra vigilance is recommended. If you know that you will constantly be at risk of catching an STI you should NOT have this type of contraceptive fitted.

Use of this type of contraceptive should be discussed with your doctor . The life span (5-10 years ) alone is an important factor for young women to talk about if they wish to have a family at some future date - the IUD does not affect your ability to have children once it is removed- pelvic infections can lead to infertility. For women who have finished having children, this method of contraception may be the answer.
PS. If you are currently using a contraceptive IUD and you think you may be pregnant see your doctor as soon as possible to rule out an ectopic (outside the uterus) pregnancy and have the IUD removed to avoid any risk of a miscarriage.

Future posts on this type of contraceptive and its fitting/insertion will also review the differences between copper IUDs and hormonal IUDs.

Popularity Disparity: Attitudes About the IUD in Europe and the United States