Friday, May 09, 2008

ACOG ♥ the IUD


Ode to the Intrauterine device (IUD) at the annual ACOG meeting in New Orleans:

1. among the most effective contraceptives

2. treatment of heavy menstrual bleeding

3. treatment of endometriosis

4. associated with a 40 percent reduction in the risk of endometrial cancer

5. suitable for both women who've never given birth, as well as for those who have

If you are about to start using a birth control method, or are considering switching methods, I can not urge you strongly enough to give the IUD serious consideration.

After all, the IUD is the bestest, prettiest method of them all.

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At 8:12 PM, Blogger Lala said...

Is it really suitable for nulliparous women? I was told I couldn't have it.

At 9:52 PM, Blogger ema said...


Yes it's quite suitable for nulliparous women.

Nulliparity is not a contraindication to use. [It used to be mentioned as a contraindication on IUD patient labels here in the US mostly for legal, not medical, reasons, but it's been removed.]

I suspect the reason you were told you couldn't use it was because your doctor is not too familiar with the method. The IUD is a very underused method here so not a lot of MDs have enough experience with it.

In any case, if you and your partner are monogamous, you can use an IUD. [There's no increased risk of PID or infertility in either parous or nulliparous women and Mirena may even be protective against infection.]

Two things to keep in mind:

1) a slightly higher risk of expulsion for nullips (for the copper IUD). There's no hard data on which brand of IUD is better, but, since only one brans is available in the US (ParaGard) your options are limited to begin with.

2) an increased likelihood of heavy periods with the copper IUD. So, depending on your particular circumstances, you might want to consider the Mirena IUD (the hormone-releasing one) as opposed to the Cu-releasing one.

Here are a couple of review articles with more references (subscription is required):

1) David Hubacher. Copper intrauterine device use by nulliparous women: review of side effects. Contraception. Volume 75, Issue 6, Supplement, Pages S8-S11 (June 2007)

2) Sarah Prager, Philip D. Darney. The levonorgestrel intrauterine system in nulliparous women. Contraception. Volume 75, Issue 6, Supplement, Pages S12-S15 (June 2007)

At 4:51 PM, Anonymous Kel said...

Wow, thank you for this info! I also was told that it wasn't an option for me as I've never given birth, and I was very disappointed.

At 2:28 AM, Anonymous red rabbit said...

As a nullip and MD who's had both copper and Mirena IUDs, I should say a couple of things:

The insertion hurts a lot more for nullips as our cervix is harder and more sensitive that a cervix that's had a baby pushed through it. But it's tolerable. Over-the-counter painkillers half an hour beforehand help a lot.

Copper IUDs may lead to heavy bleeding, so if you have heavy painful periods, consider a Mirena. They can really reduce the pain and bleeding.

I LOVE mine.

But remember: check with your doc about how long it lasts and get it taken out or changed. I have seen four recent IUD pregnancies, because the IUD was well and truly expired in every case.

At 11:22 PM, Anonymous Anonymous said...

I have never had children and tried to have a copper IUD inserted. My doctor said my uterus was too small.


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