Although some version of the intrauterine device (IUD) has been available for female contraception since the 1970s, side effects both large and small prevented most women from considering it a valid option. However, advances in design and usage have resulted in the American College of Obstetricians and Gynecologists formal endorsement of the device for all healthy adult women. Experts now say that the risk of side effects such as pelvic inflammatory disease, once associated with IUDs, is small; this, combined with its less than 1 percent contraceptive failure rate, prompted the new recommendations in a Practice Bulletin in the July issue of Obstetrics and Gynecology.
Currently, less than 6 percent of women using birth control choose an IUD. Yet the recent Practice Bulletin notes that such long-acting contraceptive methods could help lower the rates of unintended pregnancies because they eliminate the problem of gaps in the use of shorter-acting methods.
Like most birth control methods, the T-shaped devices, which are inserted into the uterus, are not risk free. According to the American Pregnancy Association, IUDs are more likely to increase the risk of pelvic inflammation if a woman has more than one sexual partner. Other possible side-effects, such as headache, weight gain, and mood changes, are similar to those associated with oral contraceptives. And, like other methods, except condoms, they do not protect against sexually transmitted diseases.
Having taken the risks and benefits of today s IUDs into account, ACSH's Dr. Gilbert Ross believes that physicians should indeed encourage the device s more wide spread use by younger women. The fact that IUDs may lower unintended pregnancy rates is very important, he says.
