The IUD Is Having a Moment
"That's it?" women say when I review currently available birth control options.
It's hard to believe--I was going to say inconceivable--but the array of contraceptive methods from which women and men can choose isn't much bigger or better than that about which their parents first learned in middle school health class a generation ago. Most patients in my practice (and most American women generally) choose birth control pills, barrier methods such as condoms or diaphragms, or, if they do not plan to have children in the future, tubal ligation and vasectomy.
Reports this week about new research involving the intrauterine device (IUD) may cause women to reconsider an old form of birth control.
According to a 2006 study, the IUD is the most popular form of reversible birth control worldwide but is used by only 2% of American women. The Dalkon shield, an IUD first produced in 1971, caused severe infections and other complications before being pulled from the market. Many women, including many of my patients, still associate the IUD with the Dalkon catastrophe even though newer versions have excellent safety records.
The two IUDs available now include: the ParaGard, which contains copper, can stay in the uterus for up to 12 years, and may cause heavier than usual periods; and the Mirena, which contains the hormone levonorgestrel, can remain in place for 5 years, and results in little if any menstrual period.
For reasons that aren't clear, according to this new research the IUD seems to reduce cervical cancer risk by nearly half--and not because women who use them are more likely to be screened.
In the past the IUD was mainly recommended for women who'd had children. But the American Congress of Obstetricians and Gynecologists (ACOG) now recommends the IUD for younger women and women who have not been pregnant before and considers it the most effective form of reversible birth control available.
It's not for everyone, and it doesn't protect against most sexually transmitted diseases, but a 99% effective, completely reversible form of birth control that may prevent cervical cancer is at least worth a fresh look.
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About the author
Suzanne Koven, M.D. practices internal medicine at Massachusetts General Hospital in Boston. She writes a monthly column for the Globe's G Health section and her essays have appeared in the More »Recent blog posts
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