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Intrauterine device or intrauterine contraceptive device is a form of birth control that involves an object placed in the uterus to promote contraception.[1] Types include:

  • IUD with copper
  • IUD with progestogen (according to some sources, in the UK, it is referred to as a "system" and not a "device" when progestogen is used. However, the WHO/ATC name is IUD for both copper and progestogen containing approaches.)

Contents

Types of IUDs

There are two broad categories of intrauterine contraceptive devices: inert and copper-based devices, and hormonally-based devices that work by releasing a progestogen.

In the United States, there are two types of intrauterine contraceptive available: the copper Paragard and the hormonal Mirena. Both of these contraceptives are referred to as IUDs.[2]

In the United Kingdom, where ten types of copper-containing IUDs are available, the term IUD only refers to inert or copper-containing devices. Hormonal intrauterine contraceptives are considered a different form of contraception from copper IUDs, and they are distinguished with the term intrauterine system or IUS.[3][4]

Inert and copper-based devices

Most non-hormonal IUDs have a plastic T-shaped frame that is wound around with pure electrolytic copper wire and/or has copper collars (sleeves). The Paragard T 380a is 32 mm (1.26") in the horizontal direction (top of the T), and 36 mm (1.42") in the vertical direction (leg of the T). In some IUDs, such as the Nova T 380, the pure copper wire has a silver core which has been shown to prevent breaking of the wire.[3][5] The arms of the frame hold the IUD in place near the top of the uterus. The GyneFix does not have a T-shape, but rather is a loop that holds several copper tubes. The GyneFix is held in place by a suture to the fundus of the uterus. All copper-containing IUDs have a number as part of their name. This is the surface area of copper (in square millimeters) the IUD provides.

Hormonal intra-uterine devices

Hormonal uterine devices do not increase bleeding as inert and copper-containing IUDs do. Rather, they reduce menstrual bleeding or prevent menstruation altogether, and can be used as a treatment for menorrhagia (heavy periods).

Although use of IntraUterine Systems results in much lower systemic progestogen levels than other very-low-dose progestogen-only hormonal contraceptives, they might possibly have some of the same side effects.

Progestasert was the first hormonal uterine device, developed in 1976[6] and manufactured until 2001.[7] It released progesterone, was replaced annually, and had a failure rate of 2% per year.[8]

As of 2007, the LNG-20 IUS - marketed as Mirena by Bayer - is the only IntraUterine System available. First introduced in 1990, it releases levonorgestrel (a progestogen) and may be used for five years.

A lower-dose T-shaped IntraUterine System named Femilis is being developed by Contrel, a Belgian company. Contrel also manufactures the FibroPlant-LNG, a frameless IUS. FibroPlant is anchored to the fundus of the uterus as the GyneFix IUD is. Although a number of trials have shown positive results, FibroPlant is not yet commercially available.[9]

See also

References

  1. ^ intrauterine device at Dorland's Medical Dictionary
  2. ^ Treiman K, Liskin L, Kols A, Rinehart W (1995). "IUDs—an update" (PDF). Popul Rep B (6): 1–35. PMID 8724322. http://www.infoforhealth.org/pr/b6/b6.pdf. Retrieved 2006-01-01. 
  3. ^ a b "Contraceptive coils (IUDs)". NetDoctor.co.uk. 2006. http://www.netdoctor.co.uk/sex_relationships/facts/contraceptivecoil.htm. Retrieved 2006-07-05. 
  4. ^ French, R; Van Vliet H, Cowan F, et al. (2004). "Hormonally impregnated intrauterine systems (IUSs) versus other forms of reversible contraceptives as effective methods of preventing pregnancy". Cochrane Database of Systematic Reviews (3): CD001776. doi:10.1002/14651858.CD001776.pub2. PMID 15266453. 
  5. ^ Schering (May 13, 2003). "Nova T380 Patient information leaflet (PIL)". http://emc.medicines.org.uk/emc/assets/c/html/displaydoc.asp?documentid=3641. Retrieved 2007-04-27. 
  6. ^ IUDs—An Update. Chapter 2: Types of IUDs.
  7. ^ Smith (pseudonym), Sydney (March 8, 2003). "Contraceptive Concerns". medpundit: Commentary on medical news by a practicing physician.. http://www.medpundit.blogspot.com/2003_03_02_medpundit_archive.html. Retrieved 2006-07-16. 
  8. ^ "Birth Control Options: The Progestasert Intrauterine Device (IUD)". Wyoming Health Council. 2004. http://wyhc.org/birth_control_options/Progestasert-IUD.php. Retrieved 2006-07-16. 
  9. ^ "New Contraceptive Choices". Population Reports, INFO Project, Center for Communication Programs (The Johns Hopkins School of Public Health) M (19). April 2005. http://www.infoforhealth.org/pr/m19/. Retrieved 2006-07-14.  Chapter 9: Intrauterine Devices.







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