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Physicians: IUD Should Be First-Line Birth Control


Although the slim t-shaped birth control device known as an IUD has been around for nearly 40 years it is just now receiving endorsement by the American College of Obstetricians and Gynecologists (ACOG). The organization of physicians says that the device's effectiveness should make it a top option for most women seeking to prevent pregnancy.

The announcement came as a part of a new set of practice guidelines released aiming to reduce the amount of unplanned pregnancies in the Untied States.

"[IUD] methods are the best tool we have to fight against unintended pregnancies, which currently account for 49% of US pregnancies each year," said Eve Espey, MD, MPH, who was a part of the panel of physicians which created the new guidelines. "The major advantage is that after insertion, LARCs work without having to do anything else. There's no maintenance required."

According to ACOG more than half of all women with unplanned pregnancies were using birth control at the time of conception, an indication incorrect and inconsistent use of current contraceptive methods.

The IUD, which stands for intrauterine device, is a small device coated with either copper or hormones and inserted by a physician into the uterus. The copper IUD can remain in place for 10 years and works by damaging the sperm as they try and pass through the uterus to the fallopian tubes. The advantage of the copper IUD is that a woman continues to ovulate and there are no additional risks associated with hormone additives. However, many women report heavier bleeding and more painful cramping during menstruation.

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The hormonal IUD can be left in place for 5 years and works by releasing progestin into the uterus. Progestin thickens the cervical mucus, thins the lining of the uteurs and discourage sperm from passing though. This form of IUD has less side effects than the copper.

In the report, ACOG also endorses a contraceptive implant which is a small device that is placed under the skin that releases a controlled amount of hormones for up to three years.

Currently in the Untied States less than 6 percent of women choose to use an IUD. Experts believe that a lack of correct information about these methods is what prevents most women from using them. Some of these misguided beliefs include that IUDs are a form of abortion and that there is an increased risk over other forms of birth control for infertility or cancer. However, experts say that this is not the case.

"Women need to know that today's IUDs are much improved from earlier versions, and complications are extremely rare. IUDs are not abortifacients—they work before pregnancy is established—and are safe for the majority of women, including adolescents and women who have never had children. And while upfront costs may be higher, LARCs are much more cost-effective than other contraceptive methods in the long run," Dr. Espey said.

The one disadvantage of the IUDs an implants are that they do not protect against sexually transmitted diseases such as gonorrhea or HIV. An additional barrier form of birth control, such as condoms, are needed.

American College of Obstetricians and Gynecologists