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Entries in IUD (4)

Wednesday
May232012

Birth Control: New Research Gives Boost to IUD Effectiveness

Photodisc/Thinkstock(NEW YORK) -- Twenty-seven-year-old Julie Vonder Haar of St. Louis describes herself as a smart and responsible person, but like many women, she found it difficult to remember taking her birth control pills while juggling four jobs. That was until she discovered the IUD.

"Having it and not having to worry about it, taking that off my plate helped immensely," she said.

As it turns out, Vonder Haar's choice may not only be more convenient but more effective as well. Long-acting reversible contraception like intrauterine devices and progestin implants can prevent unwanted pregnancy up to 20 times better than birth control pills, patches and vaginal rings, according to a study from Washington University School of Medicine, published Wednesday in the New England Journal of Medicine. Of the 3 million unwanted pregnancies in the United States, almost half of those are due to incorrect use of the most commonly prescribed forms of birth control -- pills, patches and rings.

An intrauterine device, or IUD, is a small copper or hormonal implant that is placed in the uterus. The insertion can be done in a doctor's office, and it works for 10 years to prevent pregnancy. Bayer's brand-name IUD Mirena, approved in 2009, is one such device. A progestin implant, meanwhile, is inserted in the upper arm and can prevent pregnancy for up to three years. Merck's Nexplanon is the only such implant currently available in the U.S.

Once in place, these devices prevent unwanted pregnancy as effectively as sterilization, but unlike permanent sterilization, when a woman wants to become pregnant she simply has the device removed.

So why aren't more women using long-acting reversible contraception -- and specifically IUDs?

Cost could be one reason. Since it is not covered by many insurance plans, women might find themselves forking out $700 to buy an IUD and have it inserted. Compare this to $10 to $20 per month for birth control pills, which are generally covered by insurance. Over the long term, however, IUDs are cost-effective; when you break the cost down over a five year period, IUDs cost about $11 a month, the same as birth control pills.

Still, for Vonder Haar, cost was a big factor.

"There was no way I could have gotten the Mirena before the study because I couldn't afford the cost up front," she said.

Dr. Jeff Peipert, one of the study authors and vice chair for clinical research at Washington University, said this big initial cost discourages women, since insurance usually does not cover this type of birth control. In the study he conducted, women were allowed to choose which birth control they wanted, free of charge.

"A major surprise was that many people chose long-acting reversible contraceptive (IUD) when barriers were lifted," Peipert said. "Around 75 percent of women chose a long-acting reversible contraceptive; the hormonal IUD was the most popular."

Women's health experts also said myths surrounding IUDs may keep many women from using this option.

"Many patients have heard bad things about IUDs, such as they cause infertility or infections," said Dr. Kevin Ault, associate professor of gynecology and obstetrics at Emory University School of Medicine in Atlanta. "Careful medical research over the past decade shows these fears are not true."

Dr. Lauren F. Streicher, assistant professor of obstetrics and gynecology at Northwestern Memorial Hospital in Chicago, said some women may have also heard that if they have not yet had children they should not opt for an IUD. While this is untrue, she does recommend having a doctor who is experienced place IUDs in these women as placement can be technically difficult.

And then there is the fact that many women may not know what an IUD is, or that such an option exists. IUDs are not nearly as highly advertised as birth control pills, doctors said -- at least not yet. But as more studies like this most recent one emerge, Streicher said, more women may shift to IUDs in the years to come.

"Very clearly, contraception that is not user-dependent is going to have the lowest failure rates," Streicher said. "Half of unintended pregnancies every year are not 'no contraception,' they are 'failed contraception' such as missed pills, etc."

Vonder Haar, a participant in the study, has now had an IUD for three years, and she said she is grateful to the study for giving her the opportunity to use this method of birth control.

"I have recommended this to everyone," she said. "It has made such a difference; I think every girl should be able to have access to this."

Copyright 2012 ABC News Radio

Wednesday
May092012

IUDs Work Best for Emergency Contraceptive, Study Finds

Spike Mafford/Photodisc/Thinkstock(PRINCETON, N.J.) -- Intrauterine devices, or IUDs, have been shown to be the best and most reliable emergency contraceptive for women, according to a new study published in the journal Human Reproduction.

An IUD is a T-shaped plastic or copper device that is placed in a woman's uterus to prevent pregnancy.  They can be left in the womb between five and 10 years, depending on the brand, but they can also be used as a means of emergency contraceptive.  They should be inserted within five days of unprotected sex to properly protect, experts said.

The research showed that IUDs had a failure rate of less than one per 1,000, which was more effective than the morning-after pill, which had a failure rate of 1 to 2 percent.  The morning-after pill, or Plan B One-Step, is a pill that should be taken within 72 hours of unprotected sex to avoid pregnancy.

"Emergency insertion of a copper IUD is extremely effective," said James Trussell, professor of public and international affairs at Princeton University and lead author of the study.  "We would hope [the findings] would encourage clinicians to talk with women about emergency insertion of a copper IUD during regular visits for later use, should the need arise."

The study analyzed data from 42 studies conducted in six different countries (China, Egypt, Italy, The Netherlands, U.S.A. and the U.K.) between 1979 and 2011.  They found that women became pregnant at a rate of 0.09 percent if they used an IUD, as opposed to the 1 to 2 percent pregnancy rate on the morning-after pill.

The research also found that using an IUD for emergency contraception worked just as effectively in women with higher body mass index, while the morning-after pill became less effective at preventing pregnancy in women with higher BMI.

"IUDs are certainly a highly effective form of emergency contraception," said Dr. Ranit Mishori, an assistant professor in the department of family medicine at Georgetown University.  "The study appears to confirm it, [but] I think not many women are aware that it is an effective option."

While the device is indeed better at preventing pregnancy, experts say that it is not necessarily the best option for everyone.

"Here are the problems: the IUD has to be inserted and most of the time, ordered," said Dr. Jacques Moritz, director of gynecology at St. Luke's-Roosevelt Hospital in New York.  "They are way overpriced in this country.  You can't just walk in my office and get an $800 IUD.  We have to get it authorized and ordered."

On the other hand, any woman over the age of 17 can buy Plan B One-Step at a pharmacy without a prescription.  Females under the age of 17 must have a prescription to obtain the product.

Copyright 2012 ABC News Radio

Tuesday
Sep132011

IUDs May Protect Women from Cervical Cancer

Spike Mafford/Photodisc/Thinkstock(NEW YORK) -- Intrauterine devices (IUDs), the small plastic devices inserted into the uterus to prevent pregnancy, may also offer women protection against cervical cancer, according to a new study published in The Lancet.

An international team of researchers analyzed 26 studies that included nearly 20,000 women from 14 countries and found that the risk of cervical cancer in women who used IUDs was nearly half that of women who never used them.

While the researchers did not find a link between IUDs and a lower risk of infection with human papilloma virus (HPV), the virus that leads to cervical cancer, the study's authors believe IUDs may cause an immune response that can get rid of the virus once it enters the body.

"The hypothesis is that an IUD, because it's a foreign body, creates an inflammatory response that gets rid of the HPV, which reduces the risk of cervical cancer," said Dr. Howard Jones, chair of obstetrics and gynecology at Vanderbilt University School of Medicine.

Previous studies have found IUD use reduces the risk of endometrial cancer, but few have looked at the relationship between IUDs and cervical cancer.

Experts not involved with the research say while the findings offer important insight into how cervical cancer develops, clinicians are unlikely to change how they prescribe IUDs as a result of this research since this study does not determine whether a cause-and-effect relationship exists between IUDs and cervical cancer.  The study also did not evaluate specific types of IUDs.

Copyright 2011 ABC News Radio

Wednesday
Sep292010

Contraceptive May Be Therapy for Endometrial Cancer

Photo Courtesy - ABC News(MILAN) -- An intrauterine contraceptive device may successfully treat endometrial hyperplasia, a precancerous condition, and early stage endometrial cancer, according to a small study.  As MedPage Today reports, researchers analyzed results from 34 women, ages 20 through 40, implanted with an intrauterine device (IUD).  They found that almost all of the patients with atypical endometrial hyperplasia were cured by a year's exposure to the IUD, along with six months of hormone therapy, as Dr. Lucas Minig of the Hospital Universitario Madrid Sanchinarro in Madrid and colleagues reported. Minig was formerly at the European Institute of Oncology in Milan, Italy, where the study was carried out.  Additionally, 57.1 percent of women with well-differentiated endometrial cancer limited to the endometrium had a complete response to the therapy, Minig and co-authors wrote online in Annals of Oncology.  The finding offers the possibility of therapy that would allow many women to avoid a hysterectomy and have children.

Copyright 2010 ABC News Radio







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