The New IUD

woman speaking with doctorThe first intrauterine device (IUD) was reportedly a stone placed in a camel’s uterus to prevent pregnancy during the long desert trek when a camel pregnancy would have been catastrophic. (Evidently camels are pretty randy.) The modern IUD came along in the 1960s and hit its peak during the 1970s when 10% of women used IUDs for contraception.

Today, mention “IUD” and words like dangerous, Dalkon shield and infertility still come to mind. It’s no wonder that many women steer clear, but nothing could be further from the truth. Modern IUDs do not have the same issues, and are actually one of the safest, most beneficial contraceptive options. But, despite it’s proven safety and efficacy record, only 5.5% of US women are using intrauterine contraception.

Up until now there have been two available options. The copper IUD, Paraguard™ lasts for 10 years, provides excellent contraception, but may make periods heavier than usual.

The other available IUD is the Mirena™ intrauterine system. This IUD has a small amount of progestin called levonorgestrol, which acts locally on the uterine lining to make it thin and inactive. The levonorgestrol IUD has many non-contraceptive benefits such as reducing menstrual bleeding by 95%, preventing uterine cancer, and treating endometriosis and other gynecologic conditions. The down side is that it is only good for 5 years. Some women are concerned about the hormone in the Mirena IUD, but it is a local progestin that has minimal systemic side effects.

Earlier this January, the FDA approved a lower-dose version of the Mirena IUD called Skyla. It has an even smaller amount of hormone and is reportedly easier to insert, which is great for women who have never been pregnant and may have a tighter cervical opening. The lower dose of progestin means that it only provides contraception for 3 years and may not eliminate periods as often a Mirena. Like Mirena, there may be some irregular bleeding, particularly in the first year of use.

While there is the assumption that Skyla will have many of the same non-contraceptive benefits as Mirena, I do want to emphasize that the FDA has only approved Skyla for prevention of pregnancy. And it is undisputed that all IUDs give excellent contraception in addition to scoring A+ on convenience. It’s not just my opinion. Women that use IUDs are usually the biggest fans, which is why there is an 86% continuation rate. Birth control pills have only a 55% continuation rate after 12 months of use.

The number-one group that chooses IUDs for contraception: female gynecologists. Need I say more?