CONTENTS
HIGHLIGHTS
December 1995 |
Second-generation copper IUDs are much more effective and have fewer side effects than unmedicated IUDs. The copper IUDs currently available are similar in terms of effectiveness, side effects, expulsion, and continuation rates. The hormone-releasing LNG-20 IUD may be even more effective than copper IUDs, and it generally reduces menstrual bleeding, while copper IUDs may increase it (609). Pregnancy and complication rates, even with the same IUD, vary in different clinics and studies. This is partly because the women may be dissimilar—in age, parity, and other factors that influence IUD performance. Also, the quality of care may vary. Thus randomized multicenter studies usually are the most reliable way to evaluate and compare IUD performance. Results of such studies are presented in Table 1. While efforts to design better IUDs continue, the quality of care that IUD users receive may make more difference to IUD performance than the design of a specific IUD. The health care provider's training and experience, particularly with insertion technique, are especially important. It is customary to evaluate IUDs in terms of contraceptive effectiveness, continuation, and rates of removal due to side effects and complications—bleeding and pain, perforation, expulsion, and infection. All are measured in life-table rates—the number of pregnancies or removals per 100 or 1,000 women after a specified length of IUD use. |