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Reuters
Reuters
In a new survey, most women had inaccurate perceptions about the safety and effectiveness of intrauterine devices (IUDs) in preventing pregnancy, say U.S. researchers, who urge doctors to talk more about the benefits of the devices.
In particular, many of the study participants didn't know that IUDs are more effective contraceptives than the birth control pill and that the devices don't increase the risk of getting a sexually transmitted disease.
"It's not clear whether women have an overly optimistic view of the effectiveness of the birth control pill or an overly pessimistic view of the IUD," said Dr. Lisa Callegari, the study's lead author and a clinical assistant professor at the University of Washington.
Whatever their source, these misperceptions lead to underuse of "one of the most safe and effective methods" of birth control, said Dr. Jeffrey Peipert, an obstetrics and gynecology professor at Washington University, who was not part of the study.
IUDs, which include the brand name products ParaGard and Mirena, are small plastic or copper-and-plastic objects inserted into the uterus. They can be left implanted for years, and are more than 99 percent effective at preventing pregnancy.
In contrast, the birth control pill has been found in real-world practice to be about 95 percent effective.
Callegari said that earlier studies have highlighted some of the mistaken beliefs women have about IUDs, and she and her colleagues wanted to get a better sense of how common they are among average women visiting primary care clinics.
They surveyed more than 1,600 women between the ages of 18 and 50 who had visited one of four clinics in Pennsylvania.
Five percent of the women were currently using an IUD, and another 5.8 percent had used one previously.
Only about one in five of the women correctly stated that IUDs are more effective at preventing pregnancy than the Pill.
And just 28 percent knew that an IUD is more cost effective than the Pill when it is used for more than three years, the researchers report in the medical journal Contraception.
According to Planned Parenthood, the upfront costs of an IUD are between $500 and $1,000, whereas birth control pills can cost between $15 and $50 a month - so they become more expensive over time.
The women in the study were considerably more knowledgeable about the risk of disease related to an IUD, with 57 percent answering correctly that there is no greater risk of contracting a sexually transmitted disease with an IUD compared to the Pill.
Still, Peipert said he's not surprised that women might view IUDs less favorably.
"There's been a LOT of bad press about IUDs in the past," Peipert wrote in an email to Reuters Health.
For instance, thousands of women have sued the makers of the Dalkon Shield, an IUD sold in the 1970s, because of injuries sustained from infections.
"It's not surprising, because of the history of the IUD in the United States, that people still have inaccurate perceptions of the device," said Dr. Rebecca Allen, an assistant professor of obstetrics and gynecology at Brown University, who was not involved in the study.
Currently available devices are considered to be much safer, said Allen.
Indeed, women over age 36 tended to have more misperceptions than younger women who took the survey, the researchers note in their report.
It's likely, too, that many women are simply not as familiar with the devices as they are with the Pill, said Callegari.
According to a 2012 study by the Centers for Disease Control and Prevention (CDC), 28 percent of women of reproductive age use oral contraception, making the Pill the most common form of birth control, followed closely by sterilization methods like getting the fallopian tubes "tied," used by 27 percent of women.
The same CDC study found that IUD use had risen from 0.8 percent of reproductive-age women in 1995 to 5.6 percent in 2010.
To correct widespread misconceptions about IUDs, Allen said, health care providers should be encouraged to talk to their patients about the devices.
Among women who have never used an IUD, Callagari's study found that those who had been counseled about the device by a health care provider were more knowledgeable than women who hadn't discussed it.
"I think it helps to give more evidence that providers should be talking with patients about IUDs," she told Reuters Health. "Women hear it and it affects their perceptions."
Providers themselves might need to be educated too, however.
One recent survey of physicians found that 30 percent had outdated ideas about IUDs, including thinking they are unsafe for women who had never had a baby or being unsure about their safety.
"We need to educate more primary care providers about the facts about IUDs so that they can counsel their patients," said Allen.
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I still can't believe what I heard my sister's doctor tell her after her first baby was born. The doctor came into her hospital room and straight up told her that IUD's cause abortions and then she gave my Sis a DepoProvera shot without telling her what it was first. Oh boy, I was ready to file a medical malpractice suite on her behalf right then and there. Some of these docs think they can get away with anything just because the patient is young and poor.
My perspective. The pill keeps you from 'conceiving' and there is no egg released. The IUD does not prevent conception, only implantation. Therefore, if you believe life starts at conception, you are potentially killing(aborting) a baby every month on the IUD but not on the pill. Pro lifers would be aghast at learning they are killing potential babies! Saw no mention of that as a reason women might choose the pill over an IUD.
Uneducated members of the pro-life community mistakenly started confusing fertilization with conception. They say "life begins at conception" then define conception as fertilization-instead of saying "life begins at fertilization."
That being said, more than half of fertilized eggs do not implant...so if we are to believe that life begins at fertilization-more than half of people die before they are conceived.
However, what you said is not correct either. IUD's work in 2 ways. First, and foremost, they block the sperm from entering the tubes so that an egg can not be fertilized. In the odd times when this does not work, the lining of the uterus is changed so that the fertilized egg does not implant.
Please educate 100% correctly when you say you need to educate!!!! The IUD truly acts as an abortificant....I can't spell it correctly, but it aborts a fertilized egg from implanting into the uterine wall. You won't ever know that you were pregnant.....how abhorrent for messing with God's natural law of life. God have mercy on us and on the whole world....amen. God's plan will prevail and our country had better believe that His will is the only Truthful path to be taken!!!!!
I don't infringe my beliefs upon your body. Please do not do the same to me.
Thankfully, I've had a hysterectomy so I don't have to worry about it anymore.
If that is your perspective, so don't get on IUD. Just don't expect everybody else to adhere to your beliefs.
I agree with the uterus being changed. It has a foreign object in it and your body knows it. It does NOT block the fallopian tubes. I had one and very carefully read the insert that came with it. I suggest you do the same. Some of the newer IUD's do have a spermicide, but they don't block the tubes.
The article fails to address that many doctors won't even discuss IUDs with women! It's admirable that they encourage barrier methods, but as this article points out, there's no difference in STI contraction between IUDs and oral contraceptives. In general, doctors won't give an IUD to a woman who isn't in a long-term committed relationship, citing STIs as a concern, but those same doctors will dispense the pill without a second thought. It's mind-boggling. I'm fortunate enough to live in Massachusetts, but even here, I doubt a doctor would have offered me an IUD without me asking about it specifically, whereas a pill, patch, vaginal ring, or even an injection--all of which have higher rates of failure with perfect (not real-world) use AND higher doses of hormones--have been offered to me by the various doctors I've had over the last 10 years.
Yes, IUD insertion is painful, especially for nulliparous women (I've never had children and I'm on my second Mirena, FWIW), but it's a longer-term and more effective method of birth control. Personally I've found it much less expensive, and causing fewer side effects due to the lower consistent hormone dose. I wish more women were aware of this option.
It hurts like a b&%#h to insert anything into cervical opening. Those women who can withstand that pain and discomfort should consider swallowing swords for living.
They don't block the tubes, if you leave it in for too long, it could grow into your endometrium and possibly cause need for emergency hysterectomy. They can poke through the uterine wall, same result. And the hormonal IUD's come along with neat side effects of pulmonary embolism at the young age, stroke, heart attack and the like. What was again so great about them?
Oh for pete's sake, the Mirena is only supposed to remain in place for 5 years; would you stop citing that paranoid mess. I had one, had never had children and had no ill effects. Sounds like the voice of a hypochondriac to me. Stop scaring people.
I don't know where they get the numbers that claim 27% of women have their tubes tied as a means of birth control. I couldn't get my doctor to do the procedure even after I had 2 kids. All he would do is plug the tubes, which isn't the same thing at all. Had to worry about spontaneous reversal for like 8 yrs. Yes, your own body can undo the plugging, it can't undo the cut and tie method.
I had an IUD for many years without incident. I reckon that the reason they are not recommended is due to drug company pressure. An IUD is a one off expense whereas hormonal birth control requires an ongoing relationship with their products. They want you hooked in, basically....
The prices quoted here to get one are absurd! An IUD is a small plastic trinket that probably costs a few cents to manufacture. To have one inserted takes about the same time as a pap smear. Health care costs in this country really need to be addressed...
The article mentions that they went to clinics in pa, not doctor offices. IUD are not offered to these patients because..if these women are going to the clinic they either cannot afford and dont have insurance or if they do have insurance..they have insurance from welfare. Pa women's program insurance does not cover the device. It pushes the depo shot or whatever birth control pill the clinic is getting a kick back on. Also, these doctors at the clinic assume just because you dont have insurance or you get insurance from the state that you are stupid and uneducated. They are horrible places to have to go to get care and treat you like cattle. and just maybe you lost your insurance because the place your worked forever closed and now you cant afford your regular doctor..
A very nice side effect of IUD (I have the Mirena)...your periods lessen over time. After only a few months with mine I am reduced to just a small amount of spotting for a few days rather than a regular period. I also don't don't fluctuate as much in hormones, so pms is not really an issue. I am coming to the end of my 5yr span of my iud, and certainly plan to get it replaced. Before learning of the IUD from my midwife, I had been on Depo for years, hated it, it caused hair thinning and I gained about 100 pounds with just the hormone changes, despite continuing my regular level of activity and eating well! The IUD is a no muss, no fuss blessing for most, with only a small chance of problems-get your regular exams and get checked out if you have any odd pains or problems.
I watched Dr. OZ few weeks ago and he was doing a segment on IUD with a female doctor and I didn’t get her name. The purpose of the segment is to educate audiences how the IUD is inserted and removed in patient by demonstrating on a uterus model. He also mentioned many women are not aware of the effectiveness of IUD due to lack of knowledge and the reason behind this because many family doctors are not comfortable with inserting IUD in patient and so they don’t recommended as often.
I think that women have a right to be cautious about using an IUD, seeing that they have a history of safety issues in the US. An IUD like Mirena is a long-term form of contraception that isn't without risks. While it is effective at preventing pregnancy, there are also cases where the IUD relocates from its original position and actually migrates outside of the uterus. If this happens, then you can become pregnant and this pregnancy is more likely to be an ectopic one which is why probably why some people say that it causes abortions. In other cases, the IUD gets embedded in the other tissues of your body and surgery is needed to remove it. Not every Mirena user experiences these injuries, but I don't think its worth these risks when there are safer options out there.
http://www.publichealthwatchdog.com/woman-represented-by-national-law-firm-in-lawsuit-alleging-mirena-iud-caused-ectopic-pregnancy/
And birth control pills come with the risk of deadly blood clots.
And condoms come with the risk of an undiagnosed latex allergy turning into anaphylactic shock.
There is never going to be a completely, 100% risk free method of contraception (other than abstinence of course).
Don't blow the risks out of proportion. Women are well counseled on the risks of their contraceptive of choice before it is given to them. If they choose not to listen, that's their own problem.
The risks of having unplanned pregnancies are greater than the risks that most IUDs present to the average woman.
A friend of mine had an IUD that ended up in the lining of her stomach. She had no idea until a doctor told her about it. Since it would do more harm than good to remove it, she never had it removed.
I remember years ago in college attending a birth control seminar where they showed various methods of birth control. When I saw what the IUD looked like, it had sharp edges, I wouldn't want to put that thing in my body.
I am on my second Mirena IUD and it is the best birth control I have ever used. No monthly trips to the pharmacy or monthly expense. The upfront, one time cost is well worth it. I have not had any ill side effects, in fact the side effects have all been positive. I had my first IUD removed to try to conceive and was pregnant in 3 months. After the birth of my son, I had my second IUD inserted. The insertion is not terribly uncomfortable (similar to a strong cramp), in fact I was at yoga the same day I got my second one. Like all medical devices or medications, there are risks, but that is for you and your doctor to consider and decide what is best for you.