The Intrauterine Device: Still Misunderstood After All These Years

, Division of Maternal Health, Center for Maternal and Child Health, Maryland Department of Health and Mental Hygiene, Baltimore.

South Med J. 2000;93(9) 

In This Article

Current IUDs in the United States

The IUD is used by more than 100 million women in the world, making it the most common reversible method of birth control.[3] The situation is different in the United States, where currently less than 1% of women choose the IUD as their method of birth control.[4]

The only two IUDs currently available in the United States are the copper T 380A (ParaGard) (Fig 1) and the progesterone T (Progestasert). The T 380A, developed by the Population Council, was first released in the United States in 1988 and is one of the most effective IUDs ever made. Its large surface area of copper results in a low pregnancy rate, the failure rate being less than 1% per 100 users.[5] The progesterone T, introduced in the United States in 1976, releases progesterone into the uterine cavity at a rate of 65 mg/day,[6] which acts on the endometrium to decrease bleeding and pain during menses. The progesterone T has a first year failure rate of 2.0 pregnancies per 100 users.[5] Because the progesterone T requires yearly removal and reinsertion, it is not widely used except by women who have problems with menorrhagia and dysmenorrhea. Almost all women in the United States who use an IUD use the copper T 380A because of its high degree of effectiveness, lasting 10 years.

Figure 1.

Intrauterine copper contraceptive device T 380A (ParaGard). (Reprinted with permission of copyright owner Ortho-McNeil Pharmaceutical Corp.)

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