Intrauterine Devices: Separating Fact From Fallacy

, Magee-Womens Hospital, University of Pittsburgh School of Medicine

In This Article


An IUD is a highly effective form of contraception. In fact, copper-containing IUDs are the most effective form of reversible contraception available in the US today. IUDs with greater amounts of copper have consistently lower failure rates than other types. The copper-containing ParaGard is approved for use in the US for 10 years. The progesterone-releasing Progestasert must be replaced every year because the progesterone is depleted after 12-18 months. The nonmedicated IUDs (eg, the Lippes' loop) never have to be replaced unless problems occur.

Pregnancy rates for ParaGuard are shown in Table I. The pregnancy rate associated with Progestasert is approximately double that associated with the ParaGard over the first year of use. Nevertheless, compared with other forms of contraception, the Progestasert can still be considered highly effective.

Other IUDs are available in Europe, one of the most common being a levonorgestrel-containing device, LNg-20 (Leiras, Finland). This IUD contains 52mg of levonorgestrel released at a rate of 15ug per day. It is highly effective, with pregnancy rates similar to that of copper-containing IUDs. It combines the benefits of a progesterone-containing IUD (decreased menstrual flow and less dysmenorrhea) with the high effectiveness and long life span (10 years) of a copper-containing IUD.


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