Risks of the IUD
Kremer, J.
Nederlands Tijdschrift Voor Geneeskunde 129(30): 1410-1412
1985
ISSN/ISBN: 0028-2162 PMID: 4047187 Document Number: 262134
IUD use in the Netherlands increased from 92,000 to 352,000 between 1981 due to the pill's unfavorable publicity. Only copper IUDs are used in the Netherlands (copper-covered plastic for increased effectiveness). In 1977, 1/2 of women aged 15-44 used oral contraceptives (OCs); in 1981, this figure was only 1/3. IUD use involves increased risk of salpingitis (1.8-9.3%) and extrauterine pregnancies. Doctors must be aware of these side affects and know how they can be avoided. Pelvic Inflammatory Disease (PID) occurs more frequently in IUD users, especially in nulliparas, than in women who use OCs. PID is more likely to occur after an IUD has been used for 5 years. Promiscuous IUD users are more susceptible to PID, and must be advised to use condoms as protection, though the risk of PID is higher among promiscous OC users. In order to avoid recurrence of the disease, women with diagnosed salpingitis should not use an IUD. Uterine perforations can occur during IUD implantation (8-9/1000 for inexperienced doctors and 1/1000 for experienced doctors). Copper IUDs may have to be removed due to adhesions in the abdominal cavity. All types of IUDs can cause blood loss from the endometrium. 50% of women using IUDs experience heavier menstrual blood loss during the first 3 months after the IUD is implanted, as well as longer menstrual periods and spotting between periods. Some women continue to bleed after the first 3 months and consequently discontinue IUD use. The conclusion is that the risks associated with IUD use are minimal when the device is implanted and used properly in women who do not show a high risk of genital infection. Literature must be provided pertaining to the increased risk of pregnancy compared with OCs, the negative side effects of IUDs, and the positive and negative side effects of the pill.