Long-term use of copper intrauterine devices. A statement from the Medical Advisory Committee of the Family Planning Association and the National Association of Family Planning Doctors
Newton, J.; Tacchi, D.
Lancet 335(8701): 1322-1323
1990
ISSN/ISBN: 0140-6736 PMID: 1971387 Document Number: 337562
The lifespan of newer copper IUDs is set by national licensing agencies, but practically is probably much longer. The main reason for this prolonged life is the thicker copper wire, sleeves or silver cored-wire. The lifespan of the so-called 2nd generation IUDs, Multiload Cu 250 and Nova-T are known to be in excess of manufacturers' recommendations of 3 and 5 years. That of the 3rd generation IUDs TCU 380A and Multiload Cu 375 is listed as 4-5 years, varying in different countries. The life of the copper T slimline is theoretically up to 10 years. The contraceptive efficacy of the 2nd and 3rd generation IUDs is higher than that of the older copper IUDs, 1-3 pregnancies per 100 woman years for the 2nd generation IUDs, and 1 for the 3rd generation devices. There may be a slight increase in failure rate after expiration, but this is probably balanced by women's natural decline in fertility with age. Under British law, physicians are free to use a drug or device in ways other than those specified by the product license. The advantages of not changing an IUD every 3 or 4 years when it is apparently working and not causing problems, are lower cost, inconvenience, pain, and risk of pelvic inflammatory disease, uterine perforation, expulsion and other complications that typically occur after insertion. For many women an IUD can be retained right up to menopause. After menopause IUDs should be removed because difficulties have been seen with removal.