IUDs May Be Underused Form of Birth Control

June 20, 2011 -- Intrauterine devices (IUDs) and implantable contraceptives may not be popular, but they are among the most reliable contraceptive methods available.

"IUDs and implants should be considered first-line contraceptives for a majority of women," says Eve Espey, MD, MPH, an associate professor of obstetrics and gynecology at the University of New Mexico in Albuquerque. She co-authored a paper on these choices in the American Congress of Obstetricians and Gynecologists' Practice Bulletin.

Still, these methods have never really caught on among women for several reasons, including concern about side effects such as pelvic infections. Fewer than 6% of women in the U.S. used IUDs between 2006 and 2008.

As it stands, condoms and oral contraceptives are most commonly used methods of birth control . "We should be recommending IUDs and contraceptive implants because they are so much more effective at preventing unintended pregnancy than condoms and pills," Espey says.

IUDs and implantable contraceptives do not prevent sexually transmitted diseases ( STDs ).

The majority of unintended pregnancies among contraceptive users occur because of inconsistent or incorrect contraceptive use, and this is where implants and IUDs stand out from the pack. They are maintenance-free, which means there is virtually no margin of error, she says.

There are two IUDs available in the U.S. Both are small, T-shaped devices made of flexible plastic that are inserted into the uterus during a routine doctor's visit.  ParaGard IUD contains copper and is effective for 10 years. Mirena contains a small amount of the hormone progestin and is effective for five years. Both devices prevent a fertilized egg from attaching to the uterine wall. The copper IUD also interferes with the sperm's ability to move through the uterus and into the fallopian tubes.

"These both have a tremendous safety record and well-known acceptability by patients," she says. Espey says she checks the copper IUD after five to 10 years.

"If Mirena fails, you will go back to regular, heavy menstrual period, so it may be obvious," she says.

Implanon is a single-rod contraceptive implant that inserted under the skin of the upper arm that releases the hormone progestin over a three year period. "You can feel it, so I don't recommend a lot in the way of checking," she says.

Incontinence: More widespread than you think « Bescot Healthcare ...

You’ve seen those commercials with the frequent bladder urges, and you’ve been hearing the phrase “over-active bladder.” So it seems that the once-taboo topic, urinary incontinence, is finally out of the closet. Over 25 million Americans suffer from some degree of incontinence— 75-80 percent of them women. Yet for all the attention this subject is receiving, “many continue assuming it’s part of the normal aging process—so they don’t bother discussing it with their doctor,” says the Albuquerque, New Mexico, urogynecologist Rebecca Rogers, M.D. In fact, incontinence, or loss of bladder control, is an eminently treatable medical condition—or rather several conditions. Oral medications—to tighten or strengthen the urethral and pelvic floor muscles, or to relax overactive bladder muscles. Botox—injected into the bladder muscles to deaden contraction producing nerves. It offers success in the 70 percent range, says Dr. Kobashi. Electrostimulation, biofeedback, and pelvic-muscle exercises. Management Tools For chronic bladder dysfunction, catheters come in a variety of shapes and sizes, some with smooth anti-bacterial coatings, which helps avoid urinary tract infections. What’s more, Medicare is now covering the cost of disposable singleuse catheters. A mainstay for the bedridden, but useful for active people too, incontinence garments come in a wide array of sizes, shapes, and absorbency. Attends makes numerous pads, briefs, and extended-wear briefs. For maintaining urinary health, recent scientific research shows cranberry products protect in urological health along with cancer and heart disease.

Linda dyett editorial@mediaplanet.

New Mexico magazine

American directory of obstetricians & gynecologists

De Swiet's Medical Disorders in Obstetric Practice

Inspire Women to Fitness

It's a Sistah thing, a guide to understanding and dealing with fibroids for Black women