Modern IUDs are safe, effective, but often underused

Today's intrauterine devices (IUDs) are widely available, inexpensive, and safe, but are underused in developed nations because of perceptions that they cause pain and heavy menstrual bleeding, according to an editorial published in the Sept. 1 issue of BMJ.

Sally B. Rose, of the Wellington School of Medicine and Health Sciences at the University of Otago in Wellington, New Zealand, summarized recent research, including a Cochrane review that evaluated data from 15 randomized controlled trials investi gating the effect of nonsteroidal anti-inflammatory drugs for treating or preventing IUD-related pain and bleeding. She said that the review supported the clinical practice of using short courses of such drugs during menses to treat some patients with IUDs.

Although intrauterine devices are the most common form of reversible contraception used worldwide by women of reproductive age, with China alone accounting for nearly 50% of all users, Rose noted that they are used by only 6% of women in the United Kingdom, 4.6% in Australia and New Zealand, and less than 1% in the United States.

Rose SB. Pain and heavy bleeding with intrauterine contraceptive devices. BMJ. 2007;335:410-411.