Birth Control -- Intrauterine Devices and Spermicides

Intrauterine Devices and Spermicides

An IUD is a mechanical device inserted into the uterus by a health-care professional. Two types of IUDs are available in the United States: the Paragard CopperT 380A and the Progestasert Progesterone T. The Paragard IUD can remain in place for 10 years, while the Progestasert IUD must be replaced every year.

It's not entirely clear how IUDs prevent pregnancy. They seem to prevent sperm and eggs from meeting by either immobilizing the sperm on their way to the fallopian tubes or changing the uterine lining so the fertilized egg cannot implant in it.

IUDs have one of the lowest failure rates of any contraceptive method. "In the population for which the IUD is appropriate--for those in a mutually monogamous, stable relationship who aren't at a high risk of infection--the IUD is a very safe and very effective method of contraception," says Lisa Rarick, M.D., former director of FDA's division of reproductive and urologic drug products.

The IUD's image suffered when the Dalkon Shield IUD was taken off the market in 1975. This IUD was associated with a high incidence of pelvic infections and infertility, and some deaths. Today, serious complications from IUDs are rare. Side effects can include pelvic inflammatory disease (an infection of a woman's reproductive organs), ectopic pregnancy (in which a fertilized egg implants in the fallopian tube instead of the uterus), perforation of the uterus, heavier-than-normal bleeding, and cramps. Complications occur most often during and immediately after insertion.

Vaginal Spermicides Alone

Vaginal spermicides are available in foam, cream, jelly, film, suppository, or tablet forms. All types contain a sperm-killing chemical.

Studies have not produced definitive data on how well spermicides alone prevent pregnancy, but according to the authors of Contraceptive Technology, a leading resource for contraceptive information, the failure rate for typical users may be 26 percent per year.

Package instructions must be carefully followed because some spermicide products require the couple to wait 10 minutes or more after inserting the spermicide before having sex. One dose of spermicide is usually effective for one hour. For repeated intercourse, additional spermicide must be applied. And after intercourse, the spermicide has to remain in place for at least six to eight hours to ensure that all sperm are killed. The woman should not douche or rinse the vagina during this time.

Source: http://www.fda.gov/