Intrauterine contraceptive devices

The Rand researchers concluded that A H. Robins s Daikon Shield contraceptive intrauterine device (IUD) and Merrell Dow s Bendectin antinausea medicine for pregnant women explained the bulk of liability cases for these two... 

As of 1994, there were approximately 47 progestin-containing contraceptive dmg formulations sold in the United States for use as oral contraceptives (Table 3). In addition, there are three nonoral contraceptive formulations containing progestins ie, one injectable (Depo-Provera), one as an intrauterine device (lUD) (Progestasert), and one implantable (Norplant). Of the oral formulations, all but two also contain an estrogen component, ethynylestradiol. 

Oral, transdermal, and transvaginal contraceptives, as well as intrauterine devices and most barrier contraceptives, do not protect against sexually transmitted diseases. 

A more common contraceptive device is the intrauterine device (IUD). The first type of intrauterine device used was undedicated. These have received increased attention since the use of polyethylene plastics and silicone rubbers [194-196], These materials had the ability to resume their shape following distortion. Because they are unmedicated, these IUDs cannot be classifieds as sustained-release products. It is believed that their mechanism of action is due to local endometrial responses, both cellular and cytosecretory... 

UD, intrauterine device NSAID, nonsteroidal antiinflammatory drug OC, oral contraceptive,... 

Rule 14 deals with devices used for contraception or the prevention of transmission of sexually transmitted diseases - Class 11b, for example, condoms, contraceptive diaphragms and if they are implantable or long-term invasive Class 111, for example, intrauterine devices. 

Effective forms of contraception include both primary and secondary forms of contraception. Primary forms of contraception include Tubal ligation, partner s vasectomy, intrauterine devices, birth control pills, and... 

Only one implantable contraceptive preparation is available at present in the USA. Etonogestrel, also used in some oral contraceptives, is available in the subcutaneous implant form listed in Table 40-3. Several hormonal contraceptives are available as vaginal rings or intrauterine devices. Intramuscular injection of large doses of medroxyprogesterone also provides contraception of long duration. 

Small doses of progestins administered orally or by implantation under the skin can be used for contraception. They are particularly suited for use in patients for whom estrogen administration is undesirable. They are about as effective as intrauterine devices or combination pills containing 20-30 meg of ethinyl estradiol. There is a high incidence of abnormal bleeding. 

Similarly, a massive Finnish mortality study, covering 1 585 000 women-years of oral contraceptive use and two million women-years of copper-bearing intrauterine device use, showed no increase in relative risk among oral contraceptive users for myocardial infarction or cerebral hemorrhage deaths however, there might have been an increased risk of death from pulmonary embolism among users of oral contraceptives (43). 

Hirvonen E, Idanpaan-Heikkila J. Cardiovascular death among women under 40 years of age using low-estrogen oral contraceptives and intrauterine devices in Finland from 1975 to 1984. Am J Obstet Gynecol 1990 163(1 Pt 2) 281 1. 

Levonorgestrel is used in the form of intrauterine devices, both as a contraceptive and to treat menorrhagia. They are effective, but critical reviewers continue to point to the need to be alert to the possible development of pain and hypermenorrhea, and to warn patients of the possibility of expulsion or perforation (46). 

Li C-FI, Lee SSN, Pun TC. A pilot study on the acceptability of levonorgestrel-releasing intrauterine device by young, single, nulliparous Chinese females following surgical abortion. Contraception 2004 69 247-50. 

Figure 12.9 Progestasert intrauterine device (IUD) designed to deliver progesterone for contraception at 65 p,g/day for 1 year [19]...

Sterilization Oral contraceptive Condom Spermicide Withdrawal Diaphragm Periodic abstinence Intrauterine device (IUD) Douche... 

The vaginal use of spermicidal substances during sexual intercourse is perhaps the oldest method of contraception. However, the introduction of oral contraceptives and the intrauterine device in the 1960s led to the decay in their use. Since many of these substances also offer protection against sexually transmitted diseases, interest and investigation in this field have recently increased [288], Also, the development of new potential spermicides, namely antibodies [289], contributed to further awareness. Currently used spermicides include nonoxynol-9, octoxynol, benzalkonium chloride, and chlorhexidine. 

Nelson AL (1998) Intrauterine device practice guidelines medical conditions. Contraception 58 59S-63S. 

Use of spermicides in the vagina (They are used in combination with barrier methods. This is strictly chemical rather than hormonal contraception as also are intrauterine devices that contain copper, which is gametocidal). 

Numerous field trials have shown that progestogen-oestrogen combinations, if taken precisely as directed, are the most reliable reversible contraceptive known. (The only close competitors are depot progestogens and progestogen-releasing intrauterine devices.)... 

Copper intrauterine devices are widely used and highly effective (> 99% at one year) for 5 and some for 10 years. They are especially useful in the over-40s in whom oral contraceptives may become progressively contraindicated and for whom one lUD will last into the menopause. The lUD prevents implantation of the fertilised ovum, and has an additional antifertilisation effect enhanced by the toxic effect of copper ions on the gametes. 

The Progestasert intrauterine device (lUD) is a contraceptive lUD marketed in the United States. It is a white, T-shaped unit constructed of ethylene-vinyl acetate copolymer containing titanium dioxide. It releases progesterone at a rate of 65 pg/day for 1 year, controlled by an outer coat of ethylene-vinyl acetate... 

Fortney JA, Feldblum PJ, Raymond EG. Intrauterine devices. The optimal long-term contraceptive method J Reprod Med 1999 44(3) 269-74. 

---