IUDs make a comeback in the U.S.A.

Intrauterine devices, or IUDs, are finally being recognized by significant numbers of American women as an effective and convenient contraceptive, reports Jane Brody in her column this week for The New York Times. The most recent data show that use of IUDs among U.S. women has tripled in the last decade, and now accounts for 10.4 percent of all contraceptives prescribed by doctors.

Although IUDs were once thought to be associated with an increased risk of pelvic inflammatory disease, physicians are now careful to screen women for pre-existing infections that could lead to this condition. Now, most medical experts actually consider the IUD to be safer, more effective, and more convenient than any other form of reversible contraceptive. The devices are placed in the uterus by a gynecologist and, either through the release of tiny amounts of copper or localized amounts of a synthetic progestogen, subsequently interfere with fertilization or implantation to prevent pregnancy. An IUD does not require the kind of compliance that oral contraceptives or barrier methods do, and is 99 percent effective in preventing pregnancy significantly better than other methods. This reliability, combined with the fact that it is reversible and does not interfere with a woman s menstrual cycle, is most likely part of IUDs increasing appeal.

Perhaps adding to that appeal, the IUD has been found to have benefits beyond its reliable prevention of unintended pregnancy. The hormonal version of the device helps women who experience heavy menstrual bleeding, reducing bleeding and thus lowering the risk of anemia and endometriosis. And a recent study has suggested that IUDs may protect against cervical cancer.

The cost of an IUD can range from $300 to $1,000, depending on the variety. However, the devices last from five to twelve years, a factor that could make an IUD more cost-effective for even those women whose insurance will not cover the device.

However, ACSH's Dr. Elizabeth Whelan points out, while the IUD is one of the most effective forms of birth control, women need to remember that these devices offer no protection against sexually transmitted infections. For that kind of prevention, a barrier method such as a condom is still necessary.