Goldstuck Norman D
Afr J Reprod Health. 2014 Dec;18(4):15-25.
The intrauterine device (IUD) is the oldest long acting reversible contraceptive (LARC) method. There remain widespread barriers to its general acceptance, although some have been overcome, others remain. These stem from a lack of understanding of uterine anatomy and physiology. Uterine measuring techniques did not become popular, probably because of the extra effort required prior to IUD insertion. Unfortunately the information they provided regarding IUD design was also not heeded. In some countries varying sizes of other IUDs (second generation) are now available. The third generation hormonal carrying IUDs have also reduced barriers by lowering side effects and producing added health benefits. Fourth generation IUDs will provide added health benefits in addition to contraception and should further reduce barriers to IUD use. Most remaining IUD barriers are due to provider perceptions. Most are based on psychological, moral and religious prejudices. These should not be allowed to interfere with the provision of LARC methods of contraception. There are also acceptor barriers which can be modified by providing education about the method. The use of the IUD as a LARC method is increasing in many developed and developing countries. New technology should help propel the IUD into a more mainstream contraceptive.
宫内节育器（IUD）是最古老的长效可逆避孕方法。尽管一些障碍已被克服，但仍有其他障碍存在，其被广泛接受仍面临诸多阻碍。这些障碍源于对子宫解剖学和生理学缺乏了解。子宫测量技术未得到广泛应用，可能是因为在放置宫内节育器之前需要额外的努力。不幸的是，它们所提供的有关宫内节育器设计的信息也未受到重视。在一些国家，现在有不同尺寸的其他宫内节育器（第二代）可供使用。第三代含激素宫内节育器也通过降低副作用和产生额外的健康益处减少了障碍。第四代宫内节育器除了避孕外还将提供额外的健康益处，并应进一步减少使用宫内节育器的障碍。大多数剩余的宫内节育器障碍是由于提供者的观念。大多数基于心理、道德和宗教偏见。不应允许这些偏见干扰长效可逆避孕方法的提供。也存在接受者障碍，可通过提供有关该方法的教育来加以改变。在许多发达国家和发展中国家，将宫内节育器用作长效可逆避孕方法的情况正在增加。新技术应有助于推动宫内节育器成为更主流的避孕方式。
