Nelson Anita L, Massoudi Natasha
Department of Obstetrics and Gynecology, Los Angeles BioMedical Research Institute at Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA, Torrance, CA, USA.
American University of the Caribbean School of Medicine, Cupecoy, Sint Maarten.
Open Access J Contracept. 2016 Sep 13;7:127-141. doi: 10.2147/OAJC.S85755. eCollection 2016.
Many more women in the US today rely upon intrauterine devices (IUDs) than in the past. This increased utilization may have substantially contributed to the decline in the percentage of unintended pregnancies in the US. Evidence-based practices have increased the number of women who are medically eligible for IUDs and have enabled more rapid access to the methods. Many women enjoy freedom to use IUDs without cost, but for many the impact of the Affordable Care Act has yet to be realized. Currently, there are three hormonal IUDs and one copper IUD available in the US. Each IUD is extremely effective, convenient, and safe. The newer IUDs have been tested in populations not usually included in clinical trials and provide reassuring answers to older concerns about IUD use in these women, including information about expulsion, infection, and discontinuation. On the other hand, larger surveillance studies have provided new estimates about the risks of complications such as perforation, especially in postpartum and breastfeeding women. This article summarizes significant features of each IUD and provides a summary of the differences to aid clinicians in the US and other countries in advising women about IUD choices.
如今，美国使用宫内节育器（IUD）的女性比过去多得多。这种使用率的提高可能在很大程度上促使美国意外怀孕率下降。循证实践增加了符合医学条件使用IUD的女性数量，并使她们能更快获得这些避孕方法。许多女性可免费使用IUD，但对许多人来说，《平价医疗法案》的影响尚未显现。目前，美国有三种激素IUD和一种铜IUD可供使用。每种IUD都极其有效、方便且安全。新型IUD已在通常不纳入临床试验的人群中进行了测试，并为过去对这些女性使用IUD的担忧提供了可靠答案，包括有关排出、感染和停用的信息。另一方面，规模更大的监测研究对诸如穿孔等并发症的风险给出了新的评估，尤其是在产后和哺乳期女性中。本文总结了每种IUD的显著特点，并概述了差异，以帮助美国和其他国家的临床医生为女性提供有关IUD选择的建议。
