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Contraceptive Comeback: The Maligned IUD Gets a Second Chance

August 10, 2012 • Family Planning, Reproductive Health, United States, News

The following report, which tells the story of the rise and fall — and (possibly) pending rebound — of the Intrauterine Device (IUD) is very well-written.

Contraceptive Comeback: The Maligned IUD Gets a Second Chance

By Jennifer Couzin-Frankel

See:  http://www.wired.com/magazine/2011/07/ff_iud/all/

Jeffrey Peipert’s theory about how to prevent unplanned pregnancies isn’t complicated. In 2007, Peipert, an obstetrician-gynecologist at Washington University in St. Louis, began a groundbreaking study of women’s preferences when it comes to birth control. His team began recruiting 10,000 women of childbearing age, counseling them on available contraceptives and offering them whichever form they wanted, free of charge. The goal was twofold: to see whether more women picked contraceptives that they didn’t really have to think about (as opposed to, say, taking a pill every day) and whether those “forgettable” methods in turn reduced unwanted pregnancies and abortions.

Peipert’s hypothesis: The preferred contraceptive would be highly effective and, once activated, require no intervention for years. Forgettable. And in fact, such a device has been around for eight decades, in the form of the intrauterine device, or IUD. But this forgettable contraceptive has been all but forgotten itself. And that’s a shame. While birth control pills fail about 8 percent of the time, less than 1 percent of women with an IUD get pregnant. That’s about the same as the pregnancy rate in women who’ve been surgically sterilized. But when you remove an IUD-boom, fertility rebounds.

The problem is, IUDs have been at the bottom of the contraceptive heap for years, the victim of bad press and a four-decade-old scandal. But Peipert is finding that you can let the past go-of the 8,300 women who have received counseling in his study so far, about 50 percent have chosen an IUD, making it by far the most popular choice.

IUDs are on the verge of a remarkable return to popularity. Nationally, 5.5 percent of women using contraception choose them. That sounds unimpressive, but it’s the first time in more than 20 years that the number has risen above 2 percent; in 1995, it was 1.3 percent. By that baseline, 5.5 percent represents a sea change. And a few pharmaceutical companies believe that number is poised to grow. Only two IUDs are on the market in the US, but two more are in late-stage clinical trials. Revenue for the Mirena, an IUD made by German drug company Bayer, went from $219 million in 2006 to $714 million in 2010; sales of oral contraceptives fell 2 percent over the same period.

What happened? A small contingent of doctors and researchers never stopped believing in the IUD even when a medical scandal almost erased it from history. The ultimate set-it-and-forget-it contraceptive is finally making a comeback.

When it comes to the intertwined histories of modern birth control and the sexual revolution, the pill gets all the attention. Approved by the FDA in 1960, it obviously did a lot to enable sexual freedom and women’s rights. But hormone levels in early versions of the pill were about 10 times higher than they are today, and newspaper articles and medical journals soon began documenting health risks like breast cancer and heart attacks. The 1969 book The Doctor’s Case Against the Pill argued that safety risks abounded, and in a Senate hearing on the pill’s health risks, women’s rights activist Alice Wolfson jumped up from the audience and demanded to know why there wasn’t a birth control pill for men.

All that controversy primed IUDs for takeoff. Somewhat unbelievably, no one is quite sure how they work…

To read the full article, please click here: http://www.wired.com/magazine/2011/07/ff_iud/all/



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