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    IUDs May Be Underused Form of Birth Control

    Report Suggests Intrauterine Devices and Implantable Contraceptives Should Be Used by More Women

    Matching Women With the Right Birth Control

    Steven Goldstein, MD, a professor of obstetrics and gynecology at New York University Langone Medical Center in New York City, agrees that IUDs are underused.

    The over-arching issue is one of compliance, he says. "IUDs and implantable contraceptives are most effective because they have no aspect of patient compliance, but when birth control pills are used properly, they are more effective than IUDs."

    "IUDs have gotten bad rap and they don't deserve it, and for the right women at the right time, they are a godsend," he says.

    In the 1980s, an IUD called the Dalkon Shield was linked to increased risk for pelvic infections in some women. The company was ultimately forced out of business due to lawsuits. As a result, many women may still have lingering concerns over IUD safety.

    "I recommend IUDs to women in stable monogamous relationships who have had a child already," Goldstein says. IUDs are still effective in women who have not had children, but they are easier to insert in women whose uterus has expanded as a result of a previous pregnancy.

    Monogamy is important if you are considering an IUD, he says. "If you catch an STD, the IUD can serve as wick to help spread it and can end up with a severe pelvic infection and infertility," he says. (Condoms will also reduce the risk of developing an STD).

    "It is about matching the right women with the right contraceptive method," he says. "We need to individualize the contraceptive benefits and non-contraceptive benefits and risks to the patient. It's not one-size-fits-all."

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