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IUDs and contraceptive implants recommended for women

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Move over, birth control pill. Doctors are throwing their support behind intrauterine devices and contraceptive implants as the most effective forms of reversible birth control, in a new set of guidelines for obstetricians and gynecologists.

Though the two forms of contraception aren’t as widely used as birth control pills, doctors said that partly has to do with past fears about their safety—and that new types of IUDs are quite safe.

The new suggestions guiding their use are published online in the July Obstetrics and Gynecology.

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Here’s a quick look at how the birth control methods work: IUDs are plastic, T-shaped devices inserted in the uterus that release either copper or a hormone into the uterus. The copper coaxes the uterus and fallopian tubes to produce fluid to kill sperm, and is effective at preventing pregnancy for 10 years, according to WebMD. The hormonal IUD releases progestin, which can also fight sperm and make the cervical mucus thick, preventing sperm from reaching the uterus. Hormonal IUDs prevent pregnancy for five years.

Contraceptive implants, the size of a matchstick, also release progestin, but are inserted under the skin of the arm and last three years.

The failure rates of such devices are much lower than the pill or condom—in fact, only tubal sterilization and vasectomies have lower failure rates. When used typically (not perfectly), nine out of 100 women on a combined pill have unplanned pregnancies within the first year of use, compared to one in 100 for implants and copper IUD users, and 0.1 in 100 of hormonal IUDs users, according to a fact sheet from the Guttmacher Institute.

Implantable contraceptives aren’t completely risk-free. Copper IUDs, for example, carry a slight chance of pelvic infections, pelvic pain, cramping and increased bleeding.

And as with the pill, patch and other birth control methods, neither IUDs nor implants can prevent sexually transmitted diseases. Nor are they 100% reliable in preventing pregnancy—only abstinence, of course, does both.

But the nation’s obstetricians and gynecologists suggest more women should give them a chance. As the recommendation points out: “There’s no maintenance required.”

healthkey@tribune.com

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