How IUDs Work

Improvements in materials and design eventually led to the intrauterine device's (IUD) acceptance as a contraceptive measure. For years, it was recognized as a safe and effective device with peak sales in the United States between 1965 and 1973. But all that changed in 1976 when the Dalkon Shield, one type of IUD, was removed from the U.S. market following the deaths of 17 women who developed severe pelvic infection. Other women became sterile or had fertility problems.

"In the aftermath, women and manufacturers got scared; all but two IUDs were voluntarily withdrawn from the U.S. market and the percentage of American women using the devices dropped from 10 percent to less than one percent of those who use birth control," revealed Deborah Franklin in Health magazine.

But the tragic story of the Dalkon Shield should not discourage women from using lUDs for today's models are better in terms of safety and efficacy. As Franklin said in Health:

"Most experts say it's a big mistake to visit the sins of the Dalkon Shield on other lUDs, which have since proven safe in hundreds of thousands of women worldwide. A study by the World Health Organization of more than 22,000 women using various lUDs found only a slight rise in pelvic inflammatory disease. And the increased risk was primarily in the first 20 days after insertion. Researchers now urge doctors to prescribe antibiotics at the time of insertion to preempt those early infections."

How does the IUD work? No one knows for sure. As soon as the device is inserted into the uterus by a physician, it apparently creates a mild, harmless inflammation that disturbs the uterine environment. This either prevents sperm from reaching the egg or stops the fertilized egg from implanting.

Pro-life groups say that if the IUD does the latter, that makes it an abortifacient. But current medical findings say otherwise. From the looks of it, the IUD prevents pregnancy by reducing the number of sperm that reach the egg not in aborting fertilized eggs. This was stressed by Irving Sivin, senior associate in the Center for Biomedical Research of the U.S. Population Council in Health Alert.

"Assays and other techniques have not found traces of fertilization of IUD users. It would seem that lUDs work by diminishing the number of sperm that reach the oviduct and their capacity to fertilize the ova. Similarly, some studies showed that there were less eggs found in the oviduct of IUD users as opposed to non-users," said Health Alert.

"Whatever the answer, an IUD does not work by causing early abortion or by creating a low-grade infection in the uterus. Both of these occur in a small percentage of women with lUDs, but they are not related to its contraceptive properties," added Dr. Niels Lauersen, a diplomate of the American Board of Obstetrics and Gynecology and Steven Whitney in "It's Your Body: A Woman's Guide to Gynecology." (Next: Problems with IUDs.)

Sharon Bell is an avid health and fitness enthusiast and published author. Many of her insightful articles can be found at the premier online news magazine

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