Considering the risks and benefits of intrauterine devices: should clinician advice now be changed?

Luis Bahamondes* and Maria Valeria Bahamondes

Intrauterine contraceptives (IUCs) are the most widely used contraceptive method in the world, the two most common models currently in use being the TCu380A intrauterine device and the levonorgestrel-releasing intrauterine system. IUCs and subdermal implants are referred to as ‘long-acting reversible contraceptives’ because they provide contraception for at least 3 years with a single intervention. Both IUCs and the contraceptive implant have very low rates of contraceptive failure, these rates being similar in women over and under 21 years of age. They are safe, with few side effects, have a high continuation rate and can be used irrespective of age or parity. However, even now, many healthcare professionals discourage the use of these devices by adolescents, young women and nulligravidas, although the WHO makes no restrictions in this respect. IUCs represent an excellent tool for preventing unplanned pregnancy and should be considered as a first-line contraceptive choice for any woman with no medical contraindications.