Reducing Barriers to the use of the Intrauterine Contraceptive Device as a Long Acting Reversible Contraceptive

The intrauterine device (IUD) is the oldest long acting reversible contraceptive (LARC) method. There remain widespread barriers to its general acceptance, although some have been overcome, others remain. These stem from a lack of understanding of uterine anatomy and physiology. Uterine measuring te...

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Bibliographic Details
Published in:African journal of reproductive health 2014-12, Vol.18 (4), p.15-25
Main Author: Goldstuck, Norman D.
Format: Article
Language:English
Subjects:
Adult
Anatomy
Birth control
Bleeding
COMMENTARY
Contraception
Contraception Behavior
Contraception, Barrier - psychology
Contraception, Barrier - statistics & numerical data
Delivery of Health Care - methods
Female
Fertility
Health benefits
Humans
Infections
Innovations
Intrauterine contraceptives
Intrauterine devices
Intrauterine Devices - classification
Intrauterine Devices - utilization
IUD
Medical laboratory technology
Medical research
Medical technology
Medicine, Experimental
Methods
Pregnancy
Reproductive health
South Africa
Uterus
Womens health
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Summary:The intrauterine device (IUD) is the oldest long acting reversible contraceptive (LARC) method. There remain widespread barriers to its general acceptance, although some have been overcome, others remain. These stem from a lack of understanding of uterine anatomy and physiology. Uterine measuring techniques did not become popular, probably because of the extra effort required prior to IUD insertion. Unfortunately the information they provided regarding IUD design was also not heeded. In some countries varying sizes of other IUDs (second generation) are now available. The third generation hormonal carrying IUDs have also reduced barriers by lowering side effects and producing added health benefits. Fourth generation IUDs will provide added health benefits in addition to contraception and should further reduce barriers to IUD use. Most remaining IUD barriers are due to provider perceptions. Most are based on psychological, moral and religious prejudices. These should not be allowed to interfere with the provision of LARC methods of contraception. There are also acceptor barriers which can be modified by providing education about the method. The use of the IUD as a LARC method is increasing in many developed and developing countries. New technology should help propel the IUD into a more mainstream contraceptive. Le dispositif intra-utérin (DIU) est la plus ancienne méthode contraceptive réversible à longue durée d'action (CRLDA). Il reste encore des obstacles généralisés à son acceptation globale; bien que certains aient été surmontés, d'autres restent toujours. Ceuxci découlent d'un manque de compréhension de l'anatomie et de la physiologie de l'utérus. Les techniques pour mesurer les utérins ne sont pas devenues populaires, probablement en raison de l'effort supplémentaire nécessaire avant l'insertion d'un DIU. Malheureusement, l'information qu'ils ont fournie quant à la conception de DIU n'a pas également été entendue. Dans certains pays, des tailles différentes d'autres DIU (deuxième génération) sont maintenant disponibles. L'hormonal de la a troisième génération qui portent les DIUs a également réduit les obstacles en diminuant les effets secondaires et la production de bienfaits pour la santé. Les DIUs de la quatrième génération offriront des avantages supplémentaires pour la santé, en plus de la contraception et devraient encore réduire les obstacles à l'utilisation d'un DIU. La plupart des obstacles de DIU qui subsistent sont dus à des perceptions des
ISSN:1118-4841