In a new survey, most women had inaccurate perceptions about
the safety and effectiveness of intrauterine devices (IUDs) in preventing
pregnancy, say US researchers, who urge doctors to talk more about the benefits
of the devices.
In particular, many of the study participants didn't know
that IUDs are more effective contraceptives than the birth control pill and
that the devices don't increase the risk of getting a sexually transmitted disease.
"It's not clear whether women have an overly optimistic
view of the effectiveness of the birth control pill or an overly pessimistic
view of the IUD," said Dr Lisa Callegari, the study's lead author and a
clinical assistant professor at the University of Washington.
How the study was
Whatever their source, these misperceptions lead to underuse
of "one of the most safe and effective methods" of birth control,
said Dr Jeffrey Peipert, an obstetrics and gynecology professor at Washington
University, who was not part of the study.
IUDs, which include the brand name products ParaGard and
Mirena, are small plastic or copper-and-plastic objects inserted into the
uterus. They can be left implanted for years, and are more than 99% effective
at preventing pregnancy.
In contrast, the birth control pill has been found in
real-world practice to be about 95% effective. Callegari said that earlier
studies have highlighted some of the mistaken beliefs women have about IUDs,
and she and her colleagues wanted to get a better sense of how common they are
among average women visiting primary care clinics.
They surveyed more than 1 600 women between the ages of 18
and 50 who had visited one of four clinics in Pennsylvania. Five percent of the
women were currently using an IUD, and another 5.8% had used one previously.
One in five women
stated the effectiveness of the pill
Only about one in five of the women correctly stated that
IUDs are more effective at preventing pregnancy than the Pill. And just 28%
knew that an IUD is more cost effective than the Pill when it is used for more
than three years, the researchers report in the medical journal Contraception.
According to Planned Parenthood, the upfront costs of an IUD
are between $500(R4439) and $1,000 (R 8879), whereas birth control pills can
cost between $15(R133) and $50(R443) a month - so they become more expensive
The women in the study were considerably more knowledgeable
about the risk of disease related to an IUD, with 57% answering correctly that
there is no greater risk of contracting a sexually transmitted disease with an
IUD compared to the Pill.
Still, Peipert said he's not surprised that women might view
IUDs less favorably."There's been a LOT of bad press about IUDs in the
past," Peipert wrote in an email to Reuters Health. For instance,
thousands of women have sued the makers of the Dalkon Shield, an IUD sold in
the 1970s, because of injuries sustained from infections.
"It's not surprising, because of the history of the IUD
in the United States, that people still have inaccurate perceptions of the
device," said Dr Rebecca Allen, an assistant professor of obstetrics and
gynecology at Brown University, who was not involved in the study.
available more safer
Currently available devices are considered to be much safer,
said Allen. Indeed, women over age 36 tended to have more misperceptions than
younger women who took the survey, the researchers note in their report.
It's likely, too, that many women are simply not as familiar
with the devices as they are with the Pill, said Callegari. According to a 2012
study by the Centers for Disease Control and Prevention (CDC), 28% of women of
reproductive age use oral contraception, making the Pill the most common form
of birth control, followed closely by sterilization methods like getting the
fallopian tubes "tied," used by 27% of women.
The same CDC study found that IUD use had risen from 0.8
percent of reproductive-age women in 1995 to 5.6% in 2010.To correct widespread
misconceptions about IUDs, Allen said, health care providers should be
encouraged to talk to their patients about the devices.
Among women who have never used an IUD, Callagari's study
found that those who had been counseled about the device by a health care
provider were more knowledgeable than women who hadn't discussed it."I
think it helps to give more evidence that providers should be talking with
patients about IUDs," she told Reuters Health. "Women hear it and it
affects their perceptions.
"Providers themselves might need to be educated too,
however. One recent survey of physicians found that 30 percent had outdated
ideas about IUDs, including thinking they are unsafe for women who had never
had a baby or being unsure about their safety. "We need to educate more
primary care providers about the facts about IUDs so that they can counsel
their patients," said Allen.