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Importance of Harmony between the IUD/IUS and the Uterine Cavity: Based on 20 years of Clinical Research in Intrauterine Contraception pp. 149-166 $100.00
Authors:  (D. Wildemeersch, Outpatient Gynecological Clinic and IUD Training Center, Ghent, Belgium)
Abstract:
Dimensional harmony of the intrauterine device (IUD) or intrauterine system (IUS) with the uterine cavity leads to high acceptability and continuation of use, a prerequisite to continuation of the method and to reduce the risk of an unintended pregnancy. Dimensional disharmony, on the other hand, leads to the opposite effect: cramping pain, abnormal or sometimes heavy menstrual bleeding, dislocation/expulsion and pregnancy.
A strategic advantage of the IUD/IUS is that, unlike the Pill, they are genuinely ‗fit-and-forget‘. In use, they are much more effective than Pills particularly in adolescents and nulliparous women.
However, copper intrauterine devices do not offer protection against sexually transmitted infections (STIs) and, therefore, they are not always the methods of first choice for teenagers and nulliparous women.
New evidence, however, from the World Health Organization and the American College of Obstetricians and Gynecologists, shows that IUDs can be used and that they are safe for most women, including adolescents.
Because adolescents and young nulliparous women contribute disproportionately to the epidemic of unintended pregnancies, suitable long-acting methods of contraception, such as the IUD or IUS, should be advocated as first-line choices for interval, emergency and immediate post-abortal contraception in this population of women. Uterine cavities of nulliparous women are usually significantly smaller than the uterine cavities of parous women but this is not necessarily so. As there is only one type of copper IUD and only one levonorgestrel-releasing intrauterine system (LNG-IUS) available in the US, new developments in intrauterine technology, smaller frameless and framed copper and levonorgestrel-releasing devices, could help increase the prevalence of use and especially continued use of this method in women, including in adolescents and nulliparous women. 


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Importance of Harmony between the IUD/IUS and the Uterine Cavity: Based on 20 years of Clinical Research in Intrauterine Contraception pp. 149-166