Intrauterine contraceptive device called CS-300

Intrauterine contraceptive device called CS-300 (Ho, AP File Photo)


Recent research has found that some doctors in the U.S. still harbor misconceptions about the safety of IUDs. A study by the Centers for Disease Control and Prevention found that 30 percent of health providers surveyed had doubts about the safety of IUDs for women who've never given birth.

When IUDs first came out, there were concerns that they might raise the risk of pelvic infection and jeopardize women's future fertility. So the original IUD labeling said the devices were contraindicated for women who'd never had children.

But it's now known that IUDs do not carry those risks.

"Many doctors continue to have outdated ideas about who can and cannot use an IUD," Finer said.

Cost may be another issue keeping women from using IUDs and implants.

The devices have a big upfront cost: the price of the Mirena IUD has gone up over the years and is now nearly $800. The ParaGard price tag is about $500. Then there are the doctor's charges for putting them in.

The Implanon implant costs between $400 and $800, with all charges considered.

Since the devices last for years, they are cost-effective in the long run, Finer said.

Birth control pills, for instance, cost anywhere from about $10 to $50 per month, depending on whether a woman uses generic or brand-name pills.

But if women don't have full insurance coverage of the initial cost - or have to wait to be reimbursed - they may balk at the price tag, according to Finer.

"That upfront cost can be a big hurdle," he said.

Finer said that may change, though, with healthcare reform. The new law considers birth control part of preventive healthcare, and most health plans must cover it without co-pays and deductibles.

IUDs and implants can have unwanted side effects, however. With the implant, irregular menstrual bleeding is most common; some women stop having their periods altogether.

The Mirena IUD may also cause menstrual irregularities. But it generally makes periods lighter, which is why it is also approved as a treatment for heavy bleeding. The ParaGard IUD has the opposite effect: menstrual bleeding and cramping can increase, though that may go away over time.

"There's no one best birth control method for all couples," Finer said.

But he added that now that many couples are putting off having children until their 30s, more women may want to consider long-acting birth control options.

"Childbearing has shifted to later years," Finer said. "So it makes sense to think long-term."

SOURCE: Fertility and Sterility, online July 13, 2012.