IUDs may provide birth control protection for longer than approved duration

Some intrauterine devices (IUDs), already a long-term birth control option, are effective for even longer than recommended, according to a new review of past studies.

The older women are when certain IUDs are inserted, the longer they can leave them in, the review found.

IUDs, small plastic or metal devices inserted into the uterus, prevent pregnancy either by killing or damaging sperm or by releasing hormones that thicken the cervical mucus which does not allow sperm to pass. They are the most effective type of reversible birth control, with lower failure rates than the Pill, implants, patches or condoms.

Although recommendations on IUD use have stayed the same for some time, the finding that the devices are effective for longer than advertised is actually old news, Dr. Justine P. Wu told Reuters Health.

She worked on the study at the Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey.

“We have had these data in our hands for years,” Wu said. “Our hope is that this review will bolster clinician and patient confidence, both in the United States and worldwide, in the safety and benefits of extending use of certain IUDs beyond the manufacturer-approved time period, among select women.” That includes women who have had one or more children and were at least 25 years old when the IUD was inserted.

Among those women, copper IUDs seem to be effective birth control for at least nine years, depending on the brand. ParaGard, a copper IUD recommended for up to 10 years, is effective for at least 12.

Mirena, a plastic IUD which releases the hormone levonorgestrel to prevent pregnancy, is advertised as effective for five years, but is effective for at least seven years, according to the review published in the journal Contraception.

For women who were at least 35 when the IUD was placed, studies indicate ParaGard remains effective until menopause.

There were not enough studies of women under age 25 to determine how long Mirena and ParaGard are effective beyond recommendations in that group, the researchers said.

Extended use of an IUD among women over 25 who have had a child ultimately reduces costs, improves convenience and extends birth control benefits, Wu said.

Source: fox news


Birth control type tied to time between pregnancies

Women using intrauterine devices (IUDs) and other types of long-term reversible birth control after having a baby are less likely to get pregnant again quickly, a new study suggests.

Women who used those methods were four times more likely to wait more than 18 months between pregnancies compared to those relying on condoms, researchers found.

The World Health Organization endorses a two-year period between birth and a woman’s next conception.

Still, one third of all repeat pregnancies in the U.S. occur within 18 months of the previous child’s birth. And a growing body of evidence shows this close timing increases the risk a baby will be born early or at a low birth weight.

The time between pregnancies “cannot be explained only by the mother’s preferences,” Heike Thiel de Bocanegra said.

She and her colleagues from the University of California, San Francisco investigated the link between access to birth control or family planning services and pregnancy spacing.

In the current study of 117,644 California women who’d had at least two children, 64 percent waited 18 months or more between pregnancies and the rest did not.

All women included in the study filed claims through the state’s Medicaid program for the poor, called Medi-Cal, or through health providers offering state-funded family planning services.

The researchers matched data on claims for contraceptives to California’s birth registry.

“We assumed that access to contraception . . . would improve birth spacing,” Dr. Anitra Beasley wrote in an email to Reuters Health.

“This study actually examines this assumption,” she said.

Beasley, who studies family planning at Baylor College of Medicine in Houston, was not part of the current research.

Women who used long-acting reversible contraception, including IUDs or implants, were four times more likely to wait at least 18 months to conceive again, compared to those who only used “barrier” contraceptives like condoms or spermicide.

More than half of women started using birth control pills, the ring or the patch after giving birth. They were twice as likely to wait at least 18 months between pregnancies as condom users.

Those relationships stood firm even when the researchers looked at possible influences like the mother’s race, education, age and whether she was born in the U.S., according to the report published in the American Journal of Obstetrics and Gynecology.

Women in the study counseled by a certified family planning service provider were 67 percent more likely to wait 18 months between pregnancies, compared with women who utilized Medi-Cal services only.

“Low-income women are sometimes seen only once after giving birth,” Thiel de Bocanegra said.

“Some women receive contraception – some do not,” she said.

Women in the study received four months worth of covered contraceptives, on average. That number was dragged down by the one third of women in the study who had no contraceptive claims at all.

For Meredith Matone, a researcher with PolicyLab at Children’s Hospital of Philadelphia, the study’s large size helps build a better understanding of how public health initiatives work in the real world.

“The results we find in clinical trials do not always translate well when implemented on a large scale, where they are subject to challenges that include provider performance, patient compliance and operational hurdles,” Matone wrote in an email to Reuters Health.

“Under health care reform, there are opportunities to continue to support such evidence-based public health programs for families,” said Matone, who was not involved in the new research.

“Health care providers should know that the optimal pregnancy interval is 18 months or more, and should encourage the use of highly effective contraception during this period,” Thiel de Bocanegra said.

“Pediatricians can help, too, by asking the mother what type of contraception she is using,” she said.