Intrauterine Devices
An intrauterine device (IUD), as its name implies, is a contraceptive device that is inserted into the uterus by a
doctor. Once in place, no further contraceptive action is necessary. It may be left in place for at least a year if
it has been properly fitted and there are no untoward results. It is considered slightly less effective than the pill.
IUDs come in several different types, but all are supplied with a string that extends outward from the cervix into
the vagina, so that the wearer can make sure that the device is in place. Correct fitting by a specialist is a critical
aspect of the effectiveness of this device.
While IUDs are generally safe for most women, there are certain contraindications for their use. These include
pregnancy, fibroid tumors, anemia, abnormal Pap smears, continuous treatment with cortisone-type drugs, previous
ectopic pregnancy and pelvic inflammatory disease. Recent studies also indicate that IUD users are more likely to develop
severe pelvic inflammatory disease than those who use other methods.
Barrier Methods
The use of barrier methods of contraception--the condom, diaphragm and spermicidal agents--has grown in recent years from
a number of reasons. For example, with genital herpes and other sexually transmitted diseases reaching epidemic proportions,
barrier methods probably lower the rate of spread of these diseases. For women whose sex life is intermittent rather than
regular, the day-in, day-out use of the pill or the wearing of an IUD seems out of proportion to their requirements.
Condom. the condom, or "rubber," is second only to the pill as the most popular form of contraception in the United
States and remains the most widely used device throughout the world. In addition to providing protection against pregnancy
and disease, condoms are easily available and are now being manufactured in materials so thin that interfere with sensation
has been almost entirely eliminated. Extra effectiveness and easier insertion are accomplished by the use of a spermicidal
agent.
Diaphragm. The diaphragm is a soft, rubber cap surrounded by a flexible ring that is inserted into the vagina to
cover the entrance to the cervix. Preceding intercourse, when the device is coated with spermicidal jelly, it provides
both a chemical and mechanical barrier. A diaphragm must be individually fitted by a doctor and should be checked for
proper fit about once a year, especially after pregnancy, abortion or a significant change in weight. It should also be
checked periodically for holes or other damage. Other advantages include possible protection against cervical infections
and sexually transmitted diseases.
Spermicidal agents. these chemicals--in the form of creams, jellies, suppositories and foams--act in two ways when
inserted into the vagina before intercourse: They kill sperm cells, and they create a barrier against their passage. When
used alone, they are not totally reliable. In combination with a condom or a diaphragm, they provide a fairly high rate
of effectiveness if used correctly and consistently. However, some users of the various barrier contraceptives complain
of the inconvenience and disruption caused by having to insert or apply them before each intercourse as directed.
