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  • Title: IUDs and PID: understanding the American situation.
    Journal: Netw Res Triangle Park N C; 1987; 8(2):8. PubMed ID: 12268660.
    Abstract:
    Studies that have noted higher incidence of pelvic inflammatory disease (PID) in IUD users have never suggested that IUDs are unsafe for all women and thus should be available to none. The available research shows that IUD users who have only 1 sexual partner and are that person's only partner are at no greater risk of contracting PID than women practicing other methods or no method of contraception. Women with more than 1 sexual partner appear to be at a significantly higher risk of PID, suggesting a link between PID and a sexual lifestyle which increases the risk of exposure to sexually transmitted diseases. Age and parity also are significant variables, with younger nulliparous IUD users more at risk of PID. Studies need to measure IUD users' exposure to sexually transmitted diseases in order to establish accurate causal links with PID. A major limitation of the World Health Organization (WHO) sponsored research in Thailand, India, Nigeria, the Philippines, Chile, and South Korea -- 1 of the few large studies of the relationship between IUD use and PID undertaken in developing countries -- was its lack of information about participants' sexual histories and number of sexual partners, an indicator of increased risk of sexually transmitted disease. In many cultures, such information may be difficult to obtain, but without it it is not possible to sort out the different roles in PID of sexual activity, sexually transmitted diseases, and IUD use. According to Dr. Judith Fortney of Family Health International (FHI), the current research picture suggests that in the US large numbers of women for whom the IUD is ideal are deprived of this contraceptive method. She suggests that the IUD should be prescribed for women in mutually monogamous relationships rather than taking IUDs off the market. The US Food and Drug Administration continues to approve IUDs. Safety claims against the IUDs most recently withdrawn from US sales have been repeatedly rejected by the courts. International observers need to appreciate that American marketing decisions in the field of family planning often are controlled by nonclinical considerations. In the US, the high cost of meeting unwarranted legal action forced manufacturers of the IUD to withdraw their product from sale.
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