These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: [Non-hormonal methods of female contraception].
    Author: Audebert AJ.
    Journal: Rev Prat; 1987 Sep 21; 37(38):2255-65. PubMed ID: 3659792.
    Abstract:
    The disadvantages and complications of IUD and spermicidal contraception have been reduced in recent years and their efficacy has increased. Both methods require careful patient selection and careful use. Better knowledge of their mechanism of action has made it possible to identify more precisely the causes of failure and risk factors for serious complications. The action of inert, copper, and progesterone IUDs depends essentially on an antinidatory effect that is especially powerful near the device, which explains why proper placement is crucial to good functioning. Some drug interactions lessen the efficacy of IUDs. The uterine modifications disappear rapidly after removal of the device, so that reversibility is excellent. The efficacy but also the secondary effects of inert IUDs increase with size. Different models are often available in a range of sizes. Inert IUDs can be left in place for long periods, but risks of actinomycosic infection seem to increase with duration of use. Copper devices are the most widely used. The rate of release of the copper depends on the surface area of copper and the varying physical and chemical properties of the uterus. After the normal duration of use of 3 years, the risk of fragmentation increases. The Progestasert, which releases 68 mcg of progesterone daily for 18 months, is the only IUD that reduces menstrual bleeding and dysmenorrhea and which has a local antiestrogenic effect. The recognized contraindications to IUD use must be carefully respected in patient selection, and risk factors for infection and extrauterine pregnancy should be ruled out. Postpartum and postabortal insertion are associated with higher expulsion rates. The IUD must be inserted under aseptic conditions. Surveillance is especially important in the initial period of adaptation. Abnormal uterine bleeding is the most frequent secondary effect and leads to removal in 2-10% of users during the 1st year. The rate of expulsion varies from .6-7% depending on the IUD and patient characteristics. The pregnancy rate for most IUDs varies from .5-2%/year. The risk of ectopic pregnancy is increased but still small. Uterine perforation is rare but potentially very serious. The IUD is contraindicated for women at increased risk of sexually transmitted diseases; sexual habits and especially occasional multiple partners are the single most important risk in the increased frequency of upper genital tract infections in IUD users. Progress in local spermicidal contraception has not come from development of new spermicide products but from new modes of administration such as vaginal sponges and better understanding of mechanisms of action and causes of failure. Good performance of spermicidal methods requires rigorous selection of users. The most effective spermicides are surfactants such as benzalkonium chloride and nonoxynol 9 which destroy cell membranes and inactivate sperm. Most spermicides offer some protection against sexually transmitted diseases. To be maximally effective, spermicides must be used at each intercourse exactly according to the instructions for the specific product.
    [Abstract] [Full Text] [Related] [New Search]