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  • Title: Use of drugs and intrauterine devices for birth control.
    Author: Meeker CI.
    Journal: N Engl J Med; 1969 May 08; 280(19):1058-60. PubMed ID: 4180710.
    Abstract:
    The current use of oral contraceptives and intrauterine devices for population control is reviewed including the mechanism of their antifertility actions and the use-effectiveness of each method. The use-effectiveness of the IUD has been calculated as 1.5-3.0 pregnancies per 100 woman-years of exposure. The IUD has a high continuation rate (70% after 2 years) and is excellent for poorly motivated population groups. The most serious common side-effect--pelvic infection--can be controlled by more careful screening and modern antibiotic therapy. Other side-effects include irregular bleeding and uterine perforation, but not at significantly high levels. Oral contraceptives have been found to be virtually 100% effective, even in the new lower dose preparations containing around .5 mg progesterone and .05-.15 mg estrogen per tablet. New hormonal contraceptive approaches include pills which progesterone only, high postcoital estrogen administration, and long-acting injectable progestogen (Depo-Provera). All of these methods are highly effective but have some undesirable side-effects and require further study. Careful examination of the recent research reports connecting oral contraceptive use with increased risk of thromboembolism indicate that whatever the danger in oral contraceptive use, the direct physical hazards of pregnancy after contraceptive failure are much higher and more serious. Though a 100% safe contraceptive is a desirable ideal, the safety of current oral contraceptives and IUDs is higher than most other aspects of modern life.
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