Intra-uterine contraception

[摘要] The two main methods of contraception currently in general use are the mechanical barriers and oral hormones. Both demand standards of intelligence and care not present in all patients, and there is a need to develop other safe and effective methods which are free from these disadvantages. Intra-uterine devices have some potential advantages over other methods but the modern types of device were only introduced into the United Kingdom during the last few years, and their merits and demerits have not so far been adequately studied. In the present investigation the field of application of these devices, their efficacy, and the complications associated with their use have been assessed in more than 500 women. Each of the participants in the survey attended one of three places In London: a family planning association clinic which drew its patients from a wide area, or as private patients in a West End practice, or at a clinic at the Royal Free Hospital situated in one of the poorer areas in London, where there is a large number of immigrants. IUDs were thus assessed in a wide variety of patients who came from all social classes. The main groups were nulliparous women who wished to postpone starting a family; parous women who were sufficiently intelligent and methodical to use other methods of contraception but who found such methods unacceptable or for whom such methods were contraindicated on medical grounds; parous women whose poor intelligence and motivation render them incapable of using other contraceptive methods. For this third group further pregnancies were undesirable either on socio-economic or medical grounds. The follow-up of the patients showed that intra-uterine devices provide a high degree of, but not complete, efficacy. Their main disadvantages were found to be a tendency on the part of some patients to expel the device, and the frequent occurrence of menorrhagia. Potential hazards were the occurrence of pelvic infection and perforation of the uterus, IUDs were found to be unsuitable for nulliparae, but offered a useful alternative for parous women who found other methods of contraception unacceptable. For parous women who are insufficiently intelligent or methodical to use other methods of contraception, the HID is the method of choice.

[发布机构] University:University of Glasgow

[关键词] Pharmaceutical sciences