Abstract

PIP: Although the Chinese find the IUD quite suitable as a contraceptive (83% of IUD use worldwide), women and doctors in the US are not convinced of its safety. The US fiasco of the Dalkon shield during the 1980s has not been forgotten. An Ortho Pharmaceutical study in 1991 found that 55% of US women would never use an IUD. Many types of IUDs are now available, and the single coil stainless steel ring is the most widely used in China. A Family Health International (FHI) IUD researcher, Dr. I-Cheng Chi, reports that research over the past ten years on IUDs has been "unequivocally positive" and predicts the IUD's comeback. The four IUDs which are popular are the Copper T, the MLCu375 or Multiload made of polyethylene, the Nova T (copper with a silver core), and the LNG-20, which has a T-shape and a sustained source of levonorgestrel. Only the Multiload is not available in the US. The Nova T and the LNG-20 are relatively new devices. All devices are found in Dr. Chi's study to be safe and efficient, but each has some flaws. The LNG-20 has the longest efficacy, with 40% of the hormone intact at five-year removal. The LNG-20 may be effective for 10 years. The disadvantage is amenorrhea. The life span ranges from six to eight years for the Copper T, which may be effective for 10-15 years. Only the Nova T is rated appropriately at only five years use and may have reduced effectiveness after three years. Pelvic inflammatory disease (PID) rates are low for all models. The PID rate for the Copper T is 0.59%, 0% for the Multiload, 1.06% for the Nova T, and 0% for the LNG-20. IUDs are generally prescribed for women in monogamous relationships and with children, but the Nova T may be used by young, nulliparous women because of the elasticity of the device. Population Action International reports that companies will research devices with sales over $50 million. IUD sales only total about $12 million. Norplant is considered in the US to have greater sales potential and fewer public relations problems.