Feature Article

An update on contraception. Part 3: IUDs, barriers and natural family planning

Feature Article

An update on contraception. Part 3: IUDs, barriers and natural family planning

Caroline Harvey, Christine Read

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Abstract

Intrauterine devices provide highly effective and very long-acting contraception with minimal action required on the part of the user. Their effect is rapidly reversible once they are removed and they are relatively inexpensive because of their long duration of action.

Key Points

  • Both the copper and hormonal intrauterine devices (IUDs) prevent fertilisation by inhibiting sperm migration through the cervix and into the upper genital tract, inhibiting ovum transport and preventing implantation.
  • IUDs are long-acting methods of contraception with minimal action required on the part of the user. They have an effect that is rapidly reversible once the device is removed and are relatively inexpensive because of their long duration of action.
  • Barriers are totally patient controlled, can be used by anyone because they do not contain hormones and are not contraindicated in women or men with any medical condition, except perhaps in those with an allergy to latex.
  • The use of natural family planning methods requires that couples be diligent and committed because these methods generally reduce spontaneity and may require long periods of abstinence. It can take six to 12 menstrual cycles to accurately identify fertile days of a woman’s cycle. Women with irregular periods could also have difficulty in predicting their fertile days.
  • There are constant changes and developments in the contraceptive field. One area of research currently being undertaken is on changing the use of the oral contraceptive pill to have fewer or no pill-free days. There are also smaller IUDs (both copper and hormonal) currently being marketed or trialled.