Birth control today #3 The I.U.D.
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WBA presents birth control today. Freedom and responsibility.
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This is a series of programs about birth control and how it affects us and our society.
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Today we focus on one particular method of contraception the IUD.
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The IUD or intrauterine device is a small flat flexible object between one
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and two inches in diameter which is placed in the uterus to prevent pregnancy also
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known as The Loop ring spiral or quail. The device today is made of either
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plastic or stainless steel and must be placed in the woman by a doctor. If left
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there the woman is very unlikely to get pregnant. The IUD is gaining
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widespread acceptance in many parts of the world as an effective and safe method of
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contraception. However the way it works to prevent pregnancy is still in question.
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Dr. Lowell Cohen's director of the produce Student Health Center explains some theories of its
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functioning at an open discussion on the Purdue campus how the IUD works.
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I think it's controversial. Many people
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believe that it really isn't a contraceptive agent
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that it's an abortive agent that contraception takes place. I'm
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sorry. Conception takes place in the outer third of the tube
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and with the entry uterine device conception still takes place. But in
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24 to 48 or 72 hours however long it takes as the fertilized egg
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passes down the tube and into the uterus. If there's a
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natural uterine device present it will not implant itself into the
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wall of the uterus but will pass on out the cervix.
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The theory behind this is there are a couple. One is that there is a
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foreign agent within the uterus and the uterus contraction and of course with
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this contraction of the uterus it expels the fertilized A and the
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other and maybe more plausible would be that
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when conception takes place the cervix the cervical Canal is a
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mediately plug with a mucus plug and this
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mucus plug stays there until lever begins and as you all know that some of the first symptoms
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of labor are what we call a buddy show an explosion of the mucus plug with bleeding.
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This also prevents bacteria from entering in into the uterine
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body. In other words the child can grow in a sterile median
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if the entry uterine devices there. The mucus plug does not form.
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There is no implantation of the fertilized egg and it passes out. This is theory but a lot of
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people say well ha what work. These are a couple of theories have been expounded.
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Another theory of the workings of the IUD is that the device stimulates activity of the
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Flowbee in tubes which in turn accelerates the passage of the egg into the uterine cavity
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Thus the egg arrives before the end of me or lining is suitably prepared for implantation.
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The idea of inserting an object in the womb to prevent conception is not new. The
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principle has been known for centuries to the peoples of North Africa who placed pebbles in the wombs of their
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female camels before taking long journeys across the desert. How these pebbles
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work was never known but it was a foolish man who did not take these precautions with his animals.
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In the early part of the twentieth century German physicians began to use intrauterine devices for
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contraceptive purposes. In one thousand twenty eight Graf and Berg devised a metal ring
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and reported successful results with it in this practice. Unfortunately the
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use of these rings spread to less qualified and careless practitioners who did not bother to
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sterilize their instruments during insertion. This led to pelvic infections
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and being before the days of penicillin and other antibiotics. The infections became
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dangerous situations as a result the intrauterine method became discredited and
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was generally abandoned for 30 years. Interest was revived again in one
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thousand fifty nine when two independent reports were published telling of two types of
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intrauterine rings that were considered reliable and safe. One was made of
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silk worm got and the other made of metal or molded plastic. Since then
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more modern models have been developed made of stainless steel and memory plastic. This
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new plastic is a resilient substance that can be stretched out for insertion of the device
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only to regain its original form once it is placed in the uterine cavity.
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Studies so far indicate that I made with this plastic tolerate uterine conditions
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very well and don't need to be removed for cleaning once a year is the older metal rings.
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The four best known types of plastic I use DS are the Libby's loop the Margolies
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spiral the burn burnt bow and the safety coil.
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Let's join Dr. Frank Payton and Dr. William Mansour of the women's clinic in Lafayette as
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they discuss their experiences with the IUD creator and advice is
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actually nothing new at all it has a very long history of
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Hippocrates even described the technique of inserting
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a small stone into the uterus to prevent pregnancy. We know that the Arabs
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even use stones in their camels in order to not get a
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worrisome animal on a long caravan trip that they
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may be taking. The Persian medical writers have even a ninth century
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reported. The thing that is brought it more to the front the vendor was from
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Japan and Israel reporting very effective method
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of using the entry device an IUD we feel
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has advantages over other means of contraception in there following the
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insertion.
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There is no special attention is necessary as far as following the patient.
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There is no general systemic effects or bad side effects.
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And it's also reversible means of contraception. Most of the
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IUD that are presently being used in this country are made of
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polyethylene or other plastic materials. There's
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usually a thread attached to the end of the device so that we can check to be sure that it's
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staying in position and if later on the patient desires a further
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pregnancy the this thread can be used to remove the device from
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the uterus. There are several. There are many different
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designs loops spirals coils bows
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recently Jack Peyton has been using a steel spring
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and I've been using a plastic shield.
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The action or the way that the IUD works say
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and preventing a pregnancy is truthfully currently unknown.
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I'm sure that we all feel that it is not causing an early
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abortion has a lot of folks have thought.
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Most workers feel that the device stimulates the activity of the fallopian
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tubes which in turn accelerates the passage of the
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egg down into the uterine cavity and thus the egg
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arrives there before the lining is suitably prepared
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for implantation.
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Over the past five years. I would say we
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probably have but and how you do use it over 500 women and I think
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probably Dr. Payton has found that we've begun to swing
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towards the IUD in a lot of a lot of our patients that are
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seeking advice and birth control.
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I would like to say something about the time of the month let's say or the
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technique now of this and show the IUD.
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There's a great advantage if it's inserted say on the third day of a normal
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menstrual flow.
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And I really mean a normal flow not a abnormal or a pill flow or
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anything else by one of our own normal clothes.
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One is then showed that. Not starting as I
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say on an early pregnancy and it is easier to assert at that time
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any believing that may occur from the instrumentation of this is
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masked by the menstrual flow. And lastly that the lining the
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endometrial lining of the uterus is ready to really grow old
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for the next two or three weeks and adapting itself to the presence of
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the device. Medically we also should trash
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the technique such as a very careful public examination of the
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patient and after the upper vagina has been planned the
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cervix or mouth of the womb is grasped with what we call attacking them in
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order to help straighten the uterus out and then the cervix is dilated a bit
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and then lodges the canal and at the same time we know exactly in
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what direction to put the egg. And of course
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it comes in a little crazy sterilized packet and all ready to go from there
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and makes it much easier after we put this in. We have
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something to say to the patient and.
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It might be interesting.
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What do you tell us. We feel it follow up care is important I'm mentioned earlier
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that there is no special attention that's needed but we do feel
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that this lady should be seen following her first
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period after the insertion of the IUD to make certain that it's
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staying in position to her and any other problems. And then we
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also advise that she have a checkup once a year
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or to report any abnormal bleeding or any any problems.
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The patient can actually check the IUD to be sure
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it's staying in position and we advised particularly the first month
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I would say that it's an position that they check this weekly or
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possibly each time prior to intercourse to make certain that the
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device is in position after the after the initial
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month and her first check up following the IUD. I
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think that it's advisable for him to check it once after the period
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is is over and perhaps once at the mid-cycle just to make certain that it's in
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position. This is fairly easily done the lady simply
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feels in the vagina and feels the thread is on the end of
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the IUD to make certain that it hasn't slipped out. Some
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women feel they are a little uncomfortable doing this and it is not really essential that it be
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done but I feel it's advisable that maybe Dr. Payne feels differently about
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this.
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No I think that it's very wise to accept that some women aren't
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acquainted with them shall share and they don't find that it's as simple as theirs
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are some of them may feel rather repugnant about self-examination and
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show why they.
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They can forget it as far as I'm concerned. Wonder speaking of going to
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CERN it's rather interesting that most people are afraid they're
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going to drop out or they're going to expel it.
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It has been a bit of a problem that a say since it was first used
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and this is really some of the important.
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Factors of the new designs and the new types of AI DS to decrease this
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expulsion rate which is probably in the neighborhood of 10 percent generally speaking
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our rate here is certainly much lower than that and I would say it's
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considered of little significance. Now the reason for this
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is that the cervix the mouth the womb of course should be healthy first that
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any chronic infection or deep scar you know or weakness of the
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cervix. The same could be said if there is an ill
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fitting or a poorly designed IUD. All of those things would
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increase the possibility of expulsion.
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How long do you tell him to wear the IUD.
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I tell him they can wear it as long as they don't want to get pregnant.
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Do you think that patient who or a woman who
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is wearing the IUD has a normal
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natural flow.
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I always tell a patient that the first one or two periods are
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going to be heavier and lasts longer than their normal periods
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and that they may have some spotting in between these periods
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after after these initial two periods. They should
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return pretty much to their normal menstrual flow.
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Although occasionally we have a way you would notice a slight increase in
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flow. Occasionally this is an indication for removing the IUD
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Again this doesn't happen very often but we have seen patients that have had
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flow to the menstrual flow to the extent that we've had to
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remove the IUD. Again this I think all over the country of most people's
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experience this is been around 5 percent I think this is the average
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