The copper IUD (ParaGard)

A woman who desires two children will spend three decades of her life trying to prevent an unintended pregnancy.

Contraception allows parents to choose the number and spacing of children. Each year, family planning programs prevent an estimated 187 million unintended pregnancies, including 60 million unplanned births and 105 million abortions, and avert an estimated 2.7 million infant deaths and 215,000 pregnancy related deaths.

The prevalence of contraceptive use differs across the world depending on differences in desired number of children, awareness, funding, and access to care. Female sterilization and intrauterine devices account for nearly 40% in less developed regions, and pills, intrauterine devices, and condoms for the same proportion in more developed regions.

Meet the IUD

The IUD (IntraUterine Device) is a long-acting reversible contraception method. It is a small T-shaped plastic device placed inside the uterus by a trained health professional. IUDs are extremely effective, with a failure rate of less than one pregnancy per 100 women—compared with 9 per 100 women on the Pill.

Of all contraceptive methods, this is one of the least expensive, longest lasting forms of birth control available to women today. IUDs are totally reversible.

There are two types of IUDs:

1. The hormonal IUD releases progestin. One hormonal IUD is approved for use for up to 5 years (Mirena). Another hormonal IUD is approved for use for up to 3 years (Skyla).

2. The copper IUD (ParaGard) does not contain any hormones. It is approved for use for up to 10 years.

How do intrauterine contraceptives work?

Both types of IUDs work mainly by preventing fertilization of the egg by the sperm. The hormonal IUD also thickens cervical mucus, which makes it harder for sperm to enter the uterus and fertilize the egg. It also keeps the lining of the uterus thin, which makes it less likely that a fertilized egg will attach to it.

The hormone releasing IUD (Mirena) causes thinning (but reversible) of the lining of the uterus making it successful in treating heavy painful periods. Studies show that fertility returns shortly after removal of all intrauterine contraceptives.

What are the adverse effects and complications of intrauterine contraceptives?

Insertion of intrauterine devices can be painful. Rarely, uterine perforation occurs.

Copper bearing IUDs may cause periods to be heavier and may cause more cramping. Non-steroidal anti-inflammatory drugs (Ibuprofen and Aleve) reduce bleeding and pain associated with the use of an IUD. According to recent evidence, IUDs do not increase the risk of pelvic inflammatory disease unless inserted in women with pre-existing gonorrhoea or Chlamydia infection.

Women using a hormone releasing IUDs may have more days of spotting or bleeding during the first six months, acne (if already prone to it), breast tenderness, or mood change. The persistence of these side effects may require the removal of the device. Twenty percent of women experience no menses one year after insertion of the hormone releasing intrauterine system.

The IUD is a very effective, long acting, reversible method of family planning, giving women choices. I believe that a woman who controls her fertility controls her life. Every woman should be free to decide whether and when to have children.

This column is no substitute for seeing your own health care provider. You can read about all my other escapades on my blog http://www.drpauladhanda.com/

Dr. Paula Dhanda is a practicing physician in Kelseyville. She is the founder of Worldwide Healing Hands. She may be reached at 707-279-8733 or visit http://drspecialtycare.com/ or http://worldwidehealinghands.org/

The SILCS Diaphragm is the first new cervical barrier method that will enter the market in more than a decade. Photo credit: Kessel Marketing

Original post can be found at Impact Blog

“In the early 20th century, distribution of and education about contraceptives were illegal in the United States, leading to the widespread use of ineffective contraceptive methods. This continued until Margaret Sanger visited a Dutch birth control clinic where she learned about diaphragms and thus began a revolution in the United States. The diaphragm was the first safe and effective woman-initiated contraception in much of the world and was widely used in the United States and other countries until the introduction of the birth control pill. While use of the device has decreased over the past 50 years, a comeback may be in the wings.

The SILCS Diaphragm, set to officially launch in Europe this June, is the first new cervical barrier method that will enter the market in more than a decade.

PATH, in collaboration with CONRAD and funded by USAID, designed the one-size-fits-most SILCS Diaphragm to increase access to nonhormonal barrier contraception for women in low-resource settings, as well as developed countries. PATH led a user-centered design process involving input from women, their partners, and providers. The design was then verified in clinical studies by couples in the Dominican Republic, South Africa, Thailand, and the United States. The single size should remove the need for a pelvic exam and fit assessment which are obstacles to both providers and women in many settings. PATH licensed the SILCS design to Kessel Marketing & Vertriebs GmbH of Frankfurt, Germany, who will introduce the device as the Caya™ contoured diaphragm.

While SILCS was developed to expand women’s options for nonhormonal barrier contraception, SILCS has added value due to its potential to be used as a multipurpose prevention technology when paired with tenofovir gel—a product currently in Phase III clinical testing—which is designed to protect women from acquiring HIV.

CONRAD, which owns a license for tenofovir gel, is working on a protocol for a study that will assess the safety, pharmacokinetics, and pharmacodynamics of the SILCS plus tenofovir gel. Another study will evaluate the potential of a modified tenofovir gel as a contraceptive by pairing it with the SILCS to assess their ability to prevent sperm from penetrating cervical mucus.

PATH is working with research partners in India, South Africa, and Uganda to identify opportunities and challenges for future introduction of the single-size diaphragm in developing countries. There are 222 million women worldwide who would like to avoid pregnancy but aren’t using a modern method of contraception. Some women are either unable or unwilling to use hormonal contraceptives, and many also have infrequent sex and prefer to use a product that is on demand and woman initiated.

Imagine a world where every child born is planned and their mothers are free of HIV infection. As Louis Armstrong sang, what a wonderful world this could be.”

London, July 11, 2012 –Voluntary family planning services will reach an additional 120 million women and girls in the world’s poorest countries by 2020 thanks to a new set of commitments announced today by more than 150 leaders from donor and developing countries, international agencies, civil society, foundations and the private sector.

The announcement was made at the London Summit on Family Planning, co-hosted by the UK Government’s Department for International Development and the Bill & Melinda Gates Foundation. This unprecedented effort showcased innovative partnerships and leadership at the country level, empowering women to reach their full potential. The Summit underscored the importance of access to contraceptives as both a right and a transformational health and development priority.

Secretary of State for International Development, Andrew Mitchell, said: “This is a breakthrough for the world’s poorest girls and women which will transform lives, now and for generations to come. The commitments made at the Summit today will support the rights of women to determine freely, and for themselves, whether, when and how many children they have.”

“Enabling an additional 120 million women in the world’s poorest countries to access and use contraception, something women in the developed world take for granted, will save millions of lives and enable girls and women to determine their own futures.”
By 2020, the collective efforts announced today will result in 200,000 fewer women dying in pregnancy and childbirth, more than 110 million fewer unintended pregnancies, over 50 million fewer abortions, and nearly three million fewer babies dying in their first year of life.
Melinda Gates, co-chair of the Bill & Melinda Gates Foundation, said: “When I travel and talk to women around the world they tell me that access to contraceptives can often be the difference between life and death. Today is about listening to their voices, about meeting their aspirations, and giving them the power to create a better life for themselves and their families.”

The Summit has raised the resources to deliver contraceptives to an additional 120 million women which is estimated to cost $4.3 billion. More than 20 developing countries made bold commitments to address the policy, financing and delivery barriers to women accessing contraceptive information, services and supplies. Donors made new financial commitments to support these plans amounting to $2.6 billion – exceeding the Summit’s financial goal.

Access to safe, effective methods of contraception is considered one of the most cost-effective investments a country can make in its future. Studies show that every US $1 invested in family planning services yields up to $6 in savings on health, housing, water, and other public services.

Contraceptive use also leads to more education and greater opportunities for girls, helping to end the cycle of poverty for them and their families. Up to a quarter of girls in Sub-Saharan Africa drop out of school due to unintended pregnancies, stifling their potential to improve their lives and their children’s lives.

The Summit galvanized the global community to create transformational change, calling for innovative solutions and robust public-private partnerships that put women at the heart of the equation. Commitments announced today will give women more options, easier access, and improved health care.

The Summit supports and builds on the momentum created by the UN Secretary General’s Global Strategy for Women’s and Children’s Health, “Every Woman, Every Child,” and innovative public-private and civil society partnerships developed through the Reproductive Health Supplies Coalition. The Summit also aligns with the broader framework established by the International Conference on Population and Development (ICPD) almost 20 years ago.

Media assets including b-roll and photos can be found here:
http://www.gatesfoundation.org/press-room/Pages/news-market.aspx
Details on donor commitments will be made available here:
http://www.londonfamilyplanningsummit.co.uk/media.php#media-kit

Notes for Editors
The estimated resource requirement for sustaining the current use of contraception by 260 million women in the 69 poorest countries is approximately US$10bn over eight years from 2012 to 2020. These resources – which are principally provided by country governments through their health budgets and are supported by contributions from consumers and external donors – need to be sustained. Reaching an additional 120 million women will require resources equivalent to an additional US$4.3bn over the next eight years. This number includes resources and infrastructure supported by developing countries. Of the $4.3bn total resource requirements, donors will need to contribute $2.3bn in funds above and beyond the level of funding provided for family planning in 2010.

Many donors have already announced increased commitments to family planning between 2012 and 2015 as part of the 2010 G8 Muskoka Summit and the UN Secretary General’s ‘Every Woman Every Child’ initiative. These additional contributions, disbursed from 1 January 2012 onwards, are above and beyond the level of funding provided for family planning in 2010 and therefore contribute to the additional funding sought for the Summit to reaching an additional 120 million women and girls. The Summit has agreed a methodology with donors for estimating the proportion of wider health commitments that contribute to family planning.


The Department for International Development
The Department for International Development (DFID) leads the UK government’s effort to fight global poverty. DFID’s overall aim is to reduce poverty in poorer countries, in particular through achieving the Millennium Development Goals (MDGs). This will be done by honouring the UK’s international commitments; making British aid more effective by improving transparency and value for money; leading international action to improve the lives of girls and women; strengthening governance and security in fragile and conflict-affected countries; boosting wealth creation; and driving urgent action to tackle climate change.

Bill & Melinda Gates Foundation
Guided by the belief that every life has equal value, the Bill & Melinda Gates Foundation works to help all people lead healthy, productive lives. In developing countries, it focuses on improving people’s health and giving them the chance to lift themselves out of hunger and extreme poverty. In the United States, it seeks to ensure that all people—especially those with the fewest resources—have access to the opportunities they need to succeed in school and life. Based in Seattle, Washington, the foundation is led by CEO Jeff Raikes and Co-chair William H. Gates Sr., under the direction of Bill and Melinda Gates and Warren Buffett.

Contact:
Bill & Melinda Gates Foundation Phone: +1 206 709 3400
Email: media@gatesfoundation.org
DFID press office
Phone: +44 (0)207 023 0600 Email: fpmedia@dfid.gov.uk