Utility and drawbacks of continuous use of a copper T IUD for 20 years
Utility and drawbacks of continuous use of a copper T IUD for 20 years
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DOI：
10.1016/j.contraception.2007.01.016
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发表时间：
2007-06-01
期刊：
影响因子：
2.9
通讯作者：
Sivin, Irving
中科院分区：
文献类型：
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作者：
Sivin, Irving
本文探讨了相关的问题，需要避孕的妇女40岁及以上的程度，并在何种程度上，需要在25-35岁的妇女开始使用有领T宫内节育器时，可以得到服务。还讨论了在避孕的第二个十年中使用宫内避孕器对健康问题的不同影响，虽然当今世界所有区域40-44岁妇女的生育率低于千分之一百，不采取避孕措施的已婚或同居妇女的怀孕风险估计为每1 000人270-300人，即每年27-30%。在45-49岁年龄段，不采取避孕措施的已婚妇女每年怀孕的风险为10%或以上。三项研究的数据显示，继续使用相同装置超过10年的有领铜宫内节育器使用者在15年结束时没有怀孕。少数妇女继续使用相同的IUD通过20年，仍然经历了没有pregnancy.Use领铜T IUD超过10年与副作用的加剧，也没有增加这些影响的相对频率，除了围月经期症状和问题的经验。与第一个十年相比，在连续使用同一IUD的第二个十年中，出血增加和盆腔疾病严重程度增加都不明显。根据我们目前对IUD有效性持续时间的理解，只有一小部分妇女完成了10年的使用。即使对长效铜装置的有效性持续时间有了新的认识，平均年继续使用率必须相当高，才能使20%的25-35岁妇女开始连续使用IUD的第二个十年。那些这样做的人会发现继续使用同一设备可以大大防止怀孕和合理的经济利益。(C)2007年爱思唯尔公司All rights reserved.
This article examines interrelated questions concerning the extent of need for contraception in women 40 years and older and the degree to which that need can be served when use of collared T IUDs is initiated in women aged 25-35 years. Differentials in the impacts of intrauterine device (IUD) use on health issues in the second decade of contraception are also addressed.Although fertility of all women aged 40-44 years is below 100 per 1000 in all regions of the world today, the risk of pregnancy among married or cohabiting women who do not use contraception is estimated at 270-300 per 1000 or 27-30% per year. At ages 45-49 years, the annual risk of pregnancy to women in union who do not use contraception lies at or above 10% per year. Data from three studies show that users of collared copper IUDs who continued using the same device beyond the completion of 10 years experienced no pregnancies through the end of 15 years. A small number of women continued with the same IUD through 20 years and still experienced no pregnancies.Use of collared copper T IUDs beyond 10 years was not associated with intensification of side effects nor with an increase in the relative frequency of those effects, with the exception of the experience of perimenopausal symptoms and problems. Neither increased bleeding nor increased severity of pelvic disease was manifest in the second decade of continuous use of the same IUD, as compared with the first decade of such use.Under our current understanding of the duration of IUD effectiveness, only a small percentage of women complete 10 years of use. Even with revised understanding of the duration of effectiveness of long-acting copper devices, average annual continuation rates must be quite high in order that 20% of women aged 25-35 years initiate a second decade of continuous IUD use. Those who do so would find considerable protection against pregnancy and reasonable economic benefits in continuing to use the same device. (C) 2007 Elsevier Inc. All rights reserved.