Intrauterine and barrier contraception (a practical review of recent developments)

This article briefly examines recent developments in intrauterine contraceptive technology and barrier methods and looks at issues around sexually transmitted infection associated with these methods. It is hoped that the reader will feel more confident in future clinical consultations when discussing condom use and also when giving patients guidance on intrauterine contraception. Reference is made to relevant points from two evidence-based clinical guidelines (one concerning copper IUDs and the other the LNG-IUS) published this year by the Clinical Effectiveness Unit of the Faculty of Family Planning and Reproductive Health Care, and the aim is to help the reader identify only appropriate contraindications to intrauterine contraceptive methods, since these have diminished over the last few years. The guidelines can be accessed via the Faculty website at www.ffprhc.org.uk.

This article will also draw attention to the fact that the IUS (or Mirena) and copper-bearing devices with more than 250mm2 of copper have comparable contraceptive efficacy; and that the suggestion of relative protection from pelvic inflammatory disease with IUS use is not supported by published evidence. It recommends the T-Safe CU380A as the ‘gold standard’ for copper devices, on the basis of its proven high efficacy and long lifespan.