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Wildemeersch D  
New Technologies for Intrauterine Contraception and Treatment: Design that Fits

Journal für Reproduktionsmedizin und Endokrinologie - Journal of Reproductive Medicine and Endocrinology 2011; 8 (Sonderheft 1): 222-226

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A strategic advantage of intrauterine devices and systems is that, unlike the Pill, they are genuinely ‘fit-and-forget’. In use, they are more effective than Pills, particularly in adolescents and nulliparous women, as they have a relatively high continuation of use. The World Health Organization concluded that IUDs can be used and that they are safe for young women, including adolescents. Because adolescents and young nulliparous women contribute disproportionately to the epidemic of unintended pregnancies, suitable long-acting methods of contraception, such as the IUD or IUS, should be advocated as firstline choices for interval, emergency and immediate post-abortal contraception in this population of women. However, a major drawback is that they do not fit in uterine cavities of many women. Uterine cavities of nulliparous women are usually smaller than those of parous women. As current copper IUDs and the, at present, only available LNG-IUS may not be suitable for many young women, new developments in intrauterine technology, smaller frameless and framed copper and hormone-releasing devices, could help increase the prevalence of use, particularly continued use of this method in women, including in adolescents and nulliparous women, and help reduce the number of unintended pregnancies and induced abortions.
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