Benefits of IUC
IUC offers many contraceptive benefits
- High efficacy
- Not dependent on adherence
- Long-acting
- Low hormone or no hormone options
- Estrogen-free
- Suitable for the vast majority of women
-
Reduces menstrual flow (with LNG-IUS) for women with heavy
menstrual bleeding
-
Allows women to cycle naturally (with Cu-IUD), though flow may
increase
- Discreet
- Avoids post-sterilization regret
-
Less expensive daily cost than any other method, including
condoms
- Favorable risk/benefit profile
- Rapid return to fertility upon discontinuation
Non-Contraceptive Benefits of Copper IUDs
-
The use of Cu-IUD is associated with a reduced risk of
endometrial cancer. Some data also suggests that the use of
copper IUDs is associated with a reduced risk of cervical
cancer.
Non-Contraceptive Benefits of IUS
-
LNG-IUS deliver progestin to the uterus, decreasing menstrual
flow, dysmenorrhea, and other menstrual symptoms. Additionally,
LNG-IUS are approved in other countries for endometrial
protection for estrogen replacement therapy.
-
The use of LNG-IUS is associated with a reduced risk of
endometrial and cervical cancer, though the exact mechanisms are
unknown.
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Near all published studies about non-contraceptive benefits of
LNG-IUS involve LNG-20 (Mirena®). The efficacy of
LNG-20 in idiopathic heavy menstrual bleeding is well
established. LNG-IUS use in women with menorrhagia decreases
menstrual blood loss by 79-97%. LNG-IUS’s have also been
reported to decrease bleeding in women with underlying organic
pathology (e.g. fibroids, adenomyosis) and bleeding disorders.
LNG-20 is considered an alternative to hysterectomy or ablation.
Many studies reported a reduction of dysmenorrhea and pain in
women with endometriosis and adenomyosis.
-
There are many reports of LNG-20 being used as a way to protect
the endometrium in women at elevated risk of endometrial cancer,
including those with hyperplasia. A recent review concluded that
the evidence is insufficient to conclude that a protective
benefit exists. Therefore, we cannot currently recommend for or
against the use of LNG-IUS for this indication.
-
While data for non-contraceptive benefits of LNG-12 and LNG-8
are limited, similar reductions in dysmenorrhea and menstrual
blood loss are reported in phase II and III clinical trials, as
compared to LNG-20. If a woman desiring contraception also
requires menstrual management, an LNG-20 is preferred (SOGC).
-
The data is inconclusive regarding the protective effect of the
LNG-IUS on the development of pelvic inflammatory diseases
(PID).
Black D. and Waddington A. et al. Build Your Expertise: IUC
slide deck: 37-39, 42, 61.
Costescu D. and Guilbert E. et al. Preceptorship Program on
IUC insertion - Module 2
SOGC Clinical Practice Guideline, Canadian Contraception Consensus
(part 3): Chapter 7 – Intrauterine Contraception