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Intrauterine contraception: Devices, candidates, and selection

Gillian Dean, MD, MPH
Alisa B Goldberg, MD, MPH
Section Editor
Courtney A Schreiber, MD, MPH
Deputy Editor
Kristen Eckler, MD, FACOG


Intrauterine contraception is the most commonly used method of long-acting reversible contraception because of its high efficacy and safety, ease of use, and low cost. It provides a nonsurgical option for pregnancy prevention that is as effective as surgical sterilization. Modern intrauterine contraceptives are made of plastic and release either copper or a progestin to enhance the contraceptive action of the device.

This topic will discuss intrauterine device (IUD) types, selection, and use in specific populations. Issues related to intrauterine device insertion, removal, side effects, and complications are discussed separately. (See "Intrauterine contraceptive device: Insertion and removal" and "Intrauterine contraception: Management of side effects and complications".)

Several terms are used to describe intrauterine contraception, including IUD and intrauterine contraceptive; the progestin-containing device is also referred to as an intrauterine system. In this topic, we use the term IUD for all types of intrauterine contraception.


Prevalence — The IUD is the most commonly used method of reversible contraception worldwide, and is used by an average of 23 percent of female contraceptive users, with a range of <2 to >40 percent depending on the country [1,2]. In 2014, IUDs were used by 27 percent of female contraceptive users in Asia and 17 percent of female contraceptive users in Europe [2]. Use of IUDs has increased in the United States (US): In the decade from 2002 to 2012, IUD use rose from 2 to nearly 12 percent among US women using contraception [3-5]. Actively informing women about benefits, risks, and common side effects of IUDs appears to improve consideration and acceptance of the method [6,7].

Myths, misperceptions, and barriers to use — Several factors have limited widespread use of the IUD in the US, including a history of negative publicity; misinformation regarding the risks of infection, ectopic pregnancy, and infertility; misinformation about eligible candidates for IUD use; misconceptions about the mechanism of action of the IUD; lack of clinician training; and fears of litigation [8].

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Literature review current through: Nov 2017. | This topic last updated: Nov 29, 2017.
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