Contraceptive use in the United States is virtually universal among women of reproductive age. However, unplanned pregnancies continue to occur and can be largely attributed to the nonuse and misuse of
contraception. Reducing unintended pregnancies constitutes a critical goal for managed care and the public. This can be achieved in part with
intrauterine devices (IUDs), which are an effective method of
contraception that require a one-time insertion and stay in place for 5-10 years. Therefore, compliance issues are largely mitigated, and actual use efficacy is the same as perfect use efficacy. The IUD is also reversible, unlike
tubal ligation, and could potentially be the
contraceptive of choice in today's environment. Unfortunately, safety concerns surrounding the use of older IUDs have precluded many women from recognizing the benefits of their use. Currently, the only approved IUDs in the United States are ParaGard, the
copper IUD, and
Mirena, the
levonorgestrel-releasing intrauterine system (LNG-IUS). These devices offer superior safety profiles compared with those products that were withdrawn from the market in the 1970s. In addition to a favorable safety and tolerability profile, the LNG-IUS offers an advantage over
copper IUDs, demonstrating improved efficacy in preventing intrauterine and
ectopic pregnancies. Successful communication between patients and providers regarding the improved safety and efficacy of newer IUDs will ensure an appropriate place in
therapy. Thus, greater numbers of women will recognize the IUD as a safe, cost-effective means to
contraception, thereby reducing the economic and social burdens associated with unplanned pregnancies.