ParaGard IUD Mirena IUD

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Kademyan posted Jan 4, 2019 11:37 PM4

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ParaGard (IUD) and the Mirena (IUD)

Intrauterine Devices (IUDs) are a small object usually small which are placed inside the uterus which contains copper or levonorgestrel that has two strings attached that protrude into the vagina to enable the user to check placement (Youngkin, Davis, Schadewald, 2013). IUD’s may be started to be placed six weeks postpartum, and they are safe, highly effective and convenient (Youngkin, Davis, Schadewald, 2013). IUD’s are an excellent alternative for women who are considering sterilization (Youngkin, Davis, Schadewald, 2013).

IUD (ParaGard)

Indications

• Highly effective in preventing pregnancy with high compliance and high continuation rate
• Advantage – Highly effective, allows for sexual spontaneity, cost-effective, can be used during lactation, protective against ectopic pregnancy, long-term method.
• Disadvantages- insertion requires a trained professional, menstrual disturbances occur, does not protect against STI’s, the device can be expelled without the users being aware, risks of insertion are perforation of the uterus and infection

(Youngkin, Davis, Schadewald, 2013).

Contraindications

• General, contraceptive, and menstrual histories, a physical examination, and chlamydia and gonorrhea testing
• Can’t use this product before menarche
• Current PID or PID in past three months, known or suspected pregnancy, uterine anomaly, allergy to copper for ParaGaurd, current purulent cervicitis, chlamydia, or gonorrhea, cervical cancer.

(Youngkin, Davis, Schadewald, 2013).

Side Effects

• spotting or bleeding may occur at the time of insertion especially during 3-6 months after insertion
• IUD may be embedded
• IUD string may become lost

(Youngkin, Davis, Schadewald, 2013).

Affordability

• This program provides Bayer IUDs at no cost to eligible low-income women in the United States who do not have private health insurance coverage or Medicaid. If you have any questions about Bayer IUDs, call the Women’s Health Hotline at 1-866-647-3646, 8:30 AM – 8:00 PM EST, Monday – Friday (Bayer, 2018).
• For the most part, the insurances cover the devices because it is a long-term management of contraceptive with high effectiveness.

Mechanism of action

• Appear to work by preventing sperm from fertilizing ova. The foreign body is in the uterus; the endometrium reacts by releasing WBC’s, enzymes, and prostaglandins and when it reacts, it prevents the sperm from reaching the fallopian tubes (Youngkin, Davis, Schadewald, 2013).
• Consistent with the fact that IUD’s protect against intrauterine and ectopic pregnancies (Youngkin, Davis, Schadewald, 2013).

IUD Levonorgestrel Intrauterine system (Mirena)

Indications

• Highly effective in preventing pregnancy with high compliance and high continuation rate
• Advantage – Highly effective, allows for sexual spontaneity, cost-effective, can be used during lactation, protective against ectopic pregnancy, long-term method.
• Disadvantages- insertion requires a trained professional, menstrual disturbances occur, does not protect against STI’s, the device can be expelled without the users being aware, risks of insertion are perforation of the uterus and infection

(Youngkin, Davis, Schadewald, 2013).

Contraindications

• The LNG-IUD is contraindicated with patients with pelvic infections, sexually transmitted infections (Lockwood & Hillard, 2010).
• General, contraceptive, and menstrual histories, a physical examination, and chlamydia and gonorrhea testing and can’t use this product before menarche (Youngkin, Davis, Schadewald, 2013).
• Current PID or PID in past three months, known or suspected pregnancy, uterine anomaly, allergy to copper for paragaurd, current purulent cervicitis, chlamydia, or gonorrhea, cervical cancer (Youngkin, Davis, Schadewald, 2013).
• Copper IUD, levonorgestrel-releasing IUD have a long duration of effectiveness (Curtis,Tepper & Marchbanks, 2011).

Side effects

• Alter bleeding patterns and 20 percent of women experience amenorrhea within a year

• spotting or bleeding may occur at the time of insertion especially during 3-6 months after insertion
• IUD may be embedded
• IUD string may become lost

(Youngkin, Davis, Schadewald, 2013).

Affordability

• This program provides Bayer IUDs at no cost to eligible low-income women in the United States who do not have private health insurance coverage or Medicaid. If you have any questions about Bayer IUDs, call the Women’s Health Hotline at 1-866-647-3646, 8:30 AM – 8:00 PM EST, Monday – Friday (Bayer, 2018).
• For the most part, the insurances cover the devices because it is long-term management of contraceptive with high effectiveness (Youngkin, Davis, Schadewald, 2013).

Mechanism of action

• Levonorgestrel contributes to several mechanisms that prevent pregnancy by thickening of cervical mucus preventing passage of sperm into the uterus, inhibition of sperm capacitation or survival and alteration of the endometrium (Youngkin, Davis, Schadewald, 2013).

There is a big public health problem with unintended pregnancy, and the use of safe and highly effective methods of contraception is an important strategy (Curtis,Tepper & Marchbanks, 2011). There is a need for guidance to health care providers to help them offer quality family planning care to their patient when healthcare professionals have the guidance they help individuals use methods correctly, and continue to maximize effectiveness (CDC, 2018).

This is the U.S. Medical Eligibility Criteria for Contraceptive Use Classi?cations (CDC, 2018).

BOX 1. Categories of medical eligibility criteria for contraceptive use

1 = A condition for which there is no restriction for the use of the contraceptive method.

2 = A condition for which the advantages of using the method generally outweigh the theoretical or proven risks.

3 = A condition for which the theoretical or proven risks usually outweigh the advantages of using the method.

4 = A condition that represents an unacceptable health risk if the contraceptive method is used.

Box 1 (CDC, 2018).

References:

Bayer, (2018), If Mirena isn’t covered retrieved from https://www.mirena-us.com/if-mirena-isnt-covered/

CDC, (2018). U.S. Medical Eligibility Criteria for Contraceptive Use, 2016 retrieved from https://www.cdc.gov/mmwr/volumes/65/rr/rr6503a1.ht…

Curtis, K. M., Tepper, N. K., & Marchbanks, P. A. (2011). U.S. Medical Eligibility Criteria for Contraceptive Use, 2010. Journal of Women’s Health (15409996), 20(6), 825–828. https://doi.org/10.1089/jwh.2011.2851

Lockwood CJ, & Hillard JPA. (2010). Use of CDC medical eligibility criteria provides evidence on contraceptive method risks and benefits. Contemporary OB/GYN, 55(7), 7–14. Retrieved from http://search.ebscohost.com.libauth.purdueglobal.e…

Youngkin, E.Q., Davis, M.S., Schadewald, D.M., & Juve, C. (2013). Women’s Health. A Primary Care Clinical Guide (4thEdition). Pearson Education, Inc, Upper Saddle River, New Jersey.

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