Intrauterine devices

A. lUDs represent the most commonly used method of reversible contraception worldwide. The Progestasert IUD releases progesterone and must be replaced every 12 months. The Copper-T IUD is a copper-containing device which may be used for 10 years.

B. IUDs act by causing a localized foreign-body inflammatory reaction that inhibits implantation of the ovum. An IUD may be a good choice for parous women who are in a monogamous relationship and do not have dysmenorrhea.

C. Contraindications include omen who are at high risk for STDs and those who have a history of pelvic inflammatory disease, and women at high risk for endocarditis. Oral administration of doxycycline, 200 mg, or azithromycin (Zithromax), 500 mg, one hour before insertion reduces the incidence of insertion-related infections.

References: See page 195.

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We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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