Talk:Intrauterine device

Wiki Education Foundation-supported course assignment

This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Joanalo44. Peer reviewers: Pygmysloth.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 00:44, 17 January 2022 (UTC)

Necessity of a mention on IUD's ineffective against IUD

There should be a mention that IUD does not protect against IUDs. If you do get an STI, it can easily travel to the uterus and fallopian tube, causing more serious infection, pelvic inflammation, and infertility.

Long section on "effects"

This section (now removed) was essentially an effort to catalogue the history of medical opinion on whether IUDs cause very early abortions. In my opinion, a highly detailed inquiry into 40 years of medical opinions is not well-suited to this particular namespace. Intrauterine device (the article) provides a general overview of what the term means. In my opinion, it is not the place for a section giving a great degree of detail on one particular aspect of the IUD. I am not sure where this content should go (if anywhere), but I don't think it belongs here. I did try looking for various articles that would be an appropriate host, but did not find anything suitable. Please feel free to conduct your own search. AboutIUDs (talk) 13:03, 30 November 2010 (UTC)

This text was removed a year ago, and I feel that action should be taken. The text adds quite a lot of information that shows the differences of medical opinion concerning the reasons why IUDs work. It should not be omitted, and it's a relevant topic. But I agree it doesn't belong here. I would add it as a separate article and summarize it briefly here. I'm afraid to do the editing myself due to the probability that my work would be reverted. Is there an editor out there who is WP:BOLDer than I? David Spector (talk) 18:21, 18 February 2012 (UTC)

Method of action

The article should describe this. Do the IUDs stop implantation? Malick78 (talk) 22:04, 6 December 2010 (UTC)

Intrauterine device is a summary-style article; it would not make sense to describe any IUD's method of action, in detail, in this namespace. Copper IUDs and the hormonal IUD have different methods of action and are different in other ways; IUD with copper and IUD with progestogen address each device in more detail. But regardless, in the medical field, the method of action for both types of IUD is not well understood. AboutIUDs (talk) 15:09, 7 December 2010 (UTC)

See Long section on "effects" above for evidence that medical people have differing opinions on why IUDs work. Is it the physical scraping? A chemical effect from the copper? A hormonal response to the progestogen? Aliens? There are many FDA-approved medicines and devices whose methods of action are unknown. Medicine is primarily concerned with (1) is it safe? and (2) does it work as compared to a placebo, when tested with good experimental design (double-blinded, with control group, avoiding conflicts of interest)? David Spector (talk) 18:33, 18 February 2012 (UTC)

Improving This Article

I am working in the field of reproductive health and have been doing a lot of research lately on IUDs. I would like to improve the quality of this article (particularly the section on Mirena), by including the most recent research, literature, and reviews. Would anyone be opposed to me editing this page in the coming weeks? All of my edits will be reviewed by qualified physicians. Side note: the reference in the title paragraph of this article, which states that IUDs are more effective that the progestin only pill, is misleading. If you look at the source that is cited as well as the research it mentions, it actually states that IUDS (along with other long-acting reversible contraceptives) are more effective than oral contraceptive pills in general, as well as the birth control patch, and the vaginal ring.SarahRose12 34 (talk) 18:46, 28 June 2012 (UTC)

Box on copper/hormonal IUD comparisons

I feel that it would be appropriate to put a comparison box in here somewhere on ParaGard vs. Mirena/Skyla. A lot of people making contraceptive decisions are looking for that comparison, and the article split makes it harder to make that comparison.

Any opposition to me putting one together? My main concern is that it's a little US-centric.

Triacylglyceride (talk) 20:01, 10 November 2013 (UTC)

USA IUD comparison
ParaGard
≤10 years.	Copper toxic to sperm.	Heavier menses.
Mirena
≤5 years.	Progestin thickens cervical mucus, blocks sperm.	Lighter or no menses.
Skyla
≤3 years.	Progestin thickens cervical mucus, blocks sperm.	Lighter or no menses.

I just put this together in my sandbox, let me know what you think.

Triacylglyceride (talk) 05:41, 19 November 2013 (UTC)

I prefer to stay away from brand names. One can separate it into hormonal and non hormonal. Also other countries have other brands of these. We need to stay global in scope. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:36, 19 November 2013 (UTC)

We couldn't separate it into "hormonal" and "non-hormonal", because there are many different non-hormonal options, varying from three to twelve years' duration, some of which don't involve copper at all.

The reason that I'd like to include such a box is to mitigate the problem with IUD articles being split into with-progestogen and with-copper: when I am speaking with friends about IUDs, the most frequent question I get is, "so, wait, what's the difference between them? which one should I get?"

I'm working on this page and other IUD pages to improve global scope (just added inert IUD and Gynefix info -- I hear Canada's getting Gynefix soon, btw!), but I don't think adding information relevant to the USA scope, if clearly labeled, detracts from the global scope.

Thoughts? Triacylglyceride (talk) 08:19, 19 November 2013 (UTC)

Hopefully not overbold.

I just added an inert section and rewrote the hormonal section. Please feel free to criticize the edits! The talk page seemed pretty dead, or I would have run it by here first. Triacylglyceride (talk) 05:40, 19 November 2013 (UTC)

Barriers to use section?

I think it could be helpful to include a "barriers to use" section. IUDs in the US continue to be under-utilized compared to other countries, and there are some interesting reasons why (relating to insurance coverage of post-abortion and postpartum insertion, cultural barriers, and misconceptions by patients and doctors) that could bear publishing. Thoughts? Triacylglyceride (talk) 08:16, 10 December 2013 (UTC)

Removal and Insertion.

I think there probably should be a section on removal and insertion and how they are done. — Preceding unsigned comment added by 192.199.53.2 (talk) 23:32, 27 April 2017 (UTC)

Article changes

I am a 4th year medical student from UCSF and interested in cleaning up this article and making a small contribution to the Wiki community. My goal is to update this article to answer questions/concerns that women have when I talk to them about IUDs during clinic. The changes that I am planning include the following:

1) Making lead flow a little better (Definition, LARC, implantable, SE depend on type. Two main types. Talk about general SE then more specific SE).

2) Include background section: History and prevalence, Barriers to use, What to expect during insertion/removal, Myths and misconceptions (Discuss how menstruation is not necessary. Maybe distinguish between missed periods with anovulation (like with PCOS) and missed periods with IUD.)

3) Types: Non-hormonal: Copper-containing IUD, Hormonal: Levonorgestrel-releasing IUD, Inert

4) Benefits: Consider including amount of hormone released along with other benefits (effective, set and forget, spontaneity, lack of menstruation, etc)

5) Side effects/complications: make sure to distinguish adverse effects from complications and include idea of how rare/common they each are.

6) MOA: want to include analogy of some sort, "The hormone also thickens the cervical mucus so that sperm cannot reach the fallopian tubes. Imagine the sperm is a driver trying to reach its destination. Levonorgestrel makes the road so cloudy and difficult to get through that the sperm is unable to reach its final destination, the egg."

7) Reasons to visit healthcare provider

8) History: no changes planned.

I would also like to make a table that includes the main types, MOA, common side effects, and duration.

Please let me know if there are any thoughts, comments, suggestions. I will be working on this for the next 3 weeks or so. Joanalo44 (talk) 20:48, 8 March 2018 (UTC)Joanalo44

Wikimedicine peer review

Hello! I am a fourth year medical student on a Wikimedicine elective and will be doing a peer review on Joanalo44's work. (Joanalo44 I I think you mentioned that there might be another table +/- a few more edits in the works, so I'm sorry if my feedback is a little premature. These are just initial comments and then I'll circle back to review any additional updates you might have later. :) )

Overall Impression: Prior to edits this article was considered a Class C, high importance article. While the article had a solid amount of content, I think it was rather technical as it focused on the variations in design among the different IUDs both historically and currently. I think the recent changes to the article, particularly organizing the "Types" section by Hormonal and Nonhormonal types and adding a comparison table made this page much more applicable to the average viewer trying to learn more about IUDs. Great work!!

One thing that I think would make the article even easier to navigate as a patient would be to reorganize the Nonhormonal IUD section a bit. Right now it talks about copper first (design, sizing, MOA, and then advantages), and then goes into gold and silver design followed by copper with indomethacin. I think the information that a patient might look for (advantages of copper and maybe MOA of copper) gets buried in the middle. I think if you talked about the various subtypes of non hormonal IUDS first and then went into MOA and advantages that might be a little easier to read. Another option might just be to keep everything organized as is but then just add a few subheaders.

With regards to that same section the explanation of copper's MOA seems a little repetitive ("copper acts as a spermicide," "primarily work by damaging sperm and disrupting their mobility," "cervical mucus inhibits the sperm's motility and viability"), so I would recommend cutting that down a bit.

Those were my major points of feedback! A few more specific ideas that I had...

Content related: - Include copper's ability to serve as emergency contraception in the lead section. I think it's an important fact for both patients and people in the medical field to know. - A brief overview of IUD placement - I think you had this idea earlier and I agree! I think patient could be nervous or at least curious about the procedure. - I was personally curious about the prevalence of use in the US (I saw that it mentioned that they are most common in China), but I don't know if this gets away from being relatable on a global level. - This might be overkill, but

Sentence structure: - "Difficult to sperm" (in the hormonal IUD section) - maybe change to "uninhabitable for sperm" - "pathologic causes of menorrhagia" - maybe link to an explanation of pathologic cause if there is one or use a different phrase - "In non-emergency use, prevention of implantation is at most an exceptional method of action, not a typical mechanism of action" - I didn't really understand what an exceptional method meant here. - "They can also thin the endometrial lining and potentially impair implantation but this is not their usual function" - I didn't really understand usual function here - like they don't consistently do this or studies haven't proven it?

Please let me know if I can clarify anything. Again great job! :)

Pygmysloth (talk) 02:35, 25 March 2018 (UTC)

Insertion and Removal Section - Needs Improvement

That section needs to be rewritten. It reads like a page on a health education site, not like an encyclopedia section. The most glaring problem is voice, where part of it is second person, but the structure is problematic. It’s written to an audience who is anxious about receiving the procedure, when it should be more general and describe the technical prodcedure in encyclopedia level detail. Ganondox (talk) 22:00, 3 May 2018 (UTC)

Incorrect

IUDs are contraceptive devices. They are not birth control devices. They control conception. They do not control birth. — Preceding unsigned comment added by 122.151.210.84 (talk) 19:21, 27 June 2022 (UTC)