Do copper containing intrauterine contraceptive devices need to be changed after 2 years?
A review of the prolonged use of copper containing intrauterine contraceptive devices is presented. Because of the disadvantage of changeover, the biochemical evidence, and the findings of long-term studies, a more conservative approach of changeover after every 3 or may be even 4 years is advocated. PIP: Australian manufacturers of IUDs have recommended that copper containing devices should be changed after 2 years of use. This paper reviews the research evidence on the prolonged use of copper IUDs. Biochemical evidence has noted no decrease in copper concentrations in uterine secretions during the 4 years after IUD insertion. In addition, the 3rd and 4th years after IUD insertion appear to be associated with fewer side effects and a lower incidence of accidental pregnancy than the 1st 2 years. On the basis of this evidence, it is suggested that the recommendation to change copper IUDs every 2 years is overly conservative. Rather, it appears that these devices can be left in place for
