Yes, a woman who has never had children can endure an IUD

"I asked my gynecologist if I could have an IUD inserted, she told me that it was not possible if I had no children", says Emma, ​​25. A testimony still very common in France, where the myth that we can not put intra-uterine device (IUD) to nulliparous women continues.We had experienced in 2015: 15 gynecologists contacted, only a third agreed to put an IUD to a woman who had never had children.However, at the time, the French health authorities had already authorized the placing on the market of IUDs for nulliparas for more Similarly, since 2005, the World Health Organization (WHO) has indicated that there are no contraindications to IUDs for these women.

Butdespite a convergence of international recommendations for the promotion of this contraception among young women, health professionals remain convinced of a higher rate of complications in this population and are not in favor of it for most of them. them", noted the French National College of Gynecologists and Obstetricians (CNGOF) on the occasion of its 38^e national days in 2014.

A small point on the misconceptions about the placement of IUDs that are still circulating:

• With an IUD, there are more high bad infections in nulliparas.

It's wrong. No studies have demonstrated an badociation between IUD use and high bad infections – ie, endometritis, salpingitis, tubo-vascular abscess and bad pelviperitonitis – except during the first 20 years. days after the pose. If there is infection, it is caused by an unprotected intercourse, and the IUD has no role in this infection.

• IUD insertion increases the risk of infertility in nulliparas.

It's wrong. According to the Haute Autorité de Santé (HAS), among others, there is no risk of tubal infertility (that is to say tubal obstruction). Again, complications can occur if the woman does not protect herself from STIs, but this has nothing to do with the IUD. Women do not have particular difficulties in getting pregnant after the removal of their IUD.

• IUD insertion increases the risk of ectopic pregnancy (UGI) in nulliparas.

It's wrong. IUD nulliparas are no more likely to develop a UGI than multiparous IUDs. Moreover, as Dr. Martin Winckler, an expert on the subject, explains, the very few times a woman with an IUD becomes pregnant, "UGs are related to the state of the trunk (therefore, to the user), and not to the contraceptive method used. In other words, a woman who is likely to suffer from a GEU (and who does not know her) is eight times less likely to have an IUD inserted than to have no contraception at all! (And also less risk of GEU than taking the pill, since the probability of being pregnant with an IUD is lower than that of being on the pill!)".

• A nulliparous woman is more likely to expel her IUD.

There does not seem to be any scientific consensus on the subject. A 2015 study of 5,403 women found a lower average rate of expulsion in nulliparous women (8.4%) than in multiparous women (11.4%). However, this only applies to levonorgestrel IUDs. By the way, in a 2010 study "which included the largest number of nulliparas, the risk of expulsion does not appear increased"Others report an increased risk of teenage expulsion (5-22%) compared to women (3-5%), but they are based on experimental devices (they have been published in the 70s and 80s).

• There is more risk of perforation in nulliparas.

"Since the uterine cavity is smaller in nulliparous people, it is legitimate to ask the question", concedes the CNGOF.But a study conducted between 2006 and 2013 on 61,380 women confirmed the low incidence of this accident, with no real difference according to the age or number of children of patients.

• The nulliparas have more pain during the pose.

It is true. Logically, a woman who has not had a child will feel the pose more. Nevertheless, there are now IUD sizes specially adapted to nulliparas. According to the HAS moreover, badgesics can be prescribed in prevention. Finally, the state of anxiety or the relationship with the practitioner greatly influence the level of pain felt.

French women of childbearing age are not more than 37% to use the pill, while they were nearly 45% in 2010, according to an Ifop survey published in late September. In particular, a distrust of oral contraception after the questioning of pills of 3^e and 4^e generation. At the same time, Ifop revealed that the number of users of the IUD increased significantly between 2010 and 2018, having increased from 18.7% of French women to 25%. They are 21% to think that the IUD is the best alternative to the pill, all categories combined.