What if women could use a birth control device that would also protect them from cancer? That would be “hugely impactful” says obstetrician gynecologist Dr. Patrick Chan 陳世樂醫生. According to a recent study published in the American journal Obstetrics and Gynecology, IUDs may protect against cervical cancer.
As explained by Dr. Chan, today there are two types of intrauterine devices (IUDs): hormonal and non-hormonal copper IUDs. While the traditional copper IUD has been used for over a century to prevent conception, in recent years the introduction of the hormone releasing IUDs has also provided an alternative to surgery for women with severe intractable menorrhagia (abnormally heavy menstrual bleeding). Now there could be even more advantages to IUDs: protection against cervical cancer, the 8th leading cause of death amongst female cancers in Hong Kong!
Cervical cancer is generally caused by the human papilloma virus (HPV)
The HPV virus is a commonly sexually transmitted infection (STI) that can cause genital warts. It is estimated that up to 75% of sexually active people have been infected with HPV at least once in their lives. While most infections are asymptomatic and remain latent or are cleared by the immune system, HPV in women can cause cervical cancer. In fact, cervical cancer is almost always caused by HPV.
Preventative HPV vaccines have been on the market since 2006 and in some countries (but not in Hong Kong) the HPV vaccine has been included in government childhood immunization programs. However, the HPV vaccine is only effective in girls and women who have never been exposed to HPV previously and therefore is aimed to be given to girls who are not sexually active yet. This fact leaves a generations of women unprotected against HPV and the possibility of cervical cancer.
The big news: how IUDs may protect against cervical cancer
New research by the Keck School of Medicine of USC published on November 7, 2017 in Obstetrics and Gynecology showed that the incidence of cervical cancer was a third lower in women using an intrauterine device (IUD). The data included 16 studies involving more than 12,000 women worldwide.
Two mechanisms are put forward to explain the protective effect of IUDs. It could be that the immune reaction that is caused by the IUD may simultaneously stimulate the immune system to eliminate an HPV infection. It could also be that the removal of an IUD scrapes off precancerous or HPV-infected cells. If further research can support this, IUDs could have a huge public health impact on a large portion of the female population that cannot be protected by the HPV vaccines.
What IUDs are known for: birth control
IUDs were developed to be effective and easy-to-use contraceptive methods, with a failure rate < 1%. Once inserted, which is often accompanied with discomfort and pain, an IUD can easily last 3-5 years with barely any maintenance (depending on the brand you opt for). An IUD is a T-shaped device (around 3-4 cm in size) which is placed inside the uterus. The two most common IUDs are: hormonal and non-hormonal copper IUDs. Both IUDs make the uterus a hostile environment by triggering an immune reaction that makes the uterus sperm-unfriendly. In other words, IUDs make the uterus a place where sperm cannot survive. In the non-hormonal IUD, copper is the substance responsible for this reaction, whereas in the hormonal IUD, synthetic progestin (also known as levonorgestrol) causes a hostile reaction to sperm.
Hong Kong providers and costs of IUDs
Public healthcare sector in Hong Kong does not provide subsidized IUD insertion. In the private sector, you can see your general practitioner or gynecologist to get an IUD inserted or attend one the clinics of the Family Planning Association Hong Kong (FPAHK), a non-profit and non-government organization dedicated to promoting family planning and sexual and reproductive health and rights in Hong Kong.
Private medical providers and costs of IUDs in Hong Kong
Prices vary a lot depending on the location and doctor. The price for the whole procedure generally consists of a consultation fee, the IUD itself, and an insertion fee. The consultation fee generally ranges from HK$800 to HK$1,500 and the insertion fee is approximately HK$1,800 to HK$3,200. The price of an IUD itself can range from HK$300 to HK$3,750 depending on whether you choose the copper (more affordable) or the hormonal device.
IUD costs provided by the Family Planning Association Hong Kong
Non-married women must be over 26 years old and married women are not subject to any age restriction.
For permanent residents: HK$30 initial consultation + HK$ 600-700 insertion fee + HK$30 follow-up consultation
For non-permanent residents: HK$60 initial consultation + HK$ 800-900 insertion fee + HK$60 follow-up consultation
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