State-of-the-art of intrauterine contraception

Despite its nearly 100-year history, intrauterine contraception is a modern method even in the 21st century and its development is still going on. The aim of innovations is to optimize the contraceptive efficacy and to suppress as much as possible side effects and unwanted events (e.g. menstrual irregularities, expulsion). It is important that this method be made available to all those who could not resort to it earlier (young women, milligravidae, nulliparae). Currently three areas are more particularly being investigated: (1) flexible, frameless intrauterine implants, (2) levonorgestrel-releasing intrauterine systems, and (3) metal alloy intrauterine devices. Partly relying on the author's own clinical experience and based on the literature of recent years, this article reviews the present state and possibilities with regard to further development of intrauterine contraceptive devices.