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Fertility, Pediatrics, Pregnancy, Sexual Health, Women's Health

Research supports IUD use for teens

Research supports IUD use for teens

A large body of scientific research supports the safety and effectiveness of intrauterine devices and other forms of long-acting, reversible contraception (LARC) for adolescents, and physicians should offer these birth control methods to young women in their care. That’s the message behind a series of review articles published this week in a special supplemental issue of the Journal of Adolescent Health.

Stanford ob/gyn expert Paula Hillard, MD, who edited the supplement, explained to me that doctors are missing a great opportunity to prevent unwanted pregnancies by not offering young women the LARC birth control methods, which include IUDs and hormonal implants. Not only are the LARC methods very safe, the rate of unintended pregnancy with typical use of these techniques is 20 times lower than for alternate methods such as the Pill or a hormone patch.

But a design flaw in one specific IUD used in the 1970s – the Dalkon Shield – increased women’s risk for pelvic infections and gave all IUDs a bad rap. Use of IUDs among adult American women has been low ever since; it’s even lower in teens.

“Long after it was proven that the Dalkon Shield was particularly bad and newer IUDs were much safer, women were just scared,” Hillard said. “Not only did women stop asking for for them, many doctors also stopped using IUDs.”

The new review articles that Hillard edited are targeted at physicians but contain some interesting tidbits for general readers as well. The article titled “Myths and Misperceptions about Long Acting Reversible Contraception (LARC)” provides scientific evidence to refute several common myths, concluding, for instance, that IUDs don’t cause abortions or infertility, don’t increase women’s rates of ectopic pregnancy above the rates seen in the general population, and can be used by women and teens who have never had children.

And, as Hillard put it for me during our conversation, “These birth control methods are very safe and as effective as sterilization but completely reversible. They work better than anything else, and they’re so easy to use.”

Previously: Will more women begin opting for an IUD?, Promoting the use of IUDs in the developing world, and Study shows women may overestimate the effectiveness of common contraceptives
Photo, by ATIS547, shows a public sculpture on the campus of the University of California, Santa Cruz that is affectionately known as the “Flying IUD”

2 Responses to “ Research supports IUD use for teens ”

  1. carol Says:

    You’re right that IUDs originally had a bad reputation because Dalkon Shield was giving women pelvic infections, but that’s not the only safety issue these devices are related to. Aside from the fact that an IUD won’t protect against STDs, an increasing number of women say that their Mirena IUDs migrates from its original location and perforated the uterus. If this happens, the woman will usually need to under laparoscopic surgery to remove the IUD. I am not trying to ignore the research presented here, I just think you should at least discuss the relevant risks.

  2. Paula Hillard, MD Says:

    The risks of uterine perforation with an IUD is in the range of 0.4-0.8 per 1000 women or less than .08%, which is quite uncommon.
    Physicians do discuss the risks, benefits, side effects, and alternatives to all methods of contraception, and encourage women to ask questions and get accurate information about all methods. The risks of any method of contraception can also be compared to the medical risks of pregnancy. The design and configuration of the Dalkon shield was very different from today’s IUDs, and thus the risks differ as well.


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