Study: IUDs Offer Safe Contraception Option for Teens But Rarely Prescribed

By Rachel Walden — April 23, 2013

Intrauterine devices (IUDs) are a fairly safe, long-acting form of contraception, but many myths about the devices persist. For example, it’s somewhat common to hear that women who haven’t already had a baby, and especially teenagers, are not good candidates for IUDs; neither of these is true.

For a new study published in the journal Obstetrics & Gynecology, researchers reviewed data from health insurance records of more than 90,000 women who had IUDs inserted (including both hormonal and copper IUDs). They looked specifically at how many records indicated a IUD-related complication, discontinuation, or pregnancy.

When the researchers looked at the data by age group, they found that women ages 15-19 did not discontinue using IUDs any more frequently than older women. Teens were slightly more likely than older women to experience dysmenorrhea (menstrual cramps) or absence of menstruation within one year of insertion, or failure of the IUD to prevent a normal pregnancy, but rates for both of these were very low. Only 1.8 percent of teens using a levonestrogel-releasing IUD experienced a pregnancy (3.6 percent for copper), and 2.4 percent experienced cramping (6.2 percent for copper).

Pelvic inflammatory disease occurred in less than half a percent of teens. Women of all ages using a copper IUD were much more likely to stop using it than women using the hormone-releasing IUD, and this was most true for teens, although it’s not completely clear why. Rates of removal within 30 days for any complication were estimated to be very low for teens (2.9 percent for hormone IUD, 5.2 percent for copper) as well as older women.

The researchers conclude:

Overall, these data indicate that the IUD is an appropriate contraceptive for younger women and is not likely to cause serious side effects among teenagers. Physician recommendations play an important role in their patients’ decision-making, and their recommendation of the IUD could increase the use of this cost-effective and safe method of birth control among teenagers. Thus, physicians should include information about this highly effective method when they counsel young patients on their contraceptive options to help reduce the unintended pregnancy rate among teenagers in the United States.

The authors cite evidence that teens may indeed face clinician education barriers when seeking an IUD. One survey found that “only 19% of obstetrician–gynecologists surveyed in a 2010 study stated that they would offer an IUD to an unmarried 17 year old who had never been pregnant.”

With more evidence like the current study on hand, we hope it will become easier for teens to access this long-acting, effective form of contraception.

Related: Revisiting the IUD for Contraception – Pros and Cons for Women looks at the rise in IUD use and the safety record.

8 responses to “Study: IUDs Offer Safe Contraception Option for Teens But Rarely Prescribed”

  1. This study is incredibly important.

    Young women will have better control over the timing of pregnancy, postponing it until their educations are complete.

    There is also a wonderful opportunity for young women to OWN their bodies: checking the IUD string every month is very pro-body-ownership.

    Also, the hormone emitting IUDs often result in very light menstrual periods. None of us NEED heavy periods, and heavy bleeding can lead to anemia.

    This study shows that IUDs in young women is a WIN, WIN, WIN proposition.

  2. I agree with everything the previous poster (LadyFlowersbySusan) said.

    As a medical professional, I am very excited about the increased use of IUDs, especially Mirena and Skyla, that I anticipate we’ll be seeing in the next few years.

    I think that it’s brilliant that Bayer has released Skyla, as it is smaller and has a lower dose of levonorgestrel, marked for use in nulliparous women (women who’ve never had a child). Theoretically, the expulsion rate is lower with Skyla. In the hands of a trained provider, that’s really the most common concern with an IUD, expulsion.

    I think that with proper marketing and word-of-mouth testimony, some providers may come to realize that IUDs really ARE a good option for teens and young women, despite the bad rep that IUDs have gotten from the Dalcon Shield and rare but serious complications of IUDs (perforation and PID among them). But let’s remember this: pregnancy has rare but serious complications, too!

    In my experience, the birth control methods most commonly used for teens are DepoProvera (the shot) and the Pill. The shot can, and in my experience usually does, have yucky side effects, including heavy bleeding. As the previous poster said, none of us need that. And not every teenager is yet mature enough to remember to take the Pill as directed or understand the importance of doing so. So an IUD is a really, really good option for teens and young women, in my opinion.

    Hopefully IUDs will become more commonplace with teens. Fingers crossed, for the health and well-being of those teens and the young women they will become.

  3. I have encourage my daughter to have an IUD inserted. I hate to say it but I don’t trust her to regularly take the pill and I think this is as foolproof as you are going to get. She doesn’t have to worry about unwanted pregnancy and I can relax a little. She understands the importance of safe sex but she is in a long term relationship so I don’t expect her to be using condoms.

  4. It says that 1.8 percent of teens became pregnant. Do they mean 1.8 percent during the first year of use or 1.8 percent over the course of 8 years

  5. I’m 17 and will be getting an IUD in 3 days. However, when I talked to my doctor, she almost forgot to even mention it to me! It wasn’t until she brought out a list of the different types that she did. She recommended an implant but Ive read more about IUDs and ironically feel more comfortable with them than implants or Nuva Ring.

  6. This study is unconvincing. Going if insurance records for not include a large portion of girls who use other methods like planned parenthood or Luther nonprofits that provide contraceptives. Girls use these often when they don’t want their parents to know they are sexually active, or if their parents don’t have insurance for them. This is a huge chunk of people that may skew to more girls with multiple partners. The company that makes Morena, for example, specifically recommends it for monogamous women who have had a child already.

  7. Honestly, I know this makes no sense, but what I gather from teen girls is that the idea of having a doctor hanging out in her nether regions for any amount of time tends to discourage IUD insertion. I know this is silly, considering they are or will be having sex, but hey–that’s their boyfriends (etc?), non-clinical, whatever. Of course, as a parent I SHOULD push the idea of regular health exams, BUT…right now I’m concerned with BC. I began researching implant info for my daughter today. One small rod smaller than a penny in the upper arm for 3 years? Sounds too good to be true.

    • I had the implant for 6 months and my period never stopped and I switched to the IUD. Just something to know.

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