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IUDs safe, effective for teenagers: study

By Genevra Pittman

NEW YORK (Reuters Health) - Intrauterine devices are safe for teenagers, according to a new analysis of more than 90,000 women who used the long-term contraceptives.

Researchers found less than 1 percent of all women developed serious complications from the devices, such as pelvic inflammatory disease, regardless of their age.

And teens were only slightly more likely than older women to lose their periods or become pregnant while using an intrauterine device (IUD), according to findings published in Obstetrics & Gynecology.

"It shows exactly what many of us have thought all along, that IUDs are great options for teens," said James Trussell, who studies birth control methods at Princeton University in New Jersey.

IUDs include the hormone-releasing Mirena, which can prevent pregnancy for five years, and a copper version, sold as ParaGard, which is effective for 10 years. The devices cost a few hundred dollars each, not including doctors' charges for inserting them.

Evidence has been mounting that new IUDs are safe and effective in preventing pregnancy. But some doctors have been difficult to convince since an older and badly-designed version of the IUD, the Dalkon Shield, caused serious infections and even deaths in the 1970s.

In guidelines published last year, the American College of Obstetricians and Gynecologists said IUDs and contraceptive implants should now be considered one of the best birth control options for teens because they are reliable and reversible (see Reuters Health story of September 24, 2012 here:).

To get more evidence on how they work, researchers led by Dr. Abbey Berenson from the University of Texas Medical Branch in Galveston used private health insurance claims to study 90,489 women, age 15 to 44, who had an IUD inserted between 2002 and 2009.

Between 2 and 6 percent of women reported pain during menstruation or absence of periods while using an IUD. Both symptoms were 30 to 40 percent more common among teens than older women.

Teenagers were also more likely to become pregnant while using an IUD, but both younger and older women had similar rates of stopping IUD use - between 11 and 13 percent. And serious complications were rare across the board, Berenson and her colleagues found.

"The very serious concerns that physicians had with the older IUDs just really are not appearing to be concerns with the newer IUDs," Berenson told Reuters Health.

The hormone-releasing IUD was tied to fewer complications and discontinuations than the copper version, her team found.

Trussell said the slight increase in side effects among teens wasn't concerning. Some, such as not having periods, might actually be seen as a good thing among young women and save them money on products like tampons, he pointed out.

He said he would recommend an IUD to any sexually-active teenager.

"The point is that it's just so very, very effective," Trussell, who was not involved in the new research, told Reuters Health.

"Either that or the implant would make excellent options for teens who don't want to get pregnant."

Berenson said young women who are interested in IUDs should discuss the possible side effects with their doctors.

She said the best candidates are teens who want a long-acting form of contraception and are not at high risk of sexually transmitted infections.

SOURCE: http://bit.ly/ZAoF1k Obstetrics & Gynecology, online April 5, 2013.

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