In 2020, about 158,000 babies were born in the U.S. to people between the ages of 15 and 19, the majority of which were unintended pregnancies. While teen birth rates have decreased by 75% between 2020 and their peak of 1991, the U.S. continues to have the highest rates of adolescent pregnancies and births among developed countries. Access to contraception and accurate information about pregnancy prevention contribute to these high numbers.

When considering contraceptive options for teens, gynecologists now strongly recommend IUDs as a birth control option for teens. Let’s break down some of the common questions we hear about IUDs for teens.

Are IUDs safe for teenagers?

Yes! Intrauterine devices (IUDs) are safe and effective for teenagers.

IUDs were originally considered a form of birth control only for those who already had children. Now, IUDs—also known as long-acting reversible contraception—are not only considered a good option for those who haven’t yet had children, but also specifically for adolescents.

How effective are IUDs at preventing pregnancy in teenagers?

Anyone who is sexually active and needs reliable contraception is a good candidate for an IUD. For teens especially, IUDs take away user error; unlike the pill, effectiveness does not rely on memory or sticking to a strict daily schedule.

Long-acting reversible contraceptives like IUDs are considered the most effective reversible method of birth control. Basically, once you have it inserted, it does the work for you. IUDs last for five to 10 years, depending on the type—and rarely cause the degree of hormonal side effects seen with other forms of hormonal contraception—a welcome relief from all of the other emotions teens go through!

What are the different types of IUDs, and how do they work?

Currently, there are four hormone-releasing IUDs and one non-hormonal IUD (copper):

  1. Hormonal IUDs: A hormonal IUD releases a hormone called levonorgestrel, which thickens cervical mucus, inhibits sperm movement, and can sometimes prevent ovulation. FDA-approved IUDs include Mirena, Kyleena, Liletta and Skyla. (Mirena and Kyleena are available at WHA.)
  2. Non-hormonal IUD: A non-hormonal IUD, sometimes called the copper IUD, doesn’t release hormones. It works by creating an environment that’s toxic to sperm, preventing fertilization. Paragard is the only FDA approved non-hormonal IUD.

What’s the process of getting an IUD for my teen?

A provider will go over the three options offered at WHA (Mirena, Kyleena and Paragard) during an IUD consultation appointment with you and your teen to help select the best one for them. Also at that visit, we’ll test for STIs to ensure there are no underlying infections before placement. Insertion is then done at a second visit.

It’s important for your teen to understand that condoms are still recommended with an IUD to protect against sexually transmitted infections. Although the risk of general infection with IUDs is very low, treating an STI with one in can prove difficult; antibiotics to treat the infection have a tougher time getting to what matters with a foreign body (the IUD) distracting them. So we recommend all patients continue to use condoms even when they have an IUD to protect against both pregnancy and STIs.

Is it painful to have an IUD inserted?

Parents, we know you have memories of the old IUDs you’d rather forget. Us, too. But the devices and insertion process have both come a long way.

Studies have shown no difference in placement difficulty between adolescents and adults. Is it likely to be uncomfortable and a little crampy? Unfortunately, yes. But it’s fairly short-lived (three to five minutes), and we can offer pre-medication to help with the discomfort. The consultation appointment covers the insertion process, as well, and we’ll talk your teen through any fears or misconceptions they may have.

Do IUDs have any health benefits beyond contraception for teenagers?

Teens are often more concerned with what happens next, as most want shorter, lighter periods—or no periods at all. During the first couple of months after insertion, bleeding may be irregular (much to their disappointment). But that becomes more predictable around month 3 or 4.

While we can’t say periods will always be lighter or will always disappear altogether, each IUD has different features and benefits and we’ll walk your teen through each one.

Given the increasing desire and need for reliable contraception and period management, especially among teens, IUDs are recommended as a primary method of contraception. I am always happy to see teens or discuss options with their primary providers.

A note just for teens: In the state of Oregon, you don’t need permission from a guardian to get birth control, like IUDs. That choice is yours.