Approximately 80% of pregnancies in women aged 15-19 are unintended and the U.S. continues to have the highest rates of adolescent pregnancies and births among developed countries. Until recently, intra-uterine devices (IUDs) were considered a form of birth control only for women who already had children. Now, IUDs—also known as a long-acting reversible contraception—are not only considered a good option for adolescents, but a recommended one.
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, such as IUDs, are considered the most effective reversible methods of birth control. Basically, have one put in and it does the work for you. Also, IUDs 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!
Currently, there are four hormone-releasing IUDs available in the U.S.: Mirena, Skyla, Liletta and Kyleena—and one copper-releasing IUD: Paragard. A provider will go over these options at an IUD consultation appointment with you and your teen to help select the best one for them. During that appointment, we’ll also 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 required with an IUD to protect against sexually transmitted infection. Although the risk of general infection with IUDs is very low, contracting an STI with one 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.
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 older women. 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.
Teens are often more concerned with what happens next with most wanting shorter, lighter periods—or no periods at all. During the first couple months after insertion, bleeding may be irregular (much to their chagrin). But that becomes more predictable around month three or four. 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. Currently, all of the IUDs mentioned here except Skyla and Liletta are available at WHA.