Teenage girls who are sexually active should have the option of using a long-acting form of contraception like an intrauterine device or hormonal implant, recommended the American College of Obstetricians and Gynecologists in a new opinion statement issued Thursday evening.
That’s a major shift away from previous advice against the use of IUD’s in teens due to concerns about difficulties inserting the device into the uterus and an increased risk of vaginal infections that could lead to infertility. Contraceptive implants -- which are inserted beneath the skin and prevent pregnancy by releasing the hormone progestin -- can cause irregular bleeding, which is why some doctors shied away from using them in teens.
Both forms of contraception are more than 99 percent effective for preventing pregnancy and work for several years without any effort on a woman’s part. While birth control pills can be just as effective if taken as indicated every day, many girls and women forget to take their pills, which increases the risk of unplanned pregnancies.
In fact, research has shown that shorter acting methods, such as condoms, oral contraceptives, and withdrawal (yes, that’s considered a method), are associated with higher failure rates and more unplanned pregnancies, according to the physician’s group. “Current evidence demonstrates the safety of modern IUDs,” reads the new opinion. “Infertility is not more likely after discontinuation...[and] little evidence suggests that IUD insertion is technically more difficult in adolescents.”
Before inserting an implant or hormone-secreting IUD, doctors should explain to teens that they should expect light bleeding during the first few months after which they may experience a complete cessation of their periods.
Teens who choose to have an IUD inserted should first be screened for sexually transmitted diseases such as gonorrhea and chlamydia since the device shouldn’t be used when these infections are present. They should also use condoms when using an IUD or implant, the opinion document stated, to avoid sexually transmitted infections.