• IUDs are safe, effective for teens, study finds

    By Genevra Pittman, Reuters

    NEW YORK - 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.

    142 comments

    Show more
    Explore related topics: , , , , ,

  • IUD birth control misunderstood by many women

    By Kerry Grens
    Reuters

    In a new survey, most women had inaccurate perceptions about the safety and effectiveness of intrauterine devices (IUDs) in preventing pregnancy, say U.S. researchers, who urge doctors to talk more about the benefits of the devices.
    In particular, many of the study participants didn't know that IUDs are more effective contraceptives than the birth control pill and that the devices don't increase the risk of getting a sexually transmitted disease.
    "It's not clear whether women have an overly optimistic view of the effectiveness of the birth control pill or an overly pessimistic view of the IUD," said Dr. Lisa Callegari, the study's lead author and a clinical assistant professor at the University of Washington.
    Whatever their source, these misperceptions lead to underuse of "one of the most safe and effective methods" of birth control, said Dr. Jeffrey Peipert, an obstetrics and gynecology professor at Washington University, who was not part of the study.
    IUDs, which include the brand name products ParaGard and Mirena, are small plastic or copper-and-plastic objects inserted into the uterus. They can be left implanted for years, and are more than 99 percent effective at preventing pregnancy.
    In contrast, the birth control pill has been found in real-world practice to be about 95 percent effective.
    Callegari said that earlier studies have highlighted some of the mistaken beliefs women have about IUDs, and she and her colleagues wanted to get a better sense of how common they are among average women visiting primary care clinics.
    They surveyed more than 1,600 women between the ages of 18 and 50 who had visited one of four clinics in Pennsylvania.
    Five percent of the women were currently using an IUD, and another 5.8 percent had used one previously.
    Only about one in five of the women correctly stated that IUDs are more effective at preventing pregnancy than the Pill.
    And just 28 percent knew that an IUD is more cost effective than the Pill when it is used for more than three years, the researchers report in the medical journal Contraception.
    According to Planned Parenthood, the upfront costs of an IUD are between $500 and $1,000, whereas birth control pills can cost between $15 and $50 a month - so they become more expensive over time.
    The women in the study were considerably more knowledgeable about the risk of disease related to an IUD, with 57 percent answering correctly that there is no greater risk of contracting a sexually transmitted disease with an IUD compared to the Pill.
    Still, Peipert said he's not surprised that women might view IUDs less favorably.
    "There's been a LOT of bad press about IUDs in the past," Peipert wrote in an email to Reuters Health.
    For instance, thousands of women have sued the makers of the Dalkon Shield, an IUD sold in the 1970s, because of injuries sustained from infections.
    "It's not surprising, because of the history of the IUD in the United States, that people still have inaccurate perceptions of the device," said Dr. Rebecca Allen, an assistant professor of obstetrics and gynecology at Brown University, who was not involved in the study.
    Currently available devices are considered to be much safer, said Allen.
    Indeed, women over age 36 tended to have more misperceptions than younger women who took the survey, the researchers note in their report.
    It's likely, too, that many women are simply not as familiar with the devices as they are with the Pill, said Callegari.
    According to a 2012 study by the Centers for Disease Control and Prevention (CDC), 28 percent of women of reproductive age use oral contraception, making the Pill the most common form of birth control, followed closely by sterilization methods like getting the fallopian tubes "tied," used by 27 percent of women.
    The same CDC study found that IUD use had risen from 0.8 percent of reproductive-age women in 1995 to 5.6 percent in 2010.
    To correct widespread misconceptions about IUDs, Allen said, health care providers should be encouraged to talk to their patients about the devices.
    Among women who have never used an IUD, Callagari's study found that those who had been counseled about the device by a health care provider were more knowledgeable than women who hadn't discussed it.
    "I think it helps to give more evidence that providers should be talking with patients about IUDs," she told Reuters Health. "Women hear it and it affects their perceptions."
    Providers themselves might need to be educated too, however.
    One recent survey of physicians found that 30 percent had outdated ideas about IUDs, including thinking they are unsafe for women who had never had a baby or being unsure about their safety.
    "We need to educate more primary care providers about the facts about IUDs so that they can counsel their patients," said Allen.