IUDs for Teens and Twentysomethings Before Childbearing

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OB/GYN Dr. John Thoppil with River Place OB/GYN explains risks and rewards of long-acting birth control option for younger women

Dr. John Thoppil

Birth control options are vast these days, but the expanding variety of IUDs (intrauterine devices) available help make this long-acting contraceptive one of the safest and most effective choices for women of all ages, including teens or twenty something women before childbearing.

Birth control options are vast these days, but the expanding variety of IUDs (intrauterine devices) available help make this long-acting contraceptive one of the safest and most effective choices for women of all ages, including teens or twenty something women before childbearing, according to John Thoppil, MD, of River Place OB/GYN.

Shaped like a “T,” IUDs are placed in the uterus during a doctor’s visit to prevent pregnancy by stopping sperm from reaching and fertilizing eggs. The birth control method, which is more than 99% effective, received negative publicity in the 1970s when older designs of IUDs were thought to raise the risk of pelvic inflammatory disease, which can lead to infertility. In recent years we have seen an upswing in their popularity. In 2014, the American Academy of Pediatrics also updated its policy statement to encourage teen girls who have sex to use IUDs or hormonal implants, which are also long-acting, as the failure rate in the real world is significantly lower than other methods.

Because IUDs’ pregnancy-preventing effects last several years or more, they’re particularly suitable for young women whose plans to start a family are farther in the future, Dr. Thoppil says.

“IUDs have come a long way since earlier decades, and today’s versions work well and safely,” explains Dr. Thoppil, also an assistant professor at Texas A&M University’s College of Medicine. “For teens and twenty-somethings who aren’t ready to become mothers for a number of years, they should know that using an IUD shouldn’t have any impact on their ability to have a baby later on.

IUD options
Five types of IUDs are currently obtainable in the United States, Dr. Thoppil says. They include:
●    Liletta
●    Kyleena
●    Mirena
●    Skyla
●    ParaGard

All IUD versions except ParaGard work by releasing small amounts of the hormone progestin into the body – the same hormone used in many birth control pills, he explains. The presence of progestin can result in lighter periods, which can be a boon for teens and twenty-somethings who normally experience heavy periods, Dr. Thoppil notes.

ParaGard, which is made of copper and is hormone-free, works by interfering with sperm function to prevent pregnancy. While it can also cause periods to become heavier, this downside is balanced by the fact that ParaGard lasts longer than IUDs incorporating progestin – up to 10 years.

Comparing risks and rewards
Ultimately, for most women, the benefits to the IUD outweigh any risk, Dr. Thoppil says. Among the downsides? IUDs don’t protect against sexually transmitted diseases (STDs) like condoms can. Also, inserting an IUD can produce temporary discomfort, and the chance of it falling out is slightly higher in women who don’t have children and are under 20 years old.

On the other hand, rewards of using an IUD include:
●    Less hassle: Neither the woman nor her partner need to think about it after it’s inserted.
●    Low long-term price tag: While IUDs cost more initially to have inserted, there are no ongoing costs associated with it over several years. Under the ACA IUDs are usually completely free for insured women.

“Perhaps the biggest benefit is the ‘leave-it-in-and-forget-it’ nature of IUDs, which is particularly useful to younger women before childbearing who want to not constantly worry of forgetting to use a contraceptive,” Dr. Thoppil says.

John Thoppil, MD, leads River Place Obstetrics and Gynecology, based in Austin, Texas. A board-certified obstetrician-gynecologist and a Fellow of the American College of Obstetricians and Gynecologists, Dr. Thoppil also is an assistant professor at Texas A&M University College of Medicine. He earned his MD at Baylor College of Medicine and completed residency training at Wilford Hall Medical Center, Lackland Air Force Base. http://www.riverplaceobg.com

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