Rethinking Healthcare

Teen girls need IUDs, says leading U.S. gynecology group

Teen girls need IUDs, says leading U.S. gynecology group

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These physicians say IUDs are the surest way to prevent pregnancy, but IUD cost remains high compared to birth control pills.

The New York City borough of the Bronx presents are conundrum. Teens there are more likely than average U.S. teens to use condoms when having sex. But, Bronx teens are still nearly forty percent more likely to get pregnant than teens in the rest of the nation. I reported these stats last month in a story for NPR's Latino USA, and tried to unpack their implications.

Vincent Guilamo-Ramos, co-director of the Center of Latino Adolescent and Family Health at New York University, explained it to me this way: even though a number of Bronx teens are using condoms, a lot of teens use condoms incorrectly, and, condoms are no match in efficiency to more long-term birth control methods, which Bronx teens use at lower rates than the rest of the nation.

An increasing number of doctors are saying that condoms, or even birth control pills, aren't enough to prevent distracted teenagers from getting pregnant. The American College of Obstetricians and Gynecologists announced yesterday that it's updating its guidance for teens, to put IUDs and hormonal implants at the top of its list for recommended birth control methods.The Associated Press on TIME.com reports:

While it may sound surprising that such invasive contraceptives are being endorsed for teenagers, 43 percent of girls ages 15 to 19 have had sex, a government survey found. Most are using some kind of effective birth control, but only about 5 percent use the long-lasting devices, the gynecologists group said.

While many of us adults would prefer that teens choose abstinence as their form of birth control, the truth is that a significant number of teens are having sex, and given the distracted nature of the teen brain condoms and daily pills just don't always work out.

However, the financial argument against IUDs remains strong, at least in the short term. The devices cost hundreds of dollars, compared to birth control pills which insurance companies now must cover without co-pays, or which can be found for free or low-cost through public health clinics.

Besides cost, IUD's and hormonal implants also have a poor reputation to contend with. Again, TIME.com:

An IUD called the Dalkon Shield that was sold in the 1970s was linked to dangerous and sometimes deadly infections. Newer IUDs have been found to be safe, and the gynecologists group said the risk of pelvic infections increases only slightly during the first three weeks after insertion.

The hormonal implant has been updated, too. The newest kind uses just one thin rod; an older type no longer sold in the U.S. used six rods that sometimes didn’t stay in place. IUDs and implants can be removed at any time with no lasting effect on fertility, the gynecologists group said.

It will be interesting to see if IUD and hormonal implant producers in the pharmaceutical industry follow up the gynecology group's statement with increased advertising campaigns, which have been noticeably absent compared to promotions for birth control pills.

[via TIME.com]

Photo: D Sharon Pruitt/Flickr

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Audrey Quinn

Contributing Writer

Audrey Quinn is a Brooklyn-based multimedia journalist focused on health, tech and the economy. Her radio stories can be heard on Marketplace, Studio 360, PRI's The World, NPR's Latino USA, Deutsche Welle Radio and The Believer Magazine podcast. In addition to her work with CBS Interactive she produces multimedia science stories for online publications and is a teaching assistant at the Transom Story Workshop. Her investigative work has been awarded by the Fund for Investigative Journalism and The Nation Institute’s Investigative Fund. Follow her on Twitter. Disclosure