Some doctors are still reluctant to prescribe intrauterine devices, but they are perfectly safe for teens, according to one of the largest studies to date that looks at IUD safety among adolescents and older women.
"Today's IUDs are not the same as the ones that existed decades ago and are undeserving of the outdated stigma they carry," lead researcher Dr. Abbey Berenson, director of the Center for Interdisciplinary Research in Women's Health at the University of Texas Medical Branch at Galveston, said in a press release.
In a study published Monday in Obstetrics & Gynecology, Berenson and her colleagues examined health insurance claims from more than 90,000 women, ages 15 to 44, who had an IUD inserted between 2002 and 2009. They looked at complications, failures and rates of discontinuation within the first year, breaking the results down by age and type. The women either had a copper IUD or hormonal IUD, the two types currently available in the U.S.
Serious complications occurred in less than 1 percent of the women in the study, regardless of age or the type of IUD they had been prescribed. Additionally, early discontinuation rates for teenage girls and women 25-44 years old were not significantly different.
"One of the hesitations in providing IUDs as the first-line option to adolescents has been this feeling of, 'They won't like it, they'll take it out,'" Dr. Casey Petra, an associate professor of obstetrics and gynecology at the Mayo Clinic told The Huffington Post. On the contrary, the new study suggests that IUDs are "very well accepted" by teens, and that teenage girls are not more likely to have them taken out than their slightly older counterparts, said Petra, who did not work on the study.
Overall, the researchers concluded that hormonal IUDs were tied to fewer complications and lower rates of discontinuation than copper IUDs among women of all ages.
Teenagers were slightly more likely than 25 to 44-year-olds to experience dysmenorrhea, or pain associated with menstruation, as well as amenorrhea, or the absence of periods. But neither is a significant issue that places the patient at risk of serious harm, the study's authors wrote.
Among teens using contraceptives, the birth control pill is still the most popular option: More than half of the nearly 3 million teenage women who use contraception take the pill, according to the Centers for Disease Control and Prevention. However, in the last decade, the proportion of female contraceptive users opting for long-acting reversible methods has nearly quadrupled, jumping from 2.4 percent in 2002 to 8.5 percent in 2009. And approximately 4.5 percent of teens who use a form of birth control use a long-acting method. (Long-acting reversible methods include both the IUD and the birth control implant, a small rod implanted in a woman's upper arm that provides a continuous dose of hormones.)
In 2012, the American College of Obstetricians and Gynecologists issued a committee opinion saying that adolescents exploring contraceptive options should be encouraged to consider IUDs as well as the implant, which it called "the best reversible methods for preventing unintended pregnancy" in young women.
Despite a growing body of scientific support, concerns about IUD safety persist. Fears date back to the 1970s, when hundreds of thousands of women in the U.S. testified about serious harms caused by the Dalkon Shield -- an IUD that caused infection and even death, but has long since been removed from the market.
"I think that myth is still out there, that IUDs are going to cause infection and future infertility," Casey said, "but the perception is changing."
"This [new study] adds to our evidence that IUDs are safe and effective, as well as acceptable to women of all ages, including adolescents," she said.