CullmanTimes.com - Cullman, Alabama

Health

September 22, 2012

IUDs, implants urged for teen girls’ birth control

CHICAGO — Teenage girls may prefer the pill, the patch or even wishful thinking, but their doctors should be recommending IUDs or hormonal implants  — long-lasting and more effective birth control that you don’t have to remember to use every time, the nation’s leading gynecologists group said Thursday.

The IUD and implants are safe and nearly 100 percent effective at preventing pregnancy, and should be “first-line recommendations,” the American College of Obstetricians and Gynecologists said in updating its guidance for teens.

Both types of contraception are more invasive than the pill, requiring a doctor to put them in place. That, and cost, are probably why the pill is still the most popular form of contraception in the U.S.

But birth control pills often must be taken at the very same time every day to be most potent. And forgetting to take even one can lead to pregnancy, which is why the pill is sometimes only 91 percent effective.

An IUD, or intrauterine device, is a small, T-shaped piece of plastic inserted in the uterus that can prevent pregnancy for up to 10 years. An implant is a matchstick-size plastic rod that releases hormones. It is placed under the skin of the upper arm and usually lasts three years.

The new guidelines don’t tell teens not to use other methods, but “if your goal is to prevent a pregnancy, then using an implant or an IUD would be the best way to do this,” said Dr. Tina Raine-Bennett, head of the committee that wrote the recommendations.

The organization’s previous guidelines, issued in 2007, also encouraged the use of IUDs and implants among teenagers. The new guidelines go further in saying physicians should discuss the two types of birth control with sexually active teens at every doctor visit.

The gynecologists group said condoms should still be used at all times because no other birth control method protects against AIDS and other sexually transmitted diseases.

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.

In 21 states, all teenagers can get contraceptives without parental permission, according to the Guttmacher Institute, which tracks laws affecting women’s health. A few other states allow it under certain circumstances.

The IUD and implant cost hundreds of dollars. The new health reform law requires health insurance plans to cover birth control without co-payments. Also, some publicly funded health clinics offer birth control free or at a reduced cost.

The American Academy of Pediatrics has been more cautious and has not endorsed specific methods of birth control, but is updating its guidance. Some pediatricians have been reluctant to recommend IUDs for teens, partly because of concerns over infection risks; an older model was blamed for infertility.

Dr. Paula Braverman, a University of Cincinnati physician involved in updating the academy’s position, said the gynecologists’ advice does a good job of clarifying misconceptions about IUDs and implants.

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.

“The ones on the market today are extremely safe,” said Dr. Mary Fournier, an adolescent-medicine specialist at Chicago’s Ann & Robert H. Lurie Children’s Hospital, who praised the new recommendations. “That is what everybody should be telling their patients.”

She said she already recommends IUDs for her patients and is being trained in how to insert birth control implants.

Raine-Bennett, research director for women’s health at Kaiser Permanente in Oakland, Calif., said she gets mixed reactions from her patients about both methods.

“Some of them say, ‘Great! Something that I don’t have to think about.’ Others are, like, ‘Hmmm, something in my body?’ It really varies,” she said.

Doctors need to be sensitive to that and provide detailed information to dispel any myths and allow teens to make informed decisions, Raine-Bennett said.

1
Text Only
Health
  • COMMENTARY: An alternative diagnosis to ADHD: Schoolchildren need more time to move

    The Centers for Disease Control and Prevention tells us that in recent years, there has been a jump in the percentage of young people diagnosed with attention deficit and hyperactivity disorder, commonly known as ADHD: 7.8 percent in 2003 to 9.5 percent in 2007 to 11 percent in 2011.

    July 18, 2014

  • Guideline: Most healthy women can skip pelvic exam

    No more dreaded pelvic exam? New guidelines say most healthy women can skip the yearly ritual.

    July 1, 2014

  • Sanofi targets fake Viagra market with non-prescription Cialis

    Sanofi sees an attractive opportunity in the rampant market for counterfeit Viagra: luring men away from dodgy online pharmacies with an over-the-counter version of a competing erection drug.

    June 5, 2014

  • Hospital charges to treat chest pain jump 10 percent in a year

    The charge to treat Medicare patients with chest pain at U.S. hospitals rose 10 percent to $18,568 in just a year, the biggest rise seen among the most common inpatient procedures, according to federal data.

    June 2, 2014

  • Study: Both men and women feel less stress at work than at home

    In a newly released study in the Journal of Science and Medicine, researchers carefully examined the levels of the stress hormone, cortisol, of a variety of workers throughout the day. The data clearly showed that both men and women are significantly less stressed out at work than they are at home.
     And the women they studied said they were happier at work. While the men said they felt happier at home.

    May 26, 2014

  • Jobless contend with weight gain as they search for work

    A subject long ignored by policymakers, and one that unemployment counselors are too sheepish to raise with job seekers, the link between bulging waistlines and joblessness is now of intense interest to researchers studying the long-term effects of the country's economic malaise.

    May 12, 2014

  • COMMENTARY: Helmets won't protect your kids from concussions

    When I was a kid, helmets were for motorcyclists. Now I see children wearing helmets when they're scooting down sidewalks, skating, skiing, sledding and playing soccer. Last week one of my friends saw a helmeted kid power-walking in Prospect Park. You can even buy $40 baby helmets on Amazon, because, according to the product description, "babies will always fall taking their first steps."

    May 2, 2014

  • 400px-Cannabis_Plant.jpg How bad is marijuana for your health?

    The Journal of Neuroscience recently published a study linking recreational marijuana use to subtle changes in brain structure. The researchers, led by Jodi Gilman of Massachusetts General Hospital, identified increased gray matter density in the left nucleus accumbens and some bordering areas.

    May 1, 2014 1 Photo

  • American sunscreens need an upgrade

    The last time a new sunscreen ingredient came on the U.S. market, the Y2K bug was threatening to destroy our way of life. Intel had just introduced the Pentium III processor, featuring an amazing 500 MHz of computing power.

    April 24, 2014

  • Cuba is running out of condoms

    The newest item on Cuba's list of dwindling commodities is condoms, which are now reportedly in short supply. In response, the Cuban government has approved the sale of expired condoms.

    April 23, 2014