IUDs and Contraceptive Implants Safe for Teens
September 20, 2012
Washington, DC -- Implants and intrauterine devices (IUDs) should be offered as first-line contraceptive options for sexually active adolescents, according to new guidelines issued today by The American College of Obstetricians and Gynecologists (The College). Both the implant and the IUD are the most effective reversible contraceptives for preventing unintended pregnancy and abortion in teens and adult women.
About 42% of adolescent females ages 15–19 in the US have had sexual intercourse. Although almost all sexually active adolescents have used contraception at some point, they frequently use methods with relatively high failure rates such as condoms and withdrawal, or they incorrectly use more reliable methods such as the birth control pill. The fact that 8 out of every 10 adolescent pregnancies are unintended underscores the need for dependable and effective contraceptive methods for teens.
The contraceptive implant and IUD are not only top-tier contraceptives based on their effectiveness (with pregnancy rates of less than 1% per year), but they also have the highest rates of patient satisfaction and continuation of all available reversible contraceptives. These long-acting methods eliminate the problem of inconsistent use common with other contraceptives that can lead to unintended pregnancy. Complications from IUDs and implants are rare, and both can be safely used by adolescents, including immediately after giving birth or after an abortion, according to The College.
All patients using the IUD or an implant as contraception should also use condoms to decrease the risk of acquiring sexually transmitted infections.
Committee Opinion #539 “Adolescents and Long-Acting Reversible Contraception: Implants and Intrauterine Devices” is published in the October issue of Obstetrics & Gynecology.
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Other recommendations issued in this month’s Obstetrics & Gynecology:
Practice Bulletin #130 “Prediction and Prevention of Preterm Birth” (Revised)
ABSTRACT: Preterm birth is the leading cause of neonatal mortality in the United States, and preterm labor precedes approximately 50% of preterm births (1, 2). Neonatal intensive care has improved the survival rate for neonates at the cusp of viability, but it also has increased the proportion of survivors with disabilities (3). The incidence of multiple births also has increased along with the associated risk of preterm delivery (4). The purpose of this document is to describe the various methods proposed for identifying and treating asymptomatic women at increased risk of preterm birth and the evidence for their roles in clinical practice.
Committee Opinion #537 “Reprocessed Single-Use Devices” (NEW!)
ABSTRACT: The reprocessing and reuse of single-use instruments has become increasingly common. Although there are limited data on reprocessed single-use devices, existing studies have found a significant rate of physical defects, performance issues, or improper decontamination. There are currently no data in the medical literature evaluating the cost-effectiveness of reprocessed single-use devices in gynecologic surgery. The use of a reprocessed single-use device provides no direct benefit to an individual patient or her physician. It is the operating surgeon’s ethical responsibility to make a good faith effort to know whether reprocessed single use devices are to be used, and to not use instruments if she has concerns about the quality or safety of the instrument(s). Studies on the safety, quality, and cost-effectiveness of reprocessed single-use devices in gynecologic surgery are needed. Physicians should be informed whether the instruments used in surgery are original or reprocessed, and adverse events should be reported to improve the safety information about reprocessed single-use devices.
Committee Opinion #538 “Nonmedical Use of Prescription Drugs” (NEW!)
ABSTRACT: The nonmedical use of prescription drugs, particularly opioids, sedatives, and stimulants, has been cited as epidemic in the United States, accounting for increasing numbers of emergency department visits and deaths from reactions and overdoses. The prevalence of prescription drug abuse is similar among men and women. Those who abuse prescription drugs most often obtain them from friends and family either through sharing or theft. Physicians should screen all patients annually and early in prenatal care with a validated questionnaire for the nonmedical use of prescription drugs. They should provide preventive education for all patients and referral for treatment, when psychologic or physical drug dependence is identified. Physicians should also educate patients in the proper use, storage, and disposal of prescription drugs.
The American College of Obstetricians and Gynecologists (The College), a 501(c)(3) organization, is the nation’s leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of approximately 56,000 members, The College strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women’s health care. The American Congress of Obstetricians and Gynecologists (ACOG), a 501(c)(6) organization, is its companion organization. www.acog.org