The American Academy of Pediatrics published an article Monday endorsing the use of Intrauterine Devices as their preferred method of birth control among teens, moving it ahead of the birth control pill.
IUDs are small, T-shaped devices made of copper, a spermicidal material, or plastic. The plastic version contains hormones. They are considered one of the most effective methods of birth control, with a typical annual failure rate of 0.8 percent for copper and 0.2 for hormonal.
Pediatricians and gynecologists advocate the use of IUDs for teenagers because they leave no room for user error and have a significantly lower failure rate than oral contraceptive pills, given they are much easier for users to forget or take irregularly.
Dr. Christine Peterson, director of the Gynecology Clinic at Student Health, also recommends IUDs.
“For most young women, they are an excellent choice,” Peterson said. “They are not for everyone, but they are highly effective and in general really well tolerated.”
IUDs have also been endorsed by the American College of Gynecologists and Obstetricians for the past few years. According to their Committee Opinion on Adolescents and Long-Acting Reversible Contraception, published in 2012 and reaffirmed this year, IUDs are safe and do not increase the risk of infertility in adolescents.
Dr. Carrie Sopata, an OB/GYN with the University Department of Obstetrics and Gynecology, said IUDs have been less popular than birth control pills due to concerns about future fertility issues. However, the statement from the American Academy of Pediatrics said there is no evidence to validate this concern.
“This recommendation endorsed what we’ve known to be true for a long time,” Sopata said. “Current IUDs that are on the market are very safe for young women who plan to have families in the future, so I hope that we will see a rise in reliable birth control among that age group.”
In the past, oral contraceptive pills have been overwhelmingly the most common form of birth control prescribed to adolescents, but use of IUDs has increased in recent years, Sopata said.
“The pill has been the most commonly used form of birth control for a long time, but we’re certainly seeing more placement of IUDs and more implants, so those two are definitely on the rise,” she said.
But the endorsement by the American Academy of Pediatrics will not directly cause an increase in IUD usage among the college-aged population, Peterson said.
“I don’t know how much of an impact that recommendation is going to have on U.Va. students,” Peterson said. “It certainly is going to have an impact on teenagers in high school because they go to see their pediatrician, but by the time they come to U.Va., they’re outside of the pediatric age range.”
There is often a high cost associated with IUDs, but as with most other types of birth control, with the exception of voluntary sterilization and male contraceptive methods, they are covered under most students’ health insurance plans. The upfront cost of examination, insertion and follow-up can run up to $1,000. In contrast, birth control pills are purchased and paid for continuously as they are used. Following the passage of the Affordable Care Act, plans have changed to comply with new standards mandating the coverage of all forms of birth control, though some of these changes will not be put into place for a few more years.
“A business that has had a particular plan for many years is grandfathered in, and some of them don’t yet have to cover contraception,” Peterson said. “But, that’s going to change as of 2016.”
All insurance plans will cover all forms of FDA-approved birth control, other than those exempted by the Supreme Court for religious reasons.
The publication of the article by the American Academy of Pediatrics condoning adolescent use of IUDs is expected to spark interest in long-term methods of birth control. Peterson encouraged students interested or curious about IUDs or birth control to visit Student Health.
“If anybody has any questions or concerns about birth control, or would like to start a method or talk about starting a method, we are totally happy to see you at Student Health,” Peterson said.
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