Puzzling Over the Hurt Down-Under
Serious Mental Illness and Contraception
New 13-Cycle Vaginal Contraceptive System
The Future of Family Planning in Post-COVID America
New ASCCP Guidelines: Implications for FP
On the alert: mood disorders during 2020 stressors
Challenges old and new during the pandemic
Reproductive health in the time of Covid-19
Missed Pills: The Problem That Hasn’t Gone Away
Find the “yes! . . . and” rather than “no” or “but”
Digital Family Planning: the Future is Now
Irregular Bleeding Due to Contraceptives
Ouch! Best approaches to menstrual pain
Contraceptive efficacy: understanding how user and method characteristics play their part
Strategizing treatment for chronic heavy menstrual bleeding
Untangling the literature on obesity and contraception
High tech apps for no-tech FABM
Menstrual exacerbation of other medical conditions
From Princeton University: Thomas James Trussell (1949-2018)
The Short and Long of IUD Use Duration
Selecting a Method When Guidance Isn’t Clear-cut
Healthcare in the Time of Digital Expansion
The Scoop on Two New FDA-Approved Contraceptive Methods
Pregnancy of unknown location—meeting the challenge
Big “yes” (with caveats) to CHCs during perimenopause
The role of IUDs (LNG IUDs, too!) in emergency contraception
Combined pills’ effect on mood disorders
Abortion in the U.S.: safe, declining, and under threat
Hope for ovarian cancer screening test
Breast cancer still a small risk with some hormonal contraceptives
Record rate of HPV-related throat cancer
Viruses in semen potentially transmissible
Don’t Abstain from Your Role in Abstinence
Teens births declining but geographic ‘hotspots’ defy trend
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Do Women Really Need to Wait That Long?
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PMDD: Genetic clues may lead to improved treatment
Breast cancer risk when there is a family history
Body weight link to breast and endometrial cancers (and 11 others)
Family Planning in 2017 and Beyond
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Managing implant users’ bleeding and spotting
Zika: Updated guidance for providers
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Hot off the press! 2016 MEC and SPR
Zika virus fears prompt increased request for abortion in nations outlawing abortions
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Good news on the family planning home front!
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Win-win for both treatment and prevention
Menopause, mood, mental acuity, and hormone therapy
Emergency contraception for teens
Postpartum Contraception: Now, Not Later
Are we practicing what we preach?
Be alert to VTE in hormonal contraceptive users
LARC among teens increased 15-fold, but not enough
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Free tools: Easy access to the US Medical Eligibility Criteria for Contraceptive Use
Alcohol consumption when pregnancy is unwanted or unintended
Latest Data on Contraceptive Use in the United States
LateBreaker sampler from Contraceptive Technology conference
Emergency Contraceptive Pill Efficacy and BMI/Body Weight
Handout on Unintended Pregnancy and Contraceptive Choice
Ask About Withdrawal (Really!)
Rules to Practice By: Safety First and Cleanliness is Close to. . .
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Numbers matter, so make them simple for patients
The Recession’s Effect on Unintended Pregnancies
Lessons Learned from the Contraceptive CHOICE Project: The Hull LARC Initiative
Applying the “New” Cervical Cytology Guidelines in Your Practice
Acute Excessive Uterine Bleeding: New Management Strategies
Medical indications for IUD use in teens

Beyond offering excellent contraceptive protection and several noncontraceptive benefits. However, many women are unaware that adolescents can safely use IUDs. Although IUD use increased dramatically, by more than tenfold, use remains exceedingly low at only 2.5%.[1]
Recently reporting on the St. Louis CHOICE project, in which women are offered long-acting reversible contraceptives without charge as a first-line option, Jeffrey Peipert, MD, PhD, reported that the birth rate for teens ages 15-19 years enrolled in the study was 6.1 per 1,000, a rate far below the national average of 34.3 per 1,000.[2] The study team found that teens’ rate continuation and reported satisfaction with IUDs did not differ from that of adult users. In fact, more than 80% of adolescents using the LNG-IUS, the copper IUD, and implants continued use for a full year. In contrast the 12-month continuation rate among teens using non-LARC methods was only about 50%. Although the younger teens ages 14-17 years in the project were more likely to select the implant than the IUD as their method, older teens ages 18-20 years were twice as likely to select an IUD over an implant.
A number of studies among adult women have shown that the levonorgestrel intrauterine system (LNg-IUS) can for most users reduce menstrual bleeding, decrease dysmenorrhea, suppress endometriosis, and offer endometrial protection against chronic anovulation.[3] In a recent review, Bayer and Hillard concluded that these same benefits for medical management of menstrual-related problem likely apply to adolescents as well. One of the most common problems in adolescents is heavy menstrual bleeding, which may require a change in tampon or pad every hour or two or may last longer than a week. One study of young women ages 18-25 found that IUD users reported less bleeding than did COC users.[4]
Most adolescents report dysmenorrhea (60-93%). A randomized trial of young women 18-25 years showed that LNG-IUS users had greater alleviation of dysmenorrhea than did pill users. In the rare case of an adolescent who may be at risk of endometrial hyperplasia, and so may benefit from endometrial protection, may be better managed by LNG-IUS than by pills because she may have risk of deep venous thrombosis or, simply, poor compliance and high discontinuation. The menstrual suppression accompanying LNG-IUS use may be a promising benefit for adolescents with mental retardation and developmental disorders, for whom menstrual cycling represents unique challenges with hygiene and behavioral concerns. However, this particular population may require anesthesia for IUD insertion.
[1] Whitaker AK, Sisco KM, Tomlinson AN, Dude AM, Martins SL. Use of the intrauterine device among adolescent and young adult women in the United States from 2002 to 2010. J Adol Health 2013;53:401-6.
[2] Peipert JF. The importance of long-acting reversible contraception (LARC). Presented March 14, 2013 at the Contraceptive Technology conference, San Francisco, CA.
[3] Bayer LL, Hillard PJA. Use of levonorgestrel intrauterine system for medical indications in adolescents. J Adol Health 2013;52:S54-8.
[4] Suhonen S, Jaukkamaa M, Jakobsson R, et al. clinical performance of a levonorgestrel-releasing intrauterine system and oral contraceptives in young nulliparous women. Contraception 2004;69:407-12
–Deborah Kowal, MA, PA, President & CEO, Contraceptive Technology Communications, Inc.