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Intrauterine Devices: Effective Contraception with Noncontraceptive Benefits for Adolescents

      Abstract

      Although adolescent pregnancy and birth rates have been declining since the early 1990s, the rate of intrauterine device (IUD) use in adolescents remain low. IUDs are a highly effective contraceptive method with a failure rate of less than 1%. There are currently 5 IUDs available and marketed in the United States: the nonhormonal copper-containing IUD (Paragard Copper T380A; Ortho-McNeil) and 4 hormonal levonorgestrel-releasing intrauterine systems (LNG-IUDs). IUDs can be used in adolescents, and the LNG-IUD has many noncontraceptive benefits including the treatment of heavy menstrual bleeding, dysmenorrhea, pelvic pain/endometriosis, and endometrial hyperplasia/endometrial cancer. In addition, the LNG-IUD is an effective tool for suppression of menses.

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      References

        • Finer L.B.
        • Zolna M.R.
        Declines in unintended pregnancy in the United States, 2008-2011.
        N Engl J Med. 2016; 374: 843
        • Abma J.C.
        • Martinez G.M.
        Sexual activity and contraceptive use among teenagers in the United States, 2011-2015.
        Natl Health Stat Rep. 2017; 1
      1. ACOG Committee Opinion No. 735: adolescents and long-acting reversible contraception: implants and intrauterine devices.
        Obstet Gynecol. 2018; 131: e130
        • Guttmacher Institute
        Contraceptive use in the United States.
        (Available:)
        • Curtis K.M.
        • Tepper N.K.
        • Jatlaoui T.C.
        • et al.
        U.S. medical eligibility criteria for contraceptive use, 2016.
        MMWR Recomm Rep. 2016; 65: 1
      2. Paragard [package insert]. Cooper Surgical, Trumbull, CT2018
      3. Mirena [package insert]. Bayer, Whippany, NJ2017
      4. Skyla [package insert]. Bayer, Whippany, NJ2018
      5. Liletta [package insert]. Allergan, Irvine, CA2018
      6. Kyleena [package insert]. Bayer, Whippany, NJ2018
        • Schmidt E.
        • James A.
        • Curran K.
        • et al.
        Adolescent experiences with intrauterine devices: a qualitative study.
        J Adolesc Health. 2015; 57: 381
      7. ACOG Practice Bulletin No. 152: emergency contraception.
        Obstet Gynecol. 2015; 126: e1
        • Goldstuck N.
        • Wildemeersch D.
        Practical advice for emergency IUD contraception in young women.
        Obstet Gynecol Int. 2015; 2015: 986439
      8. ACOG Practice Bulletin No. 186: long-acting reversible contraception: implants and intrauterine devices.
        Obstet Gynecol. 2017; 130: 18
        • Apter D.
        • Gemzell-Danielsson K.
        • Hauck B.
        • et al.
        Pharmacokinetics of two low-dose levonorgestrel-releasing intrauterine systems and effects on ovulation rate and cervical function: pooled analyses of phase II and III studies.
        Fertil Steril. 2014; 101: 1656
        • Nowitzki K.
        • Hoimes M.
        • Chen B.
        • et al.
        Ultrasonography of intrauterine devices.
        Ultrasonography. 2015; 34: 183
        • Rivera R.
        • Yacobson I.
        • Grimes D.
        The mechanism of action of hormonal contraceptives and intrauterine contraceptive devices.
        Am J Obstet Gynecol. 1999; 181: 1263
        • Stanford J.
        • Mikolajczyk R.
        Mechanism of action of intrauterine devices: update and estimation of postfertilization effects.
        Am J Obstet Gynecol. 2002; 187: 1699
        • Francis J.
        • Gold M.
        Long acting reversible contraception for adolescents: a review.
        JAMA. 2017; 171: 694
        • Mishell D.
        Intrauterine devices: mechanisms of action, safety, and efficacy.
        Contraception. 1998; 58: 45S
        • Sivin I.
        • Stern J.
        • Coutinho E.
        • et al.
        Prolonged intrauterine contraception: a seven-year randomized study of the levonorgestrel 20 μg/day (LNG 20) and the Copper T380 Ag IUDS.
        Contraception. 1991; 44: 473
        • Rowe P.
        • Farley T.
        • Peregoudov A.
        • et al.
        Safety and efficacy in parous women of a 52-mg levonorgestrel-medicated intrauterine device: a 7-year randomized comparative study with the TCu380A.
        Contraception. 2016; 93: 498
        • Wu J.P.
        • Pickle S.
        Extended use of the intrauterine device: a literature review and recommendations for clinical practice.
        Contraception. 2014; 89: 495
        • Secura G.M.
        • Allsworth J.E.
        • Madden T.
        • et al.
        The contraceptive CHOICE project: reducing barriers to long-acting reversible contraception.
        Am J Obstet Gynecol. 2010; 203: 115.e1
        • Diedrich J.T.
        • Klein D.A.
        • Peipert J.F.
        Long-acting reversible contraception in adolescents: a systematic review and meta-analysis.
        Am J Obstet Gynecol. 2017; 216: 364.e1
        • Usinger K.M.
        • Gola S.B.
        • Weis M.
        • et al.
        Intrauterine contraception continuation in adolescents and young women: a systematic review.
        J Pediatr Adolesc Gynecol. 2016; 29: 659
        • Rosenstock J.R.
        • Peipert J.F.
        • Madden T.
        • et al.
        Continuation of reversible contraception in teenagers and young women.
        Obstet Gynecol. 2012; 120: 1298
        • Abraham M.
        • Zhao Q.
        • Peipert J.F.
        Young age, nulliparity, and continuation of long-acting reversible contraceptive methods.
        Obstet Gynecol. 2015; 126: 823
        • Peipert J.F.
        • Zhao Q.
        • Allsworth J.E.
        • et al.
        Continuation and satisfaction of reversible contraception.
        Obstet Gynecol. 2011; 117: 1105
        • Hall A.M.
        • Kutler B.A.
        Intrauterine contraception in nulliparous women: a prospective survey.
        J Fam Plann Reprod Health Care. 2016; 42: 36
        • Jatlaoui T.C.
        • Riley H.E.M.
        • Curtis K.M.
        The safety of intrauterine devices among young women: a systematic review.
        Contraception. 2017; 95: 17
        • Mohllajee A.
        • Curtis K.
        • Peterson H.B.
        Does insertion and use of an intrauterine device increase the risk of pelvic inflammatory disease among women with sexually transmitted infection: a systematic review.
        Contraception. 2006; 73: 145
        • Stoddard A.
        • Xu H.
        • Madden T.
        • et al.
        Fertility after intrauterine device removal: a pilot study.
        Eur J Contracept Reprod Health Care. 2015; 20: 223
        • Villavicencio J.
        • Allen R.H.
        Unscheduled bleeding and contraceptive choice: increasing satisfaction and continuation rates.
        Open Access J Contracept. 2016; 7: 43
        • Rasheed S.M.
        • Abdelmonem A.M.
        Complications among adolescents using copper intrauterine contraceptive devices.
        Int J Gynaecol Obstet. 2011; 115: 269
        • Howard B.
        • Gubb E.
        • Lage M.
        • et al.
        Trends in use of and complications from intrauterine contraceptive devices and tubal ligation or occlusion.
        Reprod Health. 2017; 14: 70
        • Dickerson L.
        • Diaz V.
        • Jordon J.
        • et al.
        Satisfaction, early removal, and side effects associated with long-acting reversible contraception.
        Fam Med. 2013; 45: 701
        • Bayer L.
        • Jensen J.
        • Li H.
        • et al.
        Adolescent experience with intrauterine device insertion and use: a retrospective cohort study.
        Contraception. 2012; 86: 443
        • Teal S.
        • Romer S.
        • Goldthwaite L.
        • et al.
        Insertion characteristics of intrauterine devices in adolescents and young women: success, ancillary measures, and complications.
        Am J Obstet Gynecol. 2015; 213: 515.e1
        • Nahum G.G.
        • Kaunitz A.M.
        • Rosen K.
        • et al.
        Ovarian cyst: presence and persistence with use of a 13.5 mg levonorgestrel releasing intrauterine system.
        Contraception. 2015; 91: 412
        • Inki P.
        • Hurskainen R.
        • Palo P.
        • et al.
        Comparison of ovarian cyst formation in women using the levonorgestrel releasing intrauterine system versus hysterectomy.
        Ultrasound Obstet Gynecol. 2002; 20: 381
        • Bosanac S.S.
        • Trivedi M.
        • Clark A.K.
        • et al.
        Progestins and acne vulgaris: a review.
        Dermatol Online J. 2018; 24: 1
        • Sergison J.E.
        • Maldonado L.Y.
        • Gao X.
        • et al.
        Levonorgestrel intrauterine system associated amenorrhea: a systematic review and meta-analysis.
        Am J Obstet Gynecol. 2019; 220: 440
        • Baldaszti E.
        • Wimmer-Puchinger B.
        • Loschke K.
        Acceptability of the long-term contraceptive levonorgestrel-releasing intrauterine system (Mirena): a 3-year follow-up study.
        Contraception. 2003; 67: 87
        • Bayer L.L.
        • Hillard P.J.
        Use of levonorgestrel intrauterine system for medical indications in adolescents.
        J Adolesc Health. 2013; 52: S54
        • Haamid F.
        • Sass A.E.
        • Dietrich J.E.
        Heavy menstrual bleeding in adolescents.
        J Pediatr Adolesc Gynecol. 2017; 30: 335
        • Nur Azurah A.G.
        • Sanci L.
        • Moore E.
        • et al.
        The quality of life of adolescents with menstrual problems.
        J Pediatr Adolesc Gynecol. 2013; 26: 102
        • Andersson J.K.
        • Rybo G.
        Levonorgestrel-releasing intrauterine device in the treatment of menorrhagia.
        Br J Obstet Gynaecol. 1990; 97: 690
        • Lethaby A.
        • Hussain M.
        • Rishworth J.R.
        • et al.
        Progesterone or progestogen-releasing intrauterine systems for heavy menstrual bleeding.
        Cochrane Database Syst Rev. 2015; 4: Cd002126
        • Lukes A.S.
        • Reardon B.
        • Arepally G.
        Use of the levonorgestrel-releasing intrauterine system in women with hemostatic disorders.
        Fertil Steril. 2008; 90: 673
        • Adeyemi-Fowode O.A.
        • Santos X.M.
        • Dietrich J.E.
        • et al.
        Levonorgestrel-releasing intrauterine device use in female adolescents with heavy menstrual bleeding and bleeding disorders: single institution review.
        J Pediatr Adolesc Gynecol. 2017; 30: 479
        • Lu M.
        • Yang X.
        Levonorgestrel-releasing intrauterine system for treatment of heavy menstrual bleeding in adolescents with Glanzmann’s thrombasthenia: illustrated case series.
        BMC Womens Health. 2018; 18: 45
      9. ACOG Committee Opinion No. 760: dysmenorrhea and endometriosis in the adolescent.
        Obstet Gynecol. 2018; 132: e249
        • Suhonen S.
        • Haukkamaa M.
        • Jakobsson T.
        • et al.
        Clinical performance of a levonorgestrel-releasing intrauterine system and oral contraceptives in young nulliparous women: a comparative study.
        Contraception. 2004; 69: 407
        • Carvalho N.
        • Margatho D.
        • Cursino K.
        • et al.
        Control of endometriosis-associated pain with etonogestrel-releasing contraceptive implant and 52-mg levonorgestrel-releasing intrauterine system: randomized clinical trial.
        Fertil Steril. 2018; 110: 1129
        • Song S.Y.
        • Park M.
        • Lee G.W.
        • et al.
        Efficacy of levonorgestrel releasing intrauterine system as a postoperative maintenance therapy of endometriosis: a meta-analysis.
        Eur J Obstet Gynecol Reprod Biol. 2018; 231: 85
        • Hawkins D.R.
        • Kazmierski K.
        • Hansen A.
        • et al.
        Trends in weight loss efforts among US adolescents with overweight and obesity.
        JAMA Pediatr. 2018; 172: 782
        • Elizondo-Montemayor L.
        • Hernandez-Escobar C.
        • Lara-Torre E.
        • et al.
        Gynecologic and obstetric consequences of obesity in adolescent girls.
        J Pediatr Adolesc Gynecol. 2017; 30: 156
        • Wei J.
        • Zhang W.
        • Feng L.
        • Gao W.
        Comparison of fertility-sparing treatments in patients with early endometrial cancer and atypical complex hyperplasia: a meta-analysis and systematic review.
        Medicine. 2017; 96: e8034.
        • Pradhan S.
        • Gomez-Lobo V.
        Hormonal contraceptives, IUDs, GnRH analogues and testosterone: menstrual suppression in special populations in this supplement)..
        J Pediatr Adol Gynecol. 2019; (Supplement)