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One ob-gyn shares how she talks about birth control for teens, specifically about IUDs and implants.
There are many excellent options of birth control for teens. As an ob-gyn, I often recommend that teens consider long-acting reversible contraception, or LARC.
LARC methods include IUDs (intrauterine devices) and the birth control implant. The implant is a small rod that is placed just under the skin of your upper arm. The IUD is a small, T-shaped device that is inserted into and left inside the uterus.
IUDs and implants prevent pregnancy better than any other type of birth control. Over time, these methods are 20 times more effective at preventing pregnancy than birth control pills, the patch, or the ring. And if you want to get pregnant in the future, fertility returns within a week of removing an implant or IUD.
LARC methods may also help with period concerns. About 20 to 50 percent of those who use certain IUDs will stop having their period within a year.
I used to tell my teen patients and their parents that I would recommend LARC methods to my own daughters. Now I can say that I actually have. When one of my daughters was 13, she asked me about using an IUD to stop or lighten her periods.
She wasn’t having sex, but she’s an athlete and wanted to skip her periods if she could. I talked it over with my daughter, and she decided to have one placed. She likes the IUD and is happy to no longer deal with her period.
Here’s what I’d like all teens to know about LARC.
Some teens and their parents worry about the possible side effects of LARC, particularly IUDs. Some have read misinformation on social media claiming IUDs are harmful. Some think only women who are older or who have had a baby can use the devices.
None of these things are true. IUDs are safe and effective for teens. Serious side effects with current IUDs happen in less than 1 in 100 people who use them. Problems are also uncommon with the implant.
Pregnancy is much riskier than any form of birth control, including LARC. And that’s just in terms of the medical issues that can develop during pregnancy. When a teen has an unplanned pregnancy, it can disrupt her life, education, or ability to find or keep a job.
With a LARC method, teens need to take only one action to prevent pregnancy. That’s to visit their ob-gyn and get the implant or IUD placed. They can get it and then forget about it.
That’s why LARC options are so effective. It’s also why patients report higher satisfaction and continuation rates with IUDs and the implant than with any other form of birth control.
The implant is approved for up to 3 years of use. It works by releasing the hormone progestin into the body.
How long you can use IUDs depends on the type:
Teens have different goals and fears when it comes to birth control. Some want lighter or no periods. Some are afraid of the discomfort that can happen with a pelvic exam or IUD placement. Some teens worry they may need a parent’s permission for LARC. (Most states don’t require this, but you can check your state’s laws or ask your ob-gyn.) Some teens may decide LARC isn’t for them, and that’s okay. We’ll discuss all the other options too.
If teens are choosing between LARC methods, here’s what I share:
That’s why teens who use LARC also need to use a condom every time they have sex. Those age 15 to 24 have the highest rates of STIs of any age group.
Teens who are having sex should get tested for STIs once a year or whenever they have a new sexual partner, whichever comes first. We can use urine or blood tests to check for these infections. There’s no need for a pelvic exam unless the teen has concerns.
I try to give all my teen patients the opportunity to speak with me alone. Often, these private talks are when teens reveal they’re interested in birth control. Sometimes parents are aware of these conversations and sometimes they’re not. But I try to make sure all my teen patients know our relationship is a safe space for them.
In some cases, state laws or insurance policies may limit what health care services for minors can be confidential. I encourage teens to always ask their ob-gyn what can be kept private, and whether there’s anything that needs to be shared with parents or that might show up on an insurance bill.
We want teens to feel comfortable talking with their ob-gyn about birth control and sexual activity. Our goal is to empower them with information that can help them make the best decisions.
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