Contraception
Volume 79, Issue 6 , Pages 418-423, June 2009

Intrauterine devices for adolescents: a systematic review

  • Elizabeth I. Deans
    • ,
  • David A. Grimes

      Affiliations

    • Corresponding Author InformationCorresponding author. Family Health International, P.O. Box 13950, Research Triangle Park, NC 27709, USA. Tel.: +1 919 544 7040; fax: +1 919 544 7261.

Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC 27599-7570, USA

Family Health International, Research Triangle Park, NC 27709, USA

Received 20 November 2008; accepted 23 December 2008. published online 09 February 2009.

Abstract 

Background

The appropriateness of IUDs for adolescents remains unsettled, as does the definition of the term adolescent. Unplanned pregnancy among teenagers remains epidemic, and long-acting methods, such as IUDs, offer the promise of top-tier effectiveness.

Study Design

We conducted a systematic review of the literature concerning IUD use in adolescents using MEDLINE, Popline, EMBASE and CINAHL databases.

Results

Six cohort studies and seven case-series reports met our inclusion criteria; none included IUDs in current use in the United States. Overall, continuation rates were high and cumulative pregnancy rates low, ranging from 2% at 6 months to 11% at 48 months. Compared with combined oral contraceptives, IUDs had similar or better continuation rates; pregnancy rates were similar at 2 years. IUD expulsion rates may be inversely related to age.

Conclusions

The literature on IUD use among adolescents is scanty and obsolete. Nevertheless, published reports were generally reassuring. Randomized controlled trials and cohort studies comparing contemporary IUDs with other methods are urgently needed.

Keywords: IUD, Intrauterine device, Systematic review, Teenagers, Adolescents, Contraception

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PII: S0010-7824(08)00578-7

doi:10.1016/j.contraception.2008.12.009

Contraception
Volume 79, Issue 6 , Pages 418-423, June 2009

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