Doctors recommend IUDs as first choice for birth control

TORONTO — Teen girls who are considering contraception should look to intrauterine devices as their first-line choice as they provide the greatest protection against an unplanned pregnancy, the Canadian Paediatric Society recommends.

The position statement, the CPS’s first on the issue, was released Thursday during the organization’s annual meeting in Quebec City.

Known as IUDs or IUSs, the small and often T-shaped devices are placed inside the uterus and are more than 99 per cent effective in preventing pregnancy, compared to 91 per cent for birthcontrol pills and 82 per cent for condoms, the CPS says.

IUDs, or intrauterine devices, typically incorporate copper in their design, which is toxic to sperm; IUSs, or intrauterine systems, release a small amount of hormones over time. Both act continuously over the course of several years, but can be removed at any time by a healthcare provider.

“Intrauterine contraception and the long-acting reversible contraceptives in general ... those should be your first line because they’re the most effective,” said Dr. Giosi Di Meglio, a co-author of the paper and an adolescent medicine specialist at the Montreal Children’s Hospital.

That doesn’t mean that young women shouldn’t choose the pill or other forms of birth control like a skin patch or injectable contraceptive, she said. “What we’re saying is this should be an option and this should be something that we think about that leads our list of options.”

Di Meglio said copper-based IUDs may not need to be replaced for five to 10 years, while the protective lifespan of IUSs ranges from three to five years, depending on the make.

The devices do carry a small risk of tissue perforation during insertion and doctors also monitor patients for possible infection for a few weeks after being implanted. But Di Meglio said such an occurrence is rare and can be treated with antibiotics.