The American Pediatric Society recommends the insertion of an IUD in young girls from the age of 15 to fight against unwanted pregnancies. In theory, it is possible. In practice, French gynecologists are more reserved. The answers of our experts.
Facce to the 750,000 pregnant teens each year in the United States, medical authorities in that country are pushing for long-acting contraceptives.
The IUD is ten to forty times more effective than the pill according to the World Health Organization, the IUD has a failure rate of less than 0.8% because its effectiveness does not depend on its correct use. “This problem is less felt in France, where voluntary pregnancy interventions (IVG) mainly concern women between 18 and 30 years old1”, recalls Dr. Christian Jamin, a gynecologist. While sales of IUDs have increased by 45% since 2012, only 3% of these sales concern young girls aged 15 to 19.2. Read also :Teenage contraception: stop preconceived ideas!
IUDs: more frequent rejections in teenage girls
Its installation is in theory possible as soon as there is sexual intercourse, including in women who have not had children. “But we are more careful with teenagers because the risk of deportation is high”, says Dr. Jamin. A 2014 American study shows a rate twice as high among 14-19-year-olds: 18.8% against 9.3% among older women3. In the question: a less mature uterus that has not reached its adult size. The fragility of the cervix can also lead to heavy periods. Read also : Is there an age to have your first period? “About one in two IUDs is removed before one year for tolerance problems in those under 20”, specifies Dr. Brigitte Letombe, a gynecologist. Sometimes complicated and a little painful, “The installation is bearable if the doctor is used to inserting IUDs in nulliparous patients”, Dr. Jamin said. “It must be accepted psychologically by the teenager”, adds Dr. Letombe.
The IUD is recommended but not a priority
In a 2013 report, the Haute Autorité de santé does not systematically recommend the IUD in young girls because of the prevalence of sexually transmitted infections among those under 25.
To see also: How to talk about sex with your child?
“The threads of the device can spread the germ to the tubes and increase the risk of upper infections, such as salpingitis, with a risk of sterility”, recalls Dr Jamin.
This risk exists especially if the germ is already present at the time of installation and in the six weeks which follow, it is, therefore, essential to check it beforehand.
“There is no one ideal contraception for adolescent girls”, concludes the gynecologist.
1. According to figures from the DREES, in 2012 there were less than 10 cases per 1,000 women among 15-17-year-olds, against 27 cases per 1,000 among 20-24-year-olds. 2. ANSM, June 2014. 3.ReviewObstetrics and Gynecology, October 2014, on more than 5,400 women.
Smaller IUDs for teenage girls Copper 5.4 mm shorter than a conventional IUD, it is placed for a maximum of 5 years. € 30.50, reimbursed at 60%. Hormonal to levonorgestrel, it is 2 mm shorter and 4 mm narrower than the Mirena. It is posed for three years maximum. € 102.90, reimbursed at 60%. French Association for Contraception.