IUDs and adolescents--an under-utilized opportunity for pregnancy prevention.

Most pregnancies in adolescents are unintended and preventable if contraception were utilized. IUDs provide an under-utilized highly effective form of contraception. IUDs are appropriate for nulliparous women, including adolescents. IUDs do not increase: the incidence of Pelvic Inflammatory Disease after the 1st month of insertion, the odds of infertility, nor rate of ectopic pregnancy. Adolesecnts need more education about and increased access to IUDs. Practical points regarding IUD selection and insertion in adolescents are reviewed, including pain prophylaxis, anticipatory guidance, side effects and complications. In summary, IUDs are safe for contraception in most adolescents. IUDs are effective and eliminate the need for ongoing adherence and thus have the potential to decrease unplanned pregnancies.