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    American College Of Obstetricians And Gynecologists Says Teenage Girls Need IUDs
    By Hank Campbell | September 25th 2012 04:30 AM | 6 comments | Print | E-mail | Track Comments
    The American College Of Obstetricians And Gynecologists (ACOG) has issued new guidelines to endorse IUDs and implants as first-line birth control options for teens. Despite widespread availability of condoms and birth control for women at very low cost (31-year-old Georgetown law students disagree, of course, they think the government should pay for it so they can instead spend $50,000 a year becoming lawyers), over 80 percent of teen pregnancies are unintended, they note, and so something more permanent should be used.

    And advocates use anecdotal evidence to advance the idea that current birth control does not work and that other doctors are to blame for some of the problem. In a story worthy of Michele Bachmann, ABC News treats us to a Planned Parenthood claim that a young woman had her IUD removed when she broke up with her boyfriend because her doctor said IUDs could only be used by women in monogamous relationships. Supposedly, the woman became pregnant and had an abortion. At least they didn't claim she became retarded from the lack of government-sponsored birth control. That would just have been silly.

    In the past, IUDs were a no-no, due to rampant problems with infertility issues (well, that is birth control at least), pelvic inflammatory disease and spontaneous septic abortion. IUDs get invoked more in birth control scare stories than thalidomide gets invoked about genetically modified food.  So a new endorsement has to be making Bayer, maker of the Mirena IUD, thrilled.  It is a de facto subsidy waiting to happen. Too late for AH Robins, they went bankrupt over their IUD lawsuits.

    Most odd is that the ACOG is recommending making these a first-line choice for 15-year-old girls  even though no one in that organization can be quite sure how they work.  All we know is that plastic in the uterus is foreign and so the uterus spends its time sending in white blood cells kill it - sperm gets caught in that attack, preventing pregnancy.  I am not knocking doctors for not knowing how biology works, electromagnetics is hard too.  No one can really define a magnetic field yet it is the basis for a $500 billion semiconductor industry.  It just seems strange to recommend these for developing bodies, just like birth control pills have lots of different effects on different women.  These white bloods cells are in overdrive all of the time. I guess gynecologists are okay with that,

    Am I being anti-science in urging parents of teenage girls to use some caution about embracing IUDs again, despite the fancy name of the endorser?  No, doctors themselves often don't use evidence for making decisions and this could be no different.  Beta-blockers have never been shown to help patients right after a heart attack but doctors recommended it anyway, until the government stopped paying for it.  And the public knows what doctors seem to ignore, that antibiotics for an ear infection often do more harm than good.  Arthroscopic surgery for knee arthritis is a $3 billion a year business but is no better than physical therapy. Brachytherapy, partial-breast treatments for cancer, went up 1000% over a 5-year period despite any evidence it works. But the government started paying for it and so it got used.

    The ACOG is not all that concerned about an evidence basis for their recommendation because there is a shocking lack of evidence basis in a lot of medicine. 

    Putting something in a teenager just because an employee of Planned Parenthood has horror story anecdotes published by ABC is not critical thinking.

    Comments

    Uh, if teenagers aren't smart enough to use birth control RIGHT AFTER REMOVING THEIR ONLY FORM OF BIRTH CONTROL, what makes us think that they will not end up with an STD from using an IUD?

    Feels like the empowerment movement is empowering children to not need to think critically for themselves. Just give them a get out of trouble free card and wish them well in making bad choices.

    Gerhard Adam
    Just give them a get out of trouble free card and wish them well in making bad choices.
    ???
    IUDs sounds good in theory, but in practice sometimes they have actually torn through the wall of the uterus or become embedded somewhere else- in which case it no longer prevents against pregnancy. It seems like a type of birth control that you never have to think about, but that isn't true. You are supposed to check for the strings every month or so to make sure they're still there because if they aren't, it might mean that you are no longer protected against pregnancy.
    http://www.publichealthwatchdog.com/mirena-iud-birth-control-is-linked-t...

    I think the arguments from Sandra Fluke were a tad more complex than you pettily allude to Hank.

    Hank
    I know how you vote.  In reality, most concepts can be boiled down to something simple and a woman in her 30s attending a $50K a year law school balking because their culture and tradition doesn't have anything to do with birth control and wanting to force it legally sounds strange, right?
    Want more no-nonsense, independent science? Buy Science Left Behind
    I'm uncomfortable with the fact that ACOG is so freely advocating IUDs as a first choice for teenage girls. As you point out, IUDs aren't very popular in the US because its been associated with pelvic inflammatory disease, increased risk of ectopic pregnancy, etc. There's also a risk that it could puncture the wall of the uterus, in which case you may need surgery to remove it. I understand the appeal of reversible long-term birth control for teens, but I think that we should focus more an educating and providing them with better options that actually prevent STDs rather than risking their health with a device we don't know much about.