title: Complications and continuation of intrauterine device use among commercially insured teenagers.
abstract: OBJECTIVE
  Many U.S. health care providers remain reluctant to prescribe intrauterine devices (IUDs) to teenagers as a result of concerns about serious complications. This study examined whether 15-19-year-old IUD users were more likely to experience complications, failure, or early discontinuation than adult users aged 20-24 years and 25-44 years and whether there were differences in these outcomes between users of levonorgestrel-releasing intrauterine systems and copper IUDs.
  
  
  METHODS
  A retrospective cohort study was conducted using health insurance claims obtained from a private insurance company of 90,489 women who had an IUD inserted between 2002 and 2009. Logistic regression models were used to estimate the odds of experiencing complications, method failure, or early discontinuation within 12 months of insertion by age group and type of IUD inserted.
  
  
  RESULTS
  Serious complications, including ectopic pregnancy and pelvic inflammatory disease, occurred in less than 1% of patients regardless of age or IUD type. Women aged 15-19 years were more likely than those aged 25-44 years to have a claim for dysmenorrhea (odds ratio [OR] 1.4, confidence interval [CI] 1.1-1.6), amenorrhea (OR 1.3, CI 1.1-1.5), or normal pregnancy (OR 1.4, CI 1.1-1.8). Overall, early discontinuation did not differ between teenagers and women aged 25-44 years (13% compared with 11%, P>.05). However, use of the levonorgestrel-releasing intrauterine system was associated with fewer complications and less early discontinuation than the copper IUD in all age groups.
  
  
  CONCLUSIONS
  The IUD is as appropriate for teenagers to use as it is for older women, with serious complications occurring infrequently in all groups. The levonorgestrel-releasing intrauterine system may be a better choice than the copper IUD as a result of lower odds of complications, discontinuation, and failure.
  
  
  METHODS
  II.
authors: Department of Obstetrics & Gynecology, Center for Interdisciplinary Research in Women's Health, the Department of Preventive Medicine, Sealy Center on Aging, and the Departments of Obstetrics and Gynecology and Preventive Medicine & Community Health and Family Medicine, University of Texas Medical Branch, Galveston, Texas.
authors: Abbey B
authors: AB
authors: Berenson
authors: Alai
authors: A
authors: Tan
authors: Jacqueline M
authors: JM
authors: Hirth
authors: Gregg S
authors: GS
authors: Wilkinson
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D003271:Contraceptive Agents, Female / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007348:Insurance, Health; D007434:Intrauterine Devices / Q000009:adverse effects* / Q000706:statistics & numerical data*; D007435:Intrauterine Devices, Copper / Q000009:adverse effects / Q000706:statistics & numerical data; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects* / Q000706:statistics & numerical data*; D016912:Levonorgestrel / Q000008:administration & dosage / Q000009:adverse effects*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel
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