【Depending on the particular type copper-based IUDs may not need to be replaced for five to 10 years.】


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 set to be 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 birth-control 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 health-care 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.

蒙特利尔儿童医院青春期研究医学专家这篇论文的合著者Giosi Di Meglio博士称,“一般来讲,宫内避孕器和长效(可恢复生育能力的)避孕药.................这些应是你避孕的首选,因为它们更有效。”

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 in an interview from Quebec.


"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 that depending on the particular type 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.

Di Meglio说,取决于避孕器的类型,铜制宫内避孕器5-10年内可能都不需要更换,而宫内节育系统的使用寿命依据做工而定则是3-5年。

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

这些装置在插入阴道时确实有很小的组织穿孔风险,而且医生也会在植入该装置几周后对患者进行潜在的细菌感染监测,但是Di Meglio说这种情况发生几率很小,而且可以给予抗生素治疗。

Studies suggest that intrauterine devices are not a direct conduit for infection and there is a theoretical possibility that IUSs may actually decrease the risk of infection she said.


Still the idea of having a device inserted may cause anxiety for some teen girls and Di Meglio concedes the procedure can initially be somewhat uncomfortable.

装置植入的想法仍然可能会引起一些少女的焦虑。Di Meglio承认这一过程开始可能会有一点点不舒服。

"You get a few pretty intense cramps but nothing more than you would have with a really bad period" she said. "It subsides pretty quickly and then for the next few days you might have a few cramps on and off."


Di Meglio said a girl can get an IUD or IUS any time after getting their first period and ideally prior to becoming sexually active. By age 17 about half of Canadian youth are having sex the CPS says.

Di Meglio说,女生在第一次例假到来后,就可以在任何时间装上宫内避孕器,最好是在性生活频繁之前。加拿大儿科协会声称,大约有一半的加拿大青年在17岁的时候会有性行为。

"We're not recommending that this be used the minute the kid has their first period but there are certain benefits in using the hormonal IUS — one of them being that it can reduce the amount of bleeding or also reduce cramping a lot" she said.。


"We have even used it for that reason instead of for contraception in kids who have not even had sex."


【Percentage of women using each form of contraception:


No contraception:36.4%——无避孕:36.4%
Male condom:7.7%——男用避孕套:7.7%
The pill:8.8%——药物:8.8%
Female sterilization:19.2%——女性绝育:19.2%】


Up-front costs higher


Andrew Townsend of Planned Parenthood Toronto welcomed the CPS recommendation saying the clinic gets a lot of questions from young people who "still view the pill as the first kind of birth control that they should start on or that they have to start on.

多伦多计划生育协会的安德鲁·汤森德(Andrew Townsend)对加拿大儿科协会的建议表示欢迎,他说,诊所遇到很多年轻人的问题,那些年轻人仍然认为避孕药是他们应该开始或者不得不开始的第一项避孕选择。

"Something like IUDs being a recommended option is great because different people have different needs" he said adding that a growing number of clients being seen in the clinic are opting for the implanted devices. The program provides information and health-care services to those aged 13 to 29.


While intrauterine contraception may be the most effective means of preventing unplanned pregnancy the up-front costs of the devices are high compared with the pill and other methods said Di Meglio.

然而,宫内避孕器可能是最有效的也意味着,和避孕药以及其他方法相比,该装置的前期成本会更高,Di Meglio表示。

One hormone-releasing IUS that lasts five year costs the Quebec government's prescxtion plan about $325 while copper-based IUDs run from about $60 to $100 she said. For those not covered under private insurance the provincial plan covers 65 per cent of the cost of birth control pills and IUDs.


Coverage by public insurance plans varies across the country. In Ontario for instance long-acting reversible contraceptives are fully covered for women under age 25 along with the physician's fee for implanting one of the devices.


Di Meglio said that over time IUDs and IUSs are actually more cost-effective than most other birth-control methods because of how long they last before needing to be replaced.

Di Meglio说随着时间的推移,实际上铜制避孕器(IUD)和释放激素的宫内避孕器(IUS)的价格比其他的避孕方法更划算,因为在被更换之前,他们持续的时间更长。

The CPS statement also recommends that practitioners adopt a collaborative approach that empowers youth to make informed decisions about their birth control options weighing the benefits risks side-effects and suitability of each method based on individual preference.


"At the end of the day we just want to facilitate whatever contraceptive they choose" Di Meglio said.

Di Meglio称“不管最后他们选择哪种避孕方式,最终我们只是想要起到帮助作用。”