female-birth-control, iudI’m somewhat suspicious of hormonal IUDs and potentially other hormonal birth control methods for interfering with and/or prohibiting the growth, both physically and sexually, of females who have not yet passed through the majority of their sexual development.
This primarily stems from my (relatively naive) knowledge of the part hormones play in controlling both the timing and extent of growth. However, physically outgrowing the IUD is also a concern.
Is there such a thing as “outgrowing” an IUD, and do hormonal methods interfere with sexual development?
Hormonal methods have been used by adolescents for 50 years and have compiled an impressive safety record with respect to physical and emotional development. The old high-dose pill increased risks of some cancers, especially for smokers, but even the high-dose pill has not shown any sign of harming adolescent development. Modern IUDs and implants, with their very low dosage levels are quite probably not just harmless in this regard, but actually somewhat beneficial.
To understand why, you need to consider how unnatural the internal hormonal environment is for modern teens. Most of human physiology evolved long before herding and agricultural, more than ~10,000 years ago. In that nomadic forager environment, women were usually pregnant, nursing, or half starved, all three of which shut down the cycle.
The typical girl back then started puberty at 11 or 12, hit menarche at around 16, had perhaps 10-15 periods before getting pregnant at 18 or 19. After the baby was born, ovulation was usually suppressed while she nursed for ~4 years or until the baby died. Then she had a few more menstrual periods and got pregnant again. Rinse and repeat until she died or reached menopause. All told, she probably had less than 60 periods spread out over 30+ years.
By comparison, a young girl today may begin puberty at 7, start menstruating at 10, and have a hundred periods by age 18. That's more than a lifetime's worth of strong hormonal fluctuations starting much earlier than it "should," while the brain and endocrine system are much less mature. Today, if a woman has one or two kids and doesn't breastfeed for long, she may well have 400-500 periods in 40+ years, something her system was never designed for.
Just because something evolved doesn't mean it's benign, especially when the circumstances change that much. The human menstrual cycle is uniquely nasty and damaging. It is the product of a bizarre three-way arms race between the conflicting interests of mothers, fathers, and fetuses. Like many arms races, it produced a wasteful and dysfunctional outcome that is not to the benefit of any side. And modern high-calorie diets and sedentary lives make it worse by triggering the process much sooner.
Many scientists believe that suppressing or mitigating most of those hormonal cycles is beneficial, particularly for girls and young women. The pill, if taken continuously, eliminates the monthly cycle and creates a hormonal environment more like pregnancy, giving the woman's system some rest from hormonal fluctuations. Low-dose IUDs and implants very gently suppress ovulation, reducing the strength of the cycles and often stopping menstruation after a year or so.
Finally, any form of birth control is safer than teen pregnancy, which is still a major health and mortality risk for girls.
If I had teenage daughters, I'd want them on Implanon, the low-hormone implant. (The IUD would be a close second.) Nothing in life is ever completely risk-free, but in this case the best and safest methods of birth control are so much less risky than the alternatives, including the risk of doing nothing, that I think that choice should be a no-brainer.
tl;dr: There's been plenty of time for even subtle harm to show up in terms of adolescent development and hormonal contraception, and none has been detected; in addition, there are some reasons to think that reducing the number and severity of hormone fluctuations is beneficial, especially for adolescents.
Ref:
IUD Birth Control Like Mirena and Skyla Are Safe for Teens, Study Says
From the underlying study:
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.
American Academy of Pediatrics: IUDs, Implants Should Be First-Line Birth Control for Teen Girls
What is the evolutionary benefit or purpose of having periods?
How to Stop Periods With Birth Control
Is it safe to stop your period?
How Safe Is Continuous Birth Control?
Is it really okay to skip periods?
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