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Contraception Explained: Options for Teens & Adolescents

Contraception Explained: Options for Adolescents Contraception Explained: Options for Adolescents

​​​Contraceptives help protect people from getting pregnant and from catching infections during sexual activity. It is important for all adolescents to learn about contraception so they have information they'll need to make safe and healthy decisions.

The American Academy of Pediatrics (AAP) recommends parents talk to their adolescents about how not having sexual intercourse is the best way to prevent STIs, HIV infection and pregnancy. However, these discussions should also address reliable contraception options.

Pediatricians start talking about sexual behaviors, birth control, and ways to prevent sexually transmitted infections (STIs) at about the 11-year-old checkup. They can provide or prescribe contraception in the office or give referrals to other resources in the community.

Long-Acting Reversible Contraceptives

Long-acting reversible contraceptives (LARCs) are the most effective contraceptives to prevent pregnancy. Less than 1% of users become pregnant during the first year using them. LARCs can have other medical benefits, too including helping with heavy or painful periods​.

There are two kinds of LARCs. They are the intrauterine device (IUD) and the subdermal implant. LARCs are not “barrier methods" and do not help prevent sexually transmitted infections. That's why adolescents who use LARCs, must also use a condom or other type of barrier protection during sexual activity to prevent infections.

Subdermal Implant

  • What It Is: A thin, flexible plastic implant that contains a hormone called etonogestrel. The implant is about the size of a matchstick. It is placed under the skin (subdermal) of the upper arm.

  • Advantages:

    • 99.95% effective at preventing pregnancy.

    • Provides safe, long-term birth control.

    • Adolescents don't have to remember to do anything every day, week, or month to stay protected from unintended pregnancy.

    • Does not need to be replaced for 3 to 5 years.

    • Contains progestin, a hormone that prevents the ovary from releasing an egg.

  • Disadvantages:

    • May cause irregular bleeding.

    • Less common side effects include weight gain, headaches, and acne.

    • Does not prevent sexually transmitted infections.

Intrauterine Device (IUD)

  • What It Is: A small, flexible, T-shaped birth control device. It is inserted into the uterus by an experience provider. There are two types:

    • Copper T IUD (99.2% effective at preventing pregnancy): Does not contain hormones. Does not need to be replaced for 10 to 12 years.

    • Levonorgestrel IUD (99.8% effective at preventing pregnancy): Contains a hormone. Does not need to be replaced for 3 to 7 years.

  • Advantages:

    • Provides safe, long-term birth control.

    • Don't have to remember to do anything every day, week, or month to stay protected from unintended pregnancy.

    • May have less cramping and lighter periods with the levonorgestrel IUD. Many adolescents stop having periods over time.

  • Disadvantages:

    • Can cause pain or cramping for a short time after insertion.

    • Levonorgestrel IUD: May include irregular bleeding or spotting. This often gets better after a while.

    • Copper T IUD: May lead to increased menstrual cramping, spotting, and heavier bleeding. This usually improves with time.

    • Do not protect against sexually transmitted infections.

Short-Acting Contraceptives

There are many kinds of short-acting contraceptives. They are more than 90% effective in preventing pregnancy. They must be used with a condom or other type of barrier protection to prevent sexually transmitted infections.

Progestin Injection

  • What It Is: A shot containing a hormone that prevents the ovaries from releasing an egg.

  • Advantages:

    • 94% effective at preventing pregnancy.

    • Long-lasting protection; only requires visits to the doctor every 3 months.

    • The shot also protects against endometrial cancer and iron deficiency anemia.

    • May have less cramping and lighter periods. (Many teens stop having periods after several doses).

  • Disadvantages:

    • May cause weight gain.

    • May include irregular bleeding or light spotting at first.

    • Could affect bone density. Bone strength usually gets better after stopping.

    • May increase the risk of blood clots.

    • Do not protect against sexually transmitted infections.

Contraceptive Vaginal Ring

  • What It Is: The ring has hormones (etonogestrel/ethinyl estradiol) that prevent the ovaries from releasing an egg. You place the ring in your vagina once a month. It stays in place for 3 weeks, and you remove it for 1 week. During that week, the user has a period.

  • Advantages:

    • 91% effective at preventing pregnancy.

    • Lighter periods.

    • Less cramps.

    • Acne may improve.

  • Disadvantages:

    • Some users forget to replace the ring each month.

    • May cause headaches, nausea, vaginal discharge, or breast tenderness.

    • May increase the risk of blood clots.

    • Do not protect against sexually transmitted infections.

Transdermal Patch

  • What It Is: The patch contains hormones (norelgestromin and ethinyl estradiol) that are absorbed through the skin (transdermal). The hormones prevent the ovaries from releasing an egg. You remove the patch and put on a new one each week for three weeks. Then, you do not wear a patch for one week. During that week, the user has a period.

  • Advantages:

    • 91% effective at preventing pregnancy.

    • Lighter periods.

    • Less cramps.

    • Acne may improve.

  • Disadvantages:

    • Adolescents might forget to change the patch each week.

    • May increase the risk of blood clots.

    • Other people might see the patch if it is not covered by clothes. This may bother some teens.

    • May cause headaches, nausea, skin irritation, or breast tenderness.

    • Do not protect against sexually transmitted infections.

Oral Contraceptive Pills

  • What It Is: There are two types of oral contraceptive pills. The combined oral contraceptive pill contains estrogen and progesterone, the two female sex hormones that control the menstrual cycle. The progestin-only pill (also called the mini-pill) contains just one hormone. It is rarely prescribed for adolescents.

  • Advantages:

    • 91% effective at preventing pregnancy.

    • Lighter periods.

    • Less cramps.

    • Improves acne.

    • Reduces the risk of ovarian and endometrial cancers and iron-deficiency anemia.

  • Disadvantages:

    • Serious but rare side effects may include blood clots, stroke, hypertension and migraines.

    • May cause headaches, nausea, or breast tenderness.

    • Must be taken every day at around the same time. This can be hard for some adolescents to remember. The doctor will explain what an adolescent should do if she misses a dose.

    • Do not protect against sexually transmitted infections.

Barrier Methods of Protection

All genders should use barrier methods in addition to one of the methods of protection listed above for all types of sexual activity. Barrier methods help prevent sexually transmitted infections, HIV, and pregnancy. Sexually transmitted infections have been on the rise for people ages 15 to 24 years of age.

External Condom (Male Condom)

  • What It Is: A latex, synthetic, or natural material designed to fit over the penis.

  • Advantages:

    • 82% effective at preventing pregnancy.

    • Available without a prescription.

    • Easy to use.

  • Inexpensive.

    • One of the only methods that protects against STIs.

    • Can be used with other methods for infection protection and added pregnancy prevention.

  • Disadvantages:

    • Needs to be used correctly each time.

    • Can break or slip off during sex.

    • People allergic to latex may have to use polyurethane or polyisoprene condoms.

Internal Condom

  • What It Is: A loose-fitting polyurethane sheath with two flexible rings. One ring fits inside the vagina, anus or mouth. The other fits on the outside.

  • Advantages:

    • 79% effective at preventing pregnancy.

    • Can be used in combination with other methods to protect against infection and provide added pregnancy prevention.

  • Disadvantages:

    • Requires a prescription.

    • Can be difficult to insert.

    • May slip during use.

    • More expensive than external condoms.

Dental Dam

  • What It Is: A latex or synthetic (nitrile or polyurethane) sheet that is a barrier users place over the penis, vulva, vagina, mouth, anus, or any part of the body.

  • Advantages:

    • Available without a prescription.

    • Provides protection from infection during oral sex.

  • Disadvantages:

    • Information about how well it works is not available.

For an Emergency:

  • What It Is: Emergency contraception contains progestin hormones.

  • Advantages:

    • Available without a prescription, even for adolescents.

    • Other emergency contraception options can be prescribed by doctors.

    • It can work for up to 5 days after sex to prevent pregnancy.​

  • Disadvantages:

    • Timing is important. It is more likely to prevent pregnancy if it is taken as soon as possible after sex.

    • It does not prevent sexually transmitted infections.

    • May cause nausea or vomiting

Other Methods:

There are some methods that do not work as well at preventing pregnancy. They also do not protect people from catching sexually transmitted infections.

Withdrawal

  • In this method, the penis is taken out of the vagina before ejaculation.

  • 78% effective at preventing pregnancy.

  • Even if done correctly, the penis releases fluids into the vagina before ejaculation. This fluid contains thousands of sperm, and sometimes viruses or bacteria.

Fertility awareness methods

  • A woman keeps track of her period, takes her temperature each morning, and inspects the color and texture of cervical mucus every day. During the week she has signs of ovulating, she does not have sex.

  • 76% effective at preventing pregnancy.

Spermicide

  • This is a gel, cream, or foam that a woman inserts deep into her vagina before having sex.

  • It can be messy and difficult to use. It can be used with other methods to help prevent pregnancy, but it may increase the risk of HIV infection for those at high risk.

  • 72% effective at preventing pregnancy.

Remember

It may feel awkward to talk with your child about contraception, but it is important part of protecting their health and wellbeing. Your pediatrician is available for support and guidance.

More Information

Last Updated
7/20/2020
Source
American Academy of Pediatrics Committee on Adolescence (Copyright © 2020)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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