ADOLESCENT CONTRACEPTION

It is important to initiate discussions about contraception prior to sexual activity beginning. It must be discussed privately and confidentially. The goals of contraception discussions are to prevent sexually transmitted diseases (STDs), prevent pregnancy, and promote sexual education and healthy choices.

Failure to receive contraception advice is secondary to embarrassment, fear of parents finding out, feelings of invincibility, and lack of knowledge of how to get access for care.

Some important statistics:

1. 35% of teenagers do not use contraception during their first sexual encounter

2. 20% of teenager pregnancies occur within the first month of beginning sexual activity and 50% within 6 months.

1. Male condoms

a. Will prevent STDs

b. Inexpensive, can be purchased over the counter, can be bought by minors

c. Easily transported

d. Must be sure are used properly and female use of spermicide improves effectiveness

2. Female Condoms

a. Can be inserted 8 hour prior to intercourse

b. Should be used with spermicide

c. Many adolescents do not like to use and are embarrassed to purchase them

d. Some protection against STDs

3. Oral Contraceptive Pills (OCPs)

a. Usually contain Estrogen and/or progestins

b. Very effective but teenagers often fail to be compliant

c. Will have "regularity" and may help acne

d. Must be aware of side effects and contraindications.

e. Pelvic examination is not necessary prior to initiating

f. Must be used with a condom to prevent STDs

4. Depo- Provera

a. Long acting progestin that can be used every 12 weeks

b. Periods may be irregular and associated with weight gain and bloating

c. IM injection

d. Must use with condoms to prevent STDs

5. Norplant

a. May provide contraception for up to 5 years.

b. Must be placed and removed by professional and initial cost may be expensive.

6. Hormonal Patches

a. Patches are placed weekly for three weeks and none for the fourth week. Seem to be more compliance than with OCPs

b. Use with condoms to prevent STDs

7. Emergency Contraceptive Pills

a. Useful within 72 hours of unprotected intercourse to prevent pregnancy. Should be used only after negative pregnancy test and repeated three weeks later to discover any failures.

8. Intrauterine Devices (IUDs)

a. Not usually recommended for nullparous women

b. No protection against STDs

9. Diaphragm and Cervical Cap

a. Unpopular with teenagers

b. Require some skill for use

c. Require seeing professional to be fitted

d. Must use with spermicide and condom

1. American Academy of Pediatrics. Contraception and Adolescents. Vol 104 No. 5 November 1999

2. Greydanus D. Patel D. and Rimza E. Contraception and the Adolescent: An Update. Pediatrics Vol 107 No.3 March 2001

3. Rimza E. Counseling the Adolescent About Contraception. Pediatrics in Review. May 2003

4. AAP Committee on Adolescence.  Contraception and Adolescents.  Pediatrics Nov 2007