This article provides information about both over-the-counter and prescription forms of birth control. Many parents don't feel comfortable having sexually blunt conversations or discussing contraception with their teen. If you are nodding your head in recognition, call your child's pediatrician. He or she regularly counsels young patients about sexual behavior, birth-control methods, and techniques for preventing sexually transmitted diseases (STDs). Many times, your child's pediatrician can provide or prescribe a suitable form of contraception right there in the office, or provide a referral to an appropriate facility in your community.
Effective Methods of Birth Control for Sexually Active Teens
Contraceptive Implant (Implanon or Nexplanon)
Less than 1 in every 100 women using this method will get pregnant within the first year. (Typical use failure rate: 0.05%).
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What It Is: A thin, flexible plastic implant (about the size of a matchstick) that contains a hormone and is placed under the skin of the upper arm. The Implant does not provide protection from STDs, so it is still important to use condoms.
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Advantages:
- Provides safe and very effective long-term birth control.
- Teens 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 years.
- Contains a progestin hormone that prevents the ovary from releasing an egg.
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Disadvantages:
- May have irregular bleeding.
- Less common side effects include weight gain, headaches, and acne.
Intrauterine Device (IUD)
Less than 1 in every 100 women using this method will get pregnant within the first year. (Typical use failure rate: 0.2-0.8%).
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What It Is: A doctor inserts the small, flexible, T-shaped birth control device into the uterus. The IUD does not provide protection from STDs, so it is still important to use condoms. There are two types:
- Copper T IUD (Paraguard): Does not contain hormones and does not need to be replaced for 10 years.
- Levonorgestrel IUD (Mirena, Skyla): Contains a hormone; does not need to be replaced for 3 to 5 years.
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Advantages:
- Provides safe and very effective long-term birth control.
- Teens don't have to remember to do anything every day, week, or month to stay protected from unintended pregnancy.
- Options for both hormonal and non-hormonal types of IUD.
- May have less cramping and lighter periods with the levonorgestrel IUD (many teens stop having periods over time)
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Disadvantages:
- May have pain or cramping for a short time after insertion
- Levonorgestrel IUD: May have irregular bleeding or spotting (usually improves with time)
- Copper T IUD: May have increased menstrual cramping, spotting, and heavier bleeding (usually improve with time)
Progestin Injection (Depo-Provera)
Six in every 100 women using this method will get pregnant within the first year with typical use. (Typical use failure rate: 6%).
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What It Is: A shot containing a hormone that prevents the ovaries from releasing an egg. It lasts for 3 months. The injection does not provide protection from STDs, so it is still important to use condoms.
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Advantages:
- 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).
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Disadvantages:
- May have weight gain.
- May have irregular bleeding or light spotting (may improve with time).
- Once the hormone is discontinued, fertility may take up to two years to return to normal (usually within one year).
- Could interfere with normal increases in bone density, but this is usually restored after it is discontinued.
- May increase the risk of blood clots.
Contraceptive Vaginal Ring (NuvaRing)
Nine in every 100 women using this method will get pregnant within the first year of typical use. (Typical use failure rate: 9%).
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What It Is: You place the ring in your vagina once a month. It has hormones that prevent the ovaries from releasing an egg. The ring is in place for 3 weeks, and then removed for 1 week (during that week the user gets a period). The ring does not provide protection from STDs, so it is still important to use condoms.
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Advantages:
- May have lighter periods.
- May have less cramps.
- Acne may improve.
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Disadvantages:
- Can be hard for some teens to remember to replace the ring each month.
- May have headaches, nausea, vaginal discharge, or breast tenderness.
- May increase the risk of blood clots.
Contraceptive Patch (Ortho Evra)
Nine in every 100 women using this method will get pregnant within the first year of typical use. (Typical use failure rate: 9%).
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What It Is: The patch contains hormones that are absorbed through the skin and prevent the ovaries from releasing an egg. It needs to be replaced once a week for three weeks; then it is removed for a week (during that week the user gets a period). The patch doesn't provide protection from STDs, so it is still important to use condoms
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Advantages:
- May have lighter periods.
- May have less cramps.
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Acne may improve.
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Disadvantages:
- Some teens have trouble remembering to change the patch each week.
- May increase the risk of blood clots.
- It is visible to other people if not hidden under clothes, which may bother some teens.
- May have headaches, nausea, skin irritation, or breast tenderness.
Birth-Control Pills
Nine in every 100 women using this method will get pregnant within the first year of typical use. (Typical use failure rate: 9%).
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What It Is: There are two types: The combination pill contains estrogen and progesterone, the two female sex hormones that control the menstrual cycle. The progestin-only pill, rarely prescribed for teenagers, contains just progesterone. The doctor will explain what the teen should do if she misses a dose. The pill does not provide protection from STDs, so it is still important to use condoms.
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Advantages:
- May have lighter periods.
- May have less cramps.
- Acne may improve.
- Reduced risks of ovarian and endometrial cancers and iron-deficiency anemia.
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Disadvantages:
- Serious side effects, though rare, include blood clots, stroke, hypertension, migraine headaches.
- May have headaches, nausea, or breast tenderness.
- Must be taken consistently every day, which can be hard to remember for some teens.
Male Condom
Eighteen in every 100 women using condoms alone will get pregnant within the first year of typical use. (Typical use failure rate: 18%).
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What It Is: A thin sheath of rubber that slips over the penis. Condoms provide a barrier that prevents pregnancy and STDs by keeping semen from entering the vagina.
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Advantages:
- Available without a prescription.
- Easy to use.
- Inexpensive.
- One of the only methods that protects against STDs.
- Great to use in combination with another method for STD protection and additional pregnancy prevention.
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Disadvantages:
- Needs to be used correctly each time.
- Can break or slip off during sex.
- Some people are allergic to latex (they can use polyurethane or polyisoprene condoms).
Female Condom (Vaginal Pouch)
Twenty-one in every 100 women using condoms alone will get pregnant within the first year of typical use. (Typical use failure rate: 21%)
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What It Is: A pouch with two flexible rings, one fitting inside the vagina and the other on the outside. When it is inserted into the vagina, the closed end shields the cervix, the sheath lines the vaginal walls, and the ringed open end hangs outside the vagina to cover the labia.
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Advantages:
- Available without a prescription.
- The only female contraceptive that defends against STDs.
- Can be used in combination with another method for STD protection and additional pregnancy prevention.
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Disadvantages:
- Can be difficult to insert.
- May slip during intercourse.
- More expensive than the male condom.
For An Emergency:
Sometimes condoms break, or teens may forget to use their method properly. Emergency contraception is an option for teens. Plan B One-Step® and other similar store-brand pills contain progestin hormones. They are available over-the-counter, even for teens. Doctors can prescribe other types of emergency contraception. Emergency contraception can work for up to 5 days after sex, but the sooner it is used the better it works.
Other Methods:
There are some methods that are less effective and not recommended as primary birth control methods for teens.
Withdrawal
- In this method, the penis is taken out of the vagina before ejaculation.
- 22 women out of 100 using this method will get pregnant within 1 year, and this can be much higher for teens. Even if done correctly (which can be difficult), the penis releases fluids into the vagina before ejaculation, which contain thousands of sperm, and sometimes viruses or bacteria.
Fertility awareness methods (like the Rhythm method)
- In this method, a woman has to track her periods, take her temperature each morning, and inspect the color and texture of her cervical mucus every day. She also does not have sex for about a week around the time of her ovulation each month. This requires a level of diligence that is very difficult even for some adults.
- Twenty-four out of 100 women using this method will get pregnant within the first year, but this can be much higher for teens.
Spermicide
- This is a gel, cream, or foam that a woman inserts deep into her vagina before having sex.
- Twenty-eight out of 100 women who use spermicide alone for birth control will get pregnant within the first year, so it has a high failure rate. It can also be messy and difficult to use. While it can be used with other methods to increase the protection against unintended pregnancy, it may increase the risk of HIV infection for those at high risk.
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