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
Intrauterine Device (IUD)
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
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:
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:
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:
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)
Internal Condom
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:
Disadvantages:
For an Emergency:
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.
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