JAN RYDFORS MD FACOG, ARON SCHUFTAN MD FACOG

401 Warren st.. Suite # 300, Redwood City, CA 94063 - 650.701.1882 - www.rwcdocs.com

Contraception for teens

What is contraception?

• Contraception is a way to prevent pregnancy by not allowing the sperm and egg to meet (fertilization) or to attach to the lining in the uterus (implantation).
• Contraception can be a behavior — not having sexual intercourse at all (abstinence) or having sex only at the time of the month when a woman is very unlikely to become pregnant (periodic abstinence).
• Contraception can be a barrier device — condom (male or female), diaphragm or sponge.
• Contraception can be a form of medication that is swallowed (birth control pills, or the "pill"), injected (hormone injections or "the shot"), or surgically placed under the skin. These are all types of hormonal contraception.

Who should use contraception?

• Anyone who is having sexual intercourse and does not want to become pregnant or cause a pregnancy should use some form of contraception. If condoms or other barrier methods are used, they need to be used every time a person has intercourse.
• Anyone who is having any sexual contact (not just intercourse) and wants to avoid getting a sexually transmitted disease (STD) should use a form of protection or contraception that helps prevent contact of bodily fluids (male or female latex condoms).

What are the health benefits of contraception?

• For adolescents who are having close sexual contact, contraception greatly reduces the risk of pregnancy and one method — the latex condom — prevents the spread of human immunodeficiency virus (HIV) and can reduce the risks of other STDs, including chlamydia, gonorrhea and trichomonas. They also can reduce the risk of genital herpes, syphilis, chancroid and human papillomavirus (HPV) infection, when the infected areas are covered or protected by the condom.
• Use of contraception gives a message that the couple cares about each other's health.
• Use of contraception gives a message that the teen is willing to be responsible for her or his behavior and actions.
• For young women, hormonal contraception may decrease menstrual cramping, acne and oily skin or hair. It also helps to prevent some cancers that are specific to women. The pill keeps bones stronger by improving the deposit of calcium in bones.

Do contraceptives have any dangerous side effects?

• Abstinence is always safe.
• Latex condoms do not pose health risks unless a person has an allergy to latex.
• Hormonal contraception (the pill, the shot) is safe for most young women but only can be given out by a health professional.
• Some forms of contraception may not be safe for persons with certain chronic diseases or medical conditions. A health professional always should be asked about the risks or safety of each method talked about.

Where can teens get contraception?

• Abstinence is available to everyone. It requires determination, cooperation of your partner, and some practice in finding other ways to share your feelings. Teens may need to practice saying "No, thank you" or "Not now."
• In almost all states, teens do not need their parents' permission to get any type of contraception from a store, health facility or health professional. But, if possible, teens should involve their parents in this decision.
• Condoms are available in drug stores, food stores, discount department stores, family planning centers, STD clinics, teen clinics and some schools. It is important to use a new, unused condom every time sex occurs.
• Hormonal contraceptives must be prescribed, injected or inserted by a health professional in a doctor's office, family planning center or teen clinic. Often, but not always, the young woman will have a pelvic examination and Pap test done before the method is prescribed. If the teen has already had sexual intercourse, she might need to be checked for pregnancy and STD infections.
• Some clinics are free and some charge money. There should be a plan for how the method will be paid for, how the health professional can be contacted with any questions or concerns, and how the professional can contact the teen with any test results.

What type of contraception is best for teens?

• Abstinence is the safest and most effective way to prevent pregnancy and STDs.
• The next best approach is to use the combination of a hormonal method (the shot, the monthly vaginal ring, a weekly contraceptive skin patch, or the pill taken correctly every day) and a latex condom every time there is sexual intercourse.
• If the method fails, no method was used, or sex was forced, emergency contraception can be used up to 72 hours after the occurrence.

What is emergency contraception?

• Emergency contraception can prevent pregnancy after unprotected intercourse.
• Using certain oral contraceptive pills, Plan B ®, or Preven ®, within 72 hours offer this protection.
• It can be used when no other method of contraception has been used; when another contraception method has not worked, for example, when a condom breaks during sex; or when sex was forced.

What types of contraception are less useful for most teenagers?

• Withdrawal (taking the penis out of the vagina before ejaculation) does not work well — orgasm and ejaculation are not easy to control once they begin and a small amount of fluid containing a lot of sperm may be released before anyone realizes it. However, it is still better than using no method at all.
• Periodic abstinence (when a couple refrains from sex at certain times during each month) doesn't work as well as other methods of contraception. Again, it is still better than using no method at all.
• Spermicidal suppositories, foams and creams, and the sponge used alone may not be enough. These methods work better with a condom.
• The intrauterine device (IUD), a device inserted into the uterus to prevent pregnancy, usually is not recommended for young women.

(Adapted from the American College of Obstetricians and Gynecologists handout)