Best Contraception for Youth

Both married and unmarried young people may become sexually active before they are well versed in the attributes of contraceptives. They often remain unsure about how to avoid unintended pregnancy and prevent sexually transmitted infections (STIs). It is important for parents, pediatricians, educators and other trusted sources of health information to provide needed information about sexual issues, including contraception and STIs, and encourage teens to take responsibility for their own health.

Unintended pregnancies among teens remain high. They result from lack of access, non-use, frequent discontinuation of use, improper use, and the inherent failure rates of various contraceptives. Characteristics of contraceptives most important to teens include being appropriate for those who have infrequent sex; are reluctant to interact with the health care system; want to use contraception discreetly; and have limited resources and/or concerns about cost.

Studies have found that the contraceptive attributes prioritized highly by teens include:

• Few side effects and contraindications
• Are highly effective
• Can be used “on demand”
• Require minimal interaction with the health system
• Offer dual protection from unintended pregnancy and STIs
• Can be used discreetly without the knowledge of partners and others
• Are affordable

Any young person who is sexually active or contemplating becoming sexually active as well as their parents should seek the advice of a pediatrician, ob/gyn physician or other reproductive health professional to get information about contraception and avoidance of STIs. This websites and other sources of sexuality information can provide general background information, but the health and other circumstances of each individual should be considered by a trusted expert advisor prior to the decision to adopt a specific contraceptive method.

When considering which contraceptive methods are most suitable for use by teens. It should be recognized, and all teens should know, that abstaining from sexual intercourse is the most effective way to prevent unintended pregnancy and genital STIs, as well as HIV infection.

Because of the high efficacy in preventing pregnancy and favorable long-term cost-benefit of long-acting reversible contraception (LARC), LARC is usually the best choice for a young person. Available LARC methods include a progestin subdermal implant and various intrauterine devices (IUDs). They all are appropriate for use in the adolescent population and are highly effective in preventing pregnancy with a failure rate of less than 1% during the first year of their use. In addition to being the most effective methods to prevent pregnancy, they may also offer non-contraceptive benefits such as reducing menstrual blood flow and pain (dysmenorrhea).

Among LARCs, the single-rod contraceptive implant (such as Implanon or Nexplanon) has the lowest typical use failure rate at 0.05%. IUDs, both hormonal (levonorgestrel) and non-hormonal (copper), are also highly effective with failure rates of 0.2% and 0.8%, respectively1.

It's important to note that while LARCs are the most effective at preventing pregnancy, they do not protect against sexually transmitted infections (STIs). Teens who use LARCs, or other other contraceptive methods should also use condom or other type of barrier protection during sexual activity to prevent sexually transmitted infections.

Barrier methods include the male condom (now known as the external condom), internal condom (previously known as female condom) and other barrier methods. They are appropriate for use in the adolescent population. When used consistently and correctly, latex and synthetic barrier methods both prevent pregnancy and reduce the risk of many sexually transmitted infections including HIV.

Sexually active teens and adolescents should know about and where to get emergency contraception that is effective in preventing pregnancy if used as soon as possible after unprotected sex, ideally within six hours of intercourse for hormonal methods and within 5 days for IUD placement. Emergency contraception will not disrupt an established pregnancy.

The following website provides information on the pros and cons of each method of contraception including implants, IUDs, pills, patches, rings, injections, spermicides, fertility awareness (natural birth control) and emergency contraception:
Contraception Explained: Birth Control Options for Teens & Adolescents By: Mary A. Ott, MD, MA, FAAP & Elizabeth Alderman, MD, FAAP. https://www.healthychildren.org/English/ages-stages/teen/dating-sex/Pages/Birth-Control-for-Sexually-Active-Teens.aspx

In addition to providing sexuality education and prescribing contraception to prevent pregnancy and STIs, a young person’s health provider may also recommend hormonal contraceptives or IUDs for treatment of medical conditions. Common conditions treated with hormonal contraceptives include heavy menstrual bleeding, painful periods, iron deficiency anemia, irregular menstrual bleeding, polycystic ovarian syndrome, and acne. A health provider may recommend a hormonal IUDs or implants for heavy or painful periods or to stop periods.

Ultimately, the best contraceptive for a teenager depends on individual factors, including medical history, personal preferences, and ability to access and use the method consistently. Inconsistent use is a leading reason teens experience contraceptive failure and unintended pregnancy. A healthcare provider should always be consulted to help adolescents make an informed decision about contraception based on their specific needs and circumstances.

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