Progestin-only pills: Progestin only pills work by thickening cervical mucus. Failure rates are elevated, due to the need for strict, timed dosing schedule. They provide an option for the patient who has concerns with estrogen use.
Male condom use: Condoms remain a cheap, easily accessible form of contraception, used by 53% of female and 75% of male adolescents studied. With an 18% failure rate with typical use when used alone, condom use should be additional to another effective hormonal or long-acting contraceptive.
Emergency contraception: Various hormonal options can be used up to 5 days after unprotected intercourse. Plan B One-Step is a nonprescription form available for all women of childbearing potential.
Withdrawal: 57% of female adolescents report using this method. A 22% failure rate and lack of STI protection is important to relay to the patient and more effective contraception methods should be encouraged.
The Bottom Line
The IUD and implant should be considered safe, first-line contraceptive choices for adolescents. Physicians should counsel adolescent patients on all available methods of contraception in a developmentally appropriate, confidential manner that falls within the limits of state and federal law. Condoms should always be encouraged for STI protection.
Reference: Contraception for Adolescents. Pediatrics 2014;134:e1244-e56
Dr. Skolnik is associate director of the family medicine residency program at Abington Memorial Hospital and professor of family and community medicine at Temple University in Philadelphia. Dr. Roesing is an assistant director in the Family Medicine Residency Program at Abington Memorial Hospital.