This committee opinion is an excellent resource for clinicians taking care of adolescents. It succinctly and comprehensively provides the evidence to show that long acting reversible contraceptives (IUD and implant) should be offered as first line methods to adolescents.
In 2008, twice as many teenagers in the United States became pregnant, compared with Sweden. Birth control pills and condoms are the most popular forms of contraceptives used by teens in the United States, and have higher failure rates compared with LARC methods and high discontinuation rates. While the uptake of LARC nationally has been low in the adolescent population, data from the contraceptive CHOICE study found that with appropriate counseling, and no financial, logistical, provider or other barriers to use, over 40% of females aged 14-17 years chose the implant and over 40% of those aged 18-20 years chose an IUD. The study is a prospective cohort of more than 9,000 women aged 14-45 years who desired contraception, and after enrolling in the study were given comprehensive contraceptive counseling and their choice of contraception free of cost for a specified duration, after enrollment.
Another study of teens attending a family planning clinic showed that more than half had not heard of intrauterine contraceptives and when counseled appropriately by health care providers, they were three times more likely to be interested in using it.
LARC methods have both contraceptive and noncontraceptive benefits. There are few absolute contraindications to using LARC methods, and increasing their use has the potential to reduce unintended pregnancy in the U.S. adolescent population with appropriate counseling and in the absence of financial, logistical, provider or other barriers.
Dr. Rameet H. Singh, assistant professor of obstetrics and gynecology at the University of New Mexico, Albuquerque. Dr. Singh said she had no relevant financial disclosures.
