Many parents might not want to acknowledge it, but a lot of teenagers are having sex. A new study has identified the most effective contraception for adolescents who can't or won't delay sexual activity.
Long-acting reversible contraception (LARC), which includes progestin implants and intrauterine devices (IUDs), according to research in the journal Pediatrics, should be the first choice for teenage birth control.
The American Academy of Pediatrics (AAP) supported this conclusion. A technical report that accompanied the Pediatrics study depicted that LARCs were effective, safe and easy to use.
A story on MedPageToday.com, deemed the report an update of AAP guidelines from 2007, when the use of latex condoms was encouraged as the only specified form of birth control.
But the recommendations aren’t exactly new: In 2012, the American Congress of Obstetricians and Gynecologists (then called the American College of Obstetricians and Gynecologists), or ACOG, said that contraceptive implants and IUDs offered the best protection against unintended pregnancy in adolescents.
In 2009 only 4.5 in 100 sexually active, 15- to 19-year-olds used LARCs. The most popular contraception among teenagers was condoms — 95 in 100 sexually active kids used them, but 55 in 100 also had used oral contraceptives.
Of course, oral contraceptives aren’t effective if they’re not used exactly as intended, and if there’s any group of people who are likely to forget to take a daily pill, it’s adolescents.
An unsettling 57 in 100 female adolescents had used the withdrawal method for birth control, which, according to MedPage, has more than a 1 in 5 rate of failure rate among all users.
The Pediatrics researchers made clear that the easiest, most long-lasting form of contraception was best for adolescents. "The most effective methods rely the least on individual adherence," according to an AAP statement by the authors of the study. "For these methods, typical use effectiveness approaches perfect use effectiveness."
After one year of use, the number of unintended pregnancies among women who used progestin implants was less than 1 in 100, as it was among those use used a levonorgestrel or copper IUD.
Single-rod progestin implants are inserted into the inside of the upper arm, and are effective for three years. They contain a hormone that prevents ovulation and makes the uterine environment less hospitable to sperm and eggs.
IUD technology has a come a long way since the Dalkon Shield scare of several decades ago. That device promoted bacterial infections because of its porous design and string configuration, shortcomings that have been addressed.
IUDs, some of which remain effective for as long as 10 years, have a good safety profile, but they’re more likely to be expelled by adolescents than by older women. And many young women who have not borne children report moderate to severe pain when the IUDs are inserted.