Adolescent Contraception

Pediatric-adolescent gynecologists specialize in diagnosing and treating conditions of the reproductive organs for girls and teens up to age 18. At UT Southwestern Medical Center, our gynecology specialists also provide counseling and options for teens considering contraception.

Counseling and Options for Adolescent Contraception

Adolescent contraception is a crucial topic related to the health and well-being of young people. While teen pregnancy is on the decline, according to the Centers for Disease Control and Prevention (CDC), the U.S. teen pregnancy rate is higher than in other developed countries. The rates of sexually transmitted diseases (STDs) in teens have gradually increased after reaching historic lows around the year 2000. Half of the 20 million new STDs reported each year are among young people between ages 15 and 24.

It’s important for teens to understand and use appropriate contraceptive methods to prevent pregnancy and STDs, as they both can have life-changing effects on teens’ lives. Teen pregnancy can have physical, mental, and socioeconomic consequences for mother and child, and STDs can lead to health complications such as infertility and increased risk of HIV infection.

Our pediatricians and pediatric-adolescent gynecologists provide age-appropriate counseling to teens about sexual behavior and methods to prevent pregnancy and STDs. Our physicians and nurses also offer guidance to parents about speaking with their teens on these topics. We have experience in counseling for safe-sex practices, including abstinence, as well as extensive knowledge about the latest contraceptive methods.

Contraceptive Options for Teens

In addition to counseling about abstinence and contraception, our specialists discuss various birth control options to help teens (and, as appropriate, their parents) choose options that meet each individual’s needs. Our physicians can recommend or prescribe effective birth control methods such as:

Abstinence

Not having sex is completely effective in preventing pregnancy and protecting against most types of STDs. Some STDs, such as herpes and human papillomavirus (HPV), can be transmitted through skin-to-skin contact that does not involve sex.

Barrier Methods

To increase effectiveness of contraception, people should use barrier methods each time they have sex. Some types can be used in combination with other methods.

• Male condom: A thin sheath of latex slips over the penis to prevent semen from entering the vagina. Male condoms, which require no prescription, reduce the risk of pregnancy and STDs.
• Female condom: A pouch fits inside the vagina to prevent semen from entering the vagina. Female condoms require no prescription, can be used in combination with other methods, and help protect against pregnancy and STDs.
• Spermicide: These products, available over the counter, come in cream, film, foam, gel, suppository, or tablet forms that are inserted into the vagina before sex to kill sperm. Spermicides can be used alone or with other barrier methods.
• Diaphragm and cervical cap: These devices, typically used with spermicide to kill sperm, cover the cervix to block semen. They don’t require a prescription, but patients should see their doctor to be fitted with the correct size.
• Sponge: This over-the-counter device contains spermicide and fits over the cervix to block and kill sperm.

Short-Acting Hormonal Methods

These contraceptive methods for women use female hormones, either progestin alone or progestin combined with estrogen, to prevent pregnancy by stopping ovulation. Hormonal birth control methods do not protect against STDs and require a doctor’s prescription.

• Pills: This oral method must be taken at the same time daily.
• Patch: Women apply one patch per week on their skin for three consecutive weeks. Not wearing the patch for the fourth week allows a menstrual period during that week.
• Injection: Women see their doctors to receive this injection every three months.
• Vaginal ring: Women place the ring inside the vagina for three weeks, then take it out for the fourth week for a menstrual period.

Long-Acting Reversible Contraceptives (LARCs)

These contraceptive methods for women are effective from three up to 10 years, depending on the type. LARCs do not protect against STDs and require a doctor’s prescription.

• Implant: This method is a thin rod about the size of a matchstick that a doctor inserts under the skin of a woman’s upper arm. The implant releases progestin gradually over three years to prevent pregnancy.
• Levonorgestrel intrauterine device (IUD): Doctors place a small T-shaped device through the cervix into a woman’s uterus. This type of IUD slowly releases progestin over five years to prevent pregnancy.
• Copper IUD: A copper IUD releases small amounts of copper over 10 years to prevent pregnancy.

Emergency Contraception

Emergency contraceptive pills, sometimes called morning-after pills, can prevent pregnancy if taken soon after unprotected or under-protected sex – for example, if a condom breaks. Depending on the type of pills, they can be taken up to three to five days after unprotected sex. If a woman is already pregnant, the pills do not stop or harm the pregnancy. Some types of emergency contraceptive pills are available without a prescription.

Other Medical Uses of Contraceptive Pills

In addition to their use as birth control, contraceptive pills can help treat certain health conditions. We prescribe birth control pills for teens who have:

• Endometriosis: Pills can help relieve pelvic pain by reducing or stopping menstrual periods.
• Iron-deficiency anemia: By lightening menstrual bleeding, pills can help treat or reduce the risk of iron-deficiency anemia, which reduces iron levels in the blood. Low iron levels prevent the body from producing enough hemoglobin, a protein in red blood cells that carries oxygen to the body. Iron-deficiency anemia can lead to problems affecting the heart, growth, and development.
• Ovarian cysts: Pills can help prevent ovarian cysts from developing or coming back, because the pills stop ovulation. However, pills cannot treat existing cysts.
• Painful periods and heavy bleeding: Pills can help control menstrual periods to make periods shorter and reduce the amount of blood loss.
• Polycystic ovary syndrome (PCOS): This hormonal disorder can cause problems with the ovaries, elevated levels of male hormones (androgens), and irregular menstrual periods. Pills help balance hormone levels and regulate periods.
• Premenstrual syndrome (PMS): By balancing hormone levels, pills can relieve symptoms such as acne, bloating, breast soreness, cramps, mood swings, and weight gain.
• Severe acne: Certain types of birth control pills help reduce androgen levels, which can be a cause of severe acne. Pills are typically used if other acne treatments have not been successful.

Confidentiality

Anything that patients (either adults or teens) tell their health care providers is, by law, confidential unless the doctor believes the patient:

• Is a danger to herself or others
• Cannot make decisions on her own

However, it is important for teens and their parents to have an open line of communication between them so they can discuss any health concerns or other worries. Teens need to know their parents will be there to protect and support them.

Clinical Trials

We are active in clinical research to improve understanding and treatment of conditions that affect children. We are currently conducting research related to transgender youth as well as ovarian cysts/masses in adolescents. For more information about clinical trials, please talk to our doctors.