Long-Acting Reversible Contraceptives for Adolescents
Dr. Anne-Marie Amies Oelschlager, adolescent medicine specialist and gynecologist at Seattle Children's, provides an overview of the advantages and disadvantages of different long-acting reversible contraceptives for use by adolescents.
Approximately 29% of ninth graders and 62% of twelfth graders have engaged in intercourse, according to the Centers for Disease Control and Prevention (CDC).
In this context, Dr. Anne-Marie Amies Oelschlager, director of pediatric and adolescent gynecology at Seattle Children’s and the University of Washington, emphasizes the importance of private, confidential conversations between pediatricians and their adolescent patients to screen for sexual activity.
Among all contraceptive methods, Amies Oelschlager recommends long-acting reversible contraceptives for adolescents because they have the highest efficacy of any birth control method and the adolescent does not have to remember to take any medication for these methods to be effective.
Other methods require the adolescent to remember to use them and may have greater systemic side effects. For this reason, adolescents who take oral contraceptives are 55% more likely to have a contraceptive failure compared to adults. Also, adolescents are more likely to cease using a contraceptive. Within a year of starting oral contraceptives, the patch, Depo Provera, or the Nuva Ring, only 18.5% will continue the contraceptive.
Long-acting reversible contraceptives
The failure rate of long-acting reversible contraceptives is less than 1%. The three most common are the intrauterine device (IUD) Levonorgestrel IUS (Mirena), the etonorgestrel implant Implanon and the copper T IUD.
Using long-acting reversible contraceptives does not increase the chance of infertility. Once removed, fertility returns quickly. The biggest risk factor for infertility is the acquisition of chlamydia or gonorrhea. For this reason, all adolescents should continue to use condoms and have regular testing to decrease the likelihood of acquisition and reduce the risk of complications from sexually transmitted infections.
Patients may be referred to Seattle Children’s Adolescent Gynecology Clinic for placement of long-acting reversible contraceptives. To learn how to make a referral via phone, fax or online, please see our referral information page. For questions, contact the Adolescent Gynecology Clinic at 206-987-2028.
Advantages and disadvantages
Download a table (PDF) outlining the advantages and disadvantages of long-acting reversible contraceptives.
Videos
If parents of your patients have questions about contraceptives, you can recommend these YouTube videos featuring Dr. Anne-Marie Amies Oelschlager:
References
- American College of Obstetricians and Gynecologists. Intrauterine Device and Adolescents. Obstetrics & Gynecology. 2007;110(6):1493-1495.
- Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance – United States, 2009. Surveillance Summaries, June 4. MMWR 2010;59(No. SS-5).
- Eaton DK, Kann L, Kinchen S, Ross J, Hawkins J, Harris WA, et al. Youth risk behavior surveillance—United States, 2005. MMWR Surveill Summ 2006;55(5):1–108.
- Raine TR, Foster-Rosales A, Upadhyay UD, Boyer CB, Brown BA, Sokoloff A et al. One-year contraceptive continuation and pregnancy in adolescent girls and women initiating hormonal contraceptives. Obstetrics & Gynecology. 2011;117(2)Part 1;363-371
- National Surveys of Family Growth. 1970, 1975, 1985, 1988 and 1995.
Seattle Children’s Hospital to Provide 24/7 Pediatric Hospitalist Services at Providence St. Peter Hospital
Six newly hired Seattle Children’s hospitalists started working at Providence St. Peter Hospital on April 1.
In addition to caring for children in the pediatric unit, Children’s pediatric hospitalists will attend at high-risk deliveries, as well as care for healthy newborns and infants in the special care nursery. They will also provide onsite emergency department consultations and be available for telephone consultations with community healthcare providers.
Children’s hospitalists will work closely with community pediatricians and the Providence Family Practice Residency Program to ensure care is well coordinated between local physicians and the hospital.
Providence St. Peter Hospital recently remodeled its pediatric unit and special care nursery in 2007 and 2008, respectively, with $3 million in funds, part of a larger gift to the hospital from the estate of Bill Jones. Jones, a successful businessman and the founder of Yard Birds in Centralia and Sea Mart in Olympia, left the bulk of his estate to the Providence St. Peter Foundation to aid in the care of children. Both of the new units feature modern design elements to accommodate clinical care and efficiency as well as patient and family comfort.
Providence St. Peter Hospital is the fourth regional hospital to join the Seattle Children’s Hospitalist program. Additional participants include Evergreen Hospital in Kirkland, Providence Regional Medical Center in Everett and Skagit Valley Hospital in Skagit Valley.
CME: One-Day PALS Provider Course for Physicians and Advanced Practitioners
The next PALS course will be offered on Saturday, June 23 from 8 a.m. to 6:10 p.m. at Seattle Children’s 70th and Sand Point Way building. This course is a compressed version of the American Heart Association PALS course that honors your knowledge and experience and provides you with the tools to assess, identify and intervene for infants and children experiencing respiratory failure, shock and cardiac rhythm disturbances.
For more information and to register, visit the PALS site. Contact the PALS office at 206-987-6772 for more information on Continuing Medical Education (CME) Category I hours.
Bellevue CME: The State of Autism: 2012
Dr. Chuck Cowan, medical director of Seattle Children’s Autism Center, will lead a discussion on the current state of autism at Seattle Children’s Bellevue Clinic and Surgery Center. Category II CME credit is available. Breakfast will be served.
Date: Wednesday, May 23
Time: 7:30 to 8:30 a.m.
Location: Seattle Children’s Bellevue Clinic and Surgery Center, 2nd floor conference room
1500 116th Ave. NE
Bellevue, WA 98004
Space is limited. Please RSVP by May 16 by calling 206-987-5765 or emailing Megan Modun.
New Medical Staff and Allied Health Professionals, May 2012
Medical Staff
Fadi Aljabi, MD, Good Samaritan In-Home Services, Hospital Medicine
Marilyn Berko, MD, Providence St. Peter Hospital, Hospital Medicine
Dina Deliyanides, DO, Providence St. Peter Hospital, Hospital Medicine
Emma Germann, MD, Providence St. Peter Hospital, Hospital Medicine
Megan Hubbard, MD, Group Health – Olympia Medical Center, Hospital Medicine
Hilary Mead, PhD, Seattle Children's Bellevue, Psychiatry and Behavioral Medicine
Jenny Ringnes, MD, Seattle Children's, Hospital Medicine
Sandra Sjoberg, MD, Pediatric Associates – Factoria, Pediatrics
Akane Tanaka, MD, Richmond Pediatric Clinic, Pediatrics
Allied Health Professionals
Yingxuan Law, ARNP, Seattle Children's, Psychiatry and Behavioral Medicine
Florence Smith, ARNP, Seattle Children's, Psychiatry and Behavioral Medicine
Katherine Steffl, ARNP, Seattle Children's, Developmental Medicine