4 Essential Questions About Teen Birth Control
By Rachel Kramer, MD, Obstetrician and Gynecologist—Virtua Obstetrics & Gynecology
Q: Is it true that more teenage girls are using birth control today than in the past?
A: Yes, recent studies report that 18 percent of teenage girls (age 13 to 18), or almost 1 in 5, are on the birth control pill. It’s more socially acceptable now than it was years ago to have a frank discussions with moms and daughters about birth control.
Q: What age is the “right age” to start birth control?
A: Age 16 tends to the most common age to start birth control as it allows a young woman to be established in her cycle before potentially disrupting it. Besides the benefit of preventing unwanted pregnancy, hormonal birth control also helps women by regulating periods, reducing ovulation, and possibly reducing the risk of some types of ovarian cancer.
However, the decision to start birth control is an immensely personal one, and something that should be discussed with care between parents, doctors, and the young woman in question. Some girls may be ready at a younger age, while others that are older may not yet have developed to the level of psychological or emotional maturity required to handle the medical regimen.
Q: What methods of birth control are most appropriate for teen girls?
A: The method most often prescribed for teen girls is the birth control pill. Moms often are nervous about their daughters being careful when it comes to the pill. That’s because if you forget to take your daily birth control pill, you can experience more frequent bleeding and can easily become pregnant.
If forgetfulness is an issue for the teen, these options may be better:
Intrauterine device (IUD): And IUD is a type of long-acting reversible contraception (LARC) that, once inserted, protects against pregnancy for 3 to 10 years and offers greater than 99% protection against pregnancy. The progestin-containing IUDs (Skyla and Mirena) last for 3 to 5 years and prevent pregnancy by thickening the cervical mucous so the sperm cannot penetrate; slowing down the sperm's movement in the fallopian tube so the egg and sperm are less likely to meet; thinning the uterine lining to prevent fertilization; and, suppressing ovulation. The copper IUD (Paragard) lasts for about 10 years, but often isn’t recommended for teens. It contains no hormones, but interferes with sperm movement and egg fertilization and possibly prevents implantation.
Implant: The progestin insert (Nexplanon) is a 4 cm rod (matchstick size) that prevents pregnancy using the same strategy as the progestin IUD. It lasts for up to 3 years and provides greater than 99% protection against pregnancy.
Injection: Injectable birth control (Depo-Provera) is given as a shot 4 times a year.
Vaginal ring: A vaginal ring is a small flexible ring (NuvaRing) that gives off hormones that prevent the ovaries from releasing eggs. You leave it in place for 3 weeks and remove it in the 4th week. It’s an option that has the same medical effect as the birth control pill.
To prevent the transmission of sexually transmitted diseases, it’s important to emphasize using condoms, no matter what hormonal birth control is used.
Q: What are the risks and/or long-term effects of birth control?
A: Many of these contraception methods have similar side effects. However, differences include:
Injection (Depo-Provera): Recent studies have shown that taking the birth control shot for longer a time can lead to the bones being leached of calcium, possibly irreversibly. For that reason, patients should plan to use Depo-Provera for no more than 5 years in their entire lifetime. This is be especially useful information for teen girls and their parents making a decision about birth control, as starting earlier and using Depo-Provera will likely necessitate a switch in methods when the girl reaches young adulthood.
LARC: The most common side effect of the progestin IUD is similar to that of the birth control pill—irregular bleeding for the first 3-6 months while the body is getting used to the hormone. Although it’s not usually heavy, it may be persistent, annoying, or last for a prolonged time. Some users of the progestin IUD may not menstruate at all. Rarely, women complain of bloating, weight gain, headaches, or acne.
The copper IUD doesn’t regulate your period because it doesn’t contain hormones. So the most common side effect is a slightly heavier period.
Rarely, an IUD can move outside of the uterine cavity and into the muscle of the uterus or through the uterine muscle into the pelvic cavity, although completely falling out is especially rare (2-10%).
Insert: Patients who have the insert most often complain about an unfavorable change in their bleeding patterns or the same side effects for progestin-containing IUDs (headache, bloating or weight gain, acne, depression).
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Updated February 8, 2021