Birth Control Choices For Teens

July 13, 2011

OBGYN.net Staff

One of the great joys of life can be having a baby-when we are ready and are able to provide all the love and care a child needs. One of the great setbacks in life can be an unintended pregnancy-especially for a young woman.

To choose which birth control method to use, you need to consider how well each one will work for you:

How well will it fit into your lifestyle?
How effective will it be?
How safe will it be?
How affordable will it be?
How reversible will it be?
Will it help protect against sexually transmitted infections?

Having sex is about making choices.

We choose when we are ready and when we want to wait.
We choose our partners.
We choose what we want to do and what we don’t want to do with our partners.
We can choose to do it in the safest way.

Teens who have vaginal intercourse need to make choices about birth control.
One of the great joys of life can be having a baby-when we are ready and are able to provide all the love and care a child needs. One of the great setbacks in life can be an unintended pregnancy-especially for a young woman.

Since 1916, Planned Parenthood has upheld the right to privacy in human relationships. We believe that sexual experience can be a positive source of personal enrichment and satisfaction when it is based on informed choices and mature decisions-whether for pleasure or procreation.

Sex partners should:

Have each others consent.
Be honest with each other.
Treat each other as equals.
Be attentive to each others pleasure.
Protect each other against physical and emotional harm, unintended pregnancy, and sexually transmitted infection.
Accept responsibility for their actions.
Have access to safe and effective means to prevent unintended pregnancy and sexually transmitted infection.

Here is some information to help you choose:

If You Choose

Four Methods NOT Usually Recommended for Teens:

If You Have Unprotected Intercourse You May Want:

If You Choose Continuous Abstinence...... you will not have sex play with a partner. This will keep sperm from joining egg.

Effectiveness	100%
Advantages	No medical or hormonal side effects.
Possible Problems	Difficult for many people to abstain from sex play for long periods.
Cost	None.
Advantage for teens	Sexual relationships present physical and emotional risks. Abstinence is a very good way to postpone taking those risks until women and men are mature enough to handle them.

{return to index}If You Choose Outercourse...

... you will enjoy sex play without vaginal intercourse. This will keep sperm from joining egg.

Outercourse includes:

Masturbation-Masturbation is the most common way we enjoy sex. Partners can enjoy it together while hugging and kissing or watching one another. Masturbating together can deepen a couple's intimacy.
Erotic Massage-Many couples enjoy arousing one another with body massage. They stimulate each other's sex organs with their hands, bodies, or mouths. They take turns bringing each other to orgasm.
Body Rubbing-Many couples rub their bodies together, especially their sex organs, for intense sexual pleasure and orgasm.

Effectiveness	Nearly 100%
Advantages	No medical or hormonal side effects.
Possible Problems	Difficult for many people to abstain from vaginal intercourse for long periods.
Cost	None.
Advantage for teens	Outercourse can give complete satisfaction for both partners and take a lot of pressure off young women and men.
CAUTION	Outercourse is almost the same as foreplay. Both add to sexual excitement and pleasure. The difference is that foreplay is meant to lead to intercourse. Outercourse may also add to a couple's desire to take a risk and have intercourse. Couples who use outercourse for birth control must not give in to that impulse. Be careful, don’t turn outercourse into foreplay unless you are ready to use another form of birth control.

{return to index}If You Choose Norplant®...
... your clinician will put six small capsules under the skin of your upper arm. Capsules constantly release small amounts of progestin, a hormone that:

prevents release of egg
thickens cervical mucus to keep sperm from joining egg.
Removal can be done at any time. Must be done by clinician.

Effectiveness	99.96%
Advantages	Protects against pregnancy for five years.
Possible Problems	Side effects include irregular, late, and absent periods as well as other discomforts, including: headaches, nausea, depression, nervousness, dizziness, and weight gain.
Cost	$500-$600: exam, implants, insertion.
Advantage for teens	Many teen women lead active and unpredictable life styles. They sometimes forget to take the Pill or to make an appointment for an injection. With Norplant®, women can have long-term, reliable protection against pregnancy for five years ¾ without having to remember anything-except to use a condom for protection against sexually transmitted infection.
CONTROVERSY	Although it has not been proven, some scientists believe that prolonged use of Norplant® and other progestin-only implants or injections may decrease bone mass in young women.

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If You Choose Depo-Provera®...... your clinician will give you a shot of the hormone progestin in your arm or buttock every 12 weeks to:

prevent release of egg
thicken cervical mucus to keep sperm from joining egg
prevent fertilized egg from implanting in uterus.

Effectiveness	99.7%
Advantages	Protects against pregnancy for 12 weeks.
Possible Problems	Side effects include irregular, late, and absent periods as well as other discomforts, including: weight gain, headaches, depression, and abdominal pain.
Cost	$30-$75 per injection. May be less at clinics.
Advantage for teens	Injection is one of the most private prescription methods of birth control. No one can tell you're using it. There is no packaging or other evidence of use that might embarrass some users.
CONTROVERSY	Although it has not been proven, some scientists believe that prolonged use of Depo-Provera or other progestin-only implants or injections may decrease bone mass in young women.

{return to index}If You Choose The Pill...... your clinician will prescribe the right Pill for you. Take one Pill once a day. Complete one pill-pack every month. Combination pills contain estrogen and progestin. Mini-pills contain only progestin. Pills contain hormones that work in different ways.

Combination pills prevent release of egg.
Both types thicken cervical mucus to keep sperm from joining egg.
Both types also may prevent fertilized egg from implanting in uterus.

Effectiveness	97% - 99.9%
Advantages	Nothing to put in place before intercourse.
Possible Problems	Must be taken daily
Cost	$15-$25: monthly pill-pack at drugstores. Often less at clinics.
Advantage for teens	The Pill is often appropriate for teens, even if they are not having intercourse, because teen women are more likely than older women to have cramps and irregular periods. Women who remember to take the Pill at the same time every day have fewer cramps and more regular periods than women who don’t take the Pill.
CAUTION	Don’t smoke while you take the Pill. Doing so will increase your risk of heart attack, blood clots, and stroke.

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If You Choose The Condom...
... you will cover the penis before intercourse with a sheath made of thin latex, plastic, or animal tissue to keep sperm from joining egg.

Lubricate condoms with spermicide to immobilize sperm.

Effectiveness	88% - 98%
Advantages	Inexpensive and easy to buy in drugstores, supermarkets, etc.
Possible Problems	Allergies to latex or spermicide.
Cost	25¢ and up: dry.
Advantage for teens	One out of four teens has a sexually transmitted infection. Teens are also likely to have more than one partner during their adolescence, which increases the likelihood of their getting an infection. Latex condoms are the best protection against infection for women and men of all ages who have sexual intercourse. They are also cheap and widely available.
CAUTION	The cervix in pregnant women, young girls, and teen women is especially vulnerable to infection. Even as mature adults, women's sexual anatomy makes them 10 to 20 times more likely than men to become infected with sexually transmitted infections.

{return to index}If You Choose The Diaphragm or Cervical Cap...
... your clinician will fit you with a shallow latex cup (diaphragm) or a thimble-shaped latex cap (cervical cap). Clinician also will show you how to coat diaphragm or cap with spermicide and put it in your vagina to keep sperm from joining egg.

Effectiveness	82% - 94% ¾ diaphragm
Advantages	No medicinal or hormonal side effects.
Possible Problems	Can be messy.
Cost	$13-$25: diaphragm or cap.
Advantage for teens	Many teen women have vaginal intercourse only now and then. Many of them prefer to use the diaphragm or cap on those occasions. That way they avoid the possible, ongoing side effects of other prescription methods.
CAUTION	Prescription methods like the diaphragm, cervical cap, and the Pill are personalized for each woman's use. Do not share them with friends. The diaphragm should be checked to see if it’s the right size after a weight change of 10 or more pounds, childbirth, or abortion. The cervical cap should be checked for size after childbirth.

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If You Choose Over-the Counter Birth Control for Women...... you will follow package instructions and insert vaginal pouch (female condom) or spermicides ¾ contraceptive foam, cream, jelly, film, or suppository ¾ deep into your vagina shortly before intercourse to keep sperm from joining egg. Spermicides immobilize sperm.

Follow package instructions to remove pouch. Spermicides in other methods dissolve in vagina.

Effectiveness	72% - 97% contraceptive foam, creams, jelly, film, or suppository
Advantages	Easy to buy in drugstores, supermarkets, etc.
Possible Problems	Can be messy.
Cost	$2.50: pouch.
Advantage for teens	Many teen women have vaginal intercourse only now and then. Many of them prefer to use over-the-counter methods on those occasions. That way they avoid the possible, ongoing side effects of prescription methods.

Four Methods NOT Usually Recommended for Teens

Sterilization
an operation to keep sperm from joining egg. Tubal sterilization: Intended to permanently block a woman's tubes where sperm join egg.
Vasectomy: Intended to permanently block a man's tubes that carry sperm.

Effectiveness	9.6% - 99.8%.
Reason Not Recommended for teens	This method is intended to be permanent. It is not appropriate for anyone who may want to have a child in the future. Because people so often change their minds about having families, sterilization is usually discouraged for people under 30 who have not had children.

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The IUD (Intrauterine Device)a small plastic device inserted into the uterus. The IUD contains copper or hormones that:

keep sperm from joining egg
prevent fertilized egg from implanting in uterus.

Effectiveness	97.4% - 99.2%.
Reason Not Recommended for teens	Unless she has had a child, a young woman's uterus may be too small to hold an IUD.

{return to index}Withdrawalthe man pulls his penis out of the vagina before he ejaculates (comes) to keep sperm from joining egg.

Effectiveness	81% - 96%.
Reason Not Recommended for teens	Some men lack the experience and self-control to pull out in time.

{return to index}Periodic Abstinence or Fertility Awareness Methods (FAMs)
a professional teaches a woman how to chart her menstrual cycle and to detect certain physical signs that help her predict "unsafe" days. She must abstain from intercourse (periodic abstinence) or use barrier contraceptives during nine or more "unsafe" days of her cycle (Famous).
The physical signs that are charted include:

daily basal body temperature
daily texture of cervical mucus
occurrence of menstrual cycles.

Effectiveness	80% - 99%.
Reason Not Recommended for teens	These methods work best for women with very regular periods.

If you have unprotected vaginal intercourse, you may want... EMERGENCY CONTRACEPTION

Emergency Contraception:

can help prevent pregnancy after unprotected vaginal intercourse.
is available from health care providers, Planned Parenthood health centers, and other women's health and family planning centers.

is provided in two ways:

emergency hormonal contraception ¾ doses of certain birth control pills that are started within three days of unprotected intercourse
insertion of an IUD within 5-7 days of unprotected intercourse.

is for use only if a woman is sure she is not already pregnant. It keeps the egg from joining with the sperm or prevents the egg from implanting in the uterus. It will not cause an abortion.

Effectiveness	A woman's risk of pregnancy varies from day to day during her menstrual cycle. Emergency contraception can reduce that risk:
Possible Problems	Emergency hormonal contraception
You May Want Emergency Contraception If:	His condom broke or slipped off, and he ejaculated inside your vagina.

Contact your health care provider immediately if you have unprotected intercourse when you think you might become pregnant.
For a confidential appointment with the Planned Parenthood health center nearest you, call 1-800-230-PLAN.
To reach the Emergency Contraception Hot Line for information and referrals call 1-888-NOT-2-LATE.

For more information about emergency contraception...

Brochure: Emergency Contraception
Fact Sheet: Emergency Contraception
Fact Sheet: Emergency Hormonal Contraception: A Short History
http://opr/princeton/edu/ec/

References:

For more information about emergency contraception...

Brochure: Emergency Contraception

Fact Sheet: Emergency Contraception

Fact Sheet: Emergency Hormonal Contraception: A Short History

http://opr/princeton/edu/ec/

Text adapted from Birth Control Choices for Teens

Questions? Comments? Contact the national office of the Planned Parenthood Federation of America at communications@ppfa.org