Contraception: What Teen Girls Need To Know

McKenzie Pediatrics, P.C. 2009

What are my chances of getting pregnant without contraception?

Pretty good. Almost half of teen girls not using contraception become pregnant within the first six months of having vaginal intercourse, and 85 percent within the first year! And you can get pregnant with your first intercourse, despite what some of your friends might say. There is no absolutely safe time of the month to have sex without contraception.

What are the risks of early sexual activity?

Teens who begin sexual activity in early (age 10 to 13 years) or middle (14 to 16 years) adolescence are more likely not to use contraception, and therefore more likely to become pregnant, and more likely to become infected with a sexually transmitted infection (STI). Early sexual activity is also associated with a higher likelihood of being abused by a partner, and with a higher chance of using drugs or alcohol.

When should I be thinking about starting contraception?

Before thinking about having vaginal intercourse, of course! Unfortunately, by the time most teenagers seek contraceptive counseling from their doctor, they have been sexually active for at least 6 to 12 months. If they are not pregnant or have not yet become infected, they are very lucky.

Of course, the best and safest way to avoid becoming pregnant or becoming infected with a sexually transmitted disease is to not to engage in any sort of sexual activity until you are older and more ready. Not only does this mean avoiding vaginal intercourse, but avoiding oral and anal sex. While neither oral nor anal sex leads to pregnancy, both can easily lead to STIs.

Does contraception really work? Doesn�t it fail a lot?

Oral contraceptive pills (OCPs) are 99.7% effective at preventing pregnancy when taken as directed. So, yes, they really work, but they are not foolproof. They fail 3 to prevent pregnancy 3 times out of 1000, even when taken faithfully. And they do not prevent STIs.

Which is why a back-up method is very important, such as the use of male condoms. However, male condoms alone are also risky, because they fail 3 times out of 100. The safest way to prevent pregnancy and sexually transmitted infections, besides abstaining from sex, is to use hormonal contraception AND male condoms.

Can I just use the withdrawal method?

No! Too many teens use this method, which involves the male partner�s attempt to withdraw the penis before ejaculation. However, this method has a high failure rate. On average, of every 100 women whose partners use withdrawal, nineteen will become pregnant during the first year of use!

Do OCPs have a lot of side effects?

A few are possible, but most teenagers tolerate OCPs very well with mild if any side effects. OCPs do not stunt growth. They do not cause significant weight gain in most teens � most teens, if they gain any weight, gain no more than 1 to 3 pounds. And OCPs are between 10 to 25 times safer than pregnancy!

Some teens may initially experience more acne with OCPs, and if this is not improving after three months a pill with a lower amount of Progestin may be tried. Some teens experience higher blood pressure at the beginning, which seldom persists. Some teens have headaches at the beginning, but these usually wear off quickly � if not, a �minipill� may be tried. Some teens experience mild and temporary depression, which if not better in three months may require a change to a pill with less estrogen. Breakthrough bleeding is common in the first three months, but usually stops � if it does not, a pill with more estrogen may be tried. And many teens experience nausea with OCPs, but this side effect seldom last more than the first 2 months, and can be reduced by taking the pill with meals or at bedtime.

Who should NOT use Oral Contraceptives?

Any one with a history of significant hypertension, liver disease, diabetes with complications, cancer, active hepatitis, severely high cholesterol, severe focal migraines, Lupus, or anyone with a history of having had a stroke, pulmonary embolism, or deep venous thrombosis. Anyone on seizure medications might need to avoid OCPs, as might anyone who has had breast cancer, whose mother has had breast cancer, or who has had a heart attack or has a heart valve problem.

What needs to be done before starting an Oral Contraceptive?

OCPs cannot be taken if you are pregnant, therefore the first thing to do is take a urine pregnancy test to prove that you are not. If you are sexually active already, it is also important to have a pelvic examination before starting OCPs, and to have a follow-up �Pap and Pelvic� every 6 to 12 months.

It is also important before beginning an OCP to ask yourself whether you can remember to take a medicine every day. If you are fourteen or older, you can be prescribed an OCP without your parent knowing about it, but we feel that it is very important that if at all possible at least one of your parents knows. If you are always hiding your medications from your parents, you are more likely to forget taking them!

What else should I know before starting an OCP?

It is important to stick with the same brand of OCP for at least three months; most annoying side effects will disappear within that time. It is also important to begin an OCP on the first day of your menses. Most OCPs packs are completed in a 28-day cycle, with 21 pills containing active hormones, and 7 pills containing placebo �reminder pills�.

What if I forget to take a pill?

If just one pill was missed, take the pill as soon as possible, and take the pill regularly scheduled for that day at its usual time.

If you forgot to take two pills in a row in the first two weeks of a four week pack, take 2 pills the day you remember, and 2 pills the next day. Then take one pill a day until the pack is finished. Use a condom with any sexual activity over the next 7 days!!

If you forgot to take 2 pills in a row in the third week, throw away your current pack, and start a new pack. Use a condom for the next 7 days after realizing you�d forgotten.

And if you forgot to take 3 pills in a row at any time, throw away your current pack, wait 4 to 7 days, and start a new pack. Again, use a condom for the next 7 days!

When should I stop taking OCPs?

If you develop a migraine with changes to your vision, if you are about to have surgery, if you are about to experience prolonged bed rest, or if you discover a strong and close family history of leg clots or pulmonary embolism.