OBGYN.net.
Birth Control Choices For Teens
July 13, 2011
Reprinted with permission from Planned Parenthood® Federation of America, Inc.
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%
- Prevents sexually transmitted infections.
| | Advantages | - No medical or hormonal side effects.
- Many religions endorse abstinence for unmarried people.
| | Possible Problems | - Difficult for many people to abstain from sex play for long periods.
- People often forget to protect themselves against pregnancy or sexually transmitted infections when they stop abstaining.
| | Cost | | | 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.
- Women who postpone vaginal intercourse until their 20s have certain health advantages. They are less likely to suffer from sexually transmitted infections, infertility, and cancer of the cervix than women who have vaginal intercourse at younger ages.
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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%
- Pregnancy is possible if semen or pre-ejaculate is spilled near the opening of the vagina.
- Effective against HIV and other serious sexually transmitted infections, unless body fluids are exchanged through oral or anal intercourse.
| | Advantages | - No medical or hormonal side effects.
- Can be used as safer sex if no body fluids are exchanged.
- May prolong sex play and enhance orgasm.
- Can be fully satisfying without the risks of sexual intercourse.
| | Possible Problems | - Difficult for many people to abstain from vaginal intercourse for long periods.
| | Cost | | | Advantage for teens | - Outercourse can give complete satisfaction for both partners and take a lot of pressure off young women and men.
- Many teen women get little or no pleasure from sexual intercourse because their partners do not know how to give them pleasure. Outercourse helps partners learn about their bodies and how to give themselves and each other sexual pleasure.
- Women have very different sexual response cycles than men. Men usually have one orgasm, and it is usually some time before they can have another. Women can have frequent and multiple orgasms. But most women don’t have orgasms from vaginal stimulation. Most of them get orgasms when the clitoris is stimulated ¾ whether or not they are having vaginal intercourse. Sex play without intercourse can help women learn how to have orgasms.
- Men also enjoy outercourse ¾ even if they're shy about it in front of their partners. Outercourse allows men to be truly erotic without worrying about how well they perform.
| | 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. |
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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%
- Not effective against sexually transmitted infections. Use a condom for good protection against infection.
| | Advantages | - Protects against pregnancy for five years.
- No daily pill.
- Nothing to put in place before intercourse.
- Can use while breastfeeding (six weeks after delivery).
- Can be used by some women who cannot take the Pill.
| | Possible Problems | - Side effects include irregular, late, and absent periods as well as other discomforts, including: headaches, nausea, depression, nervousness, dizziness, and weight gain.
- Medical procedure needed for insertion and removal.
- Possible scarring at insertion site.
- Rarely, infection at insertion site.
- Rarely, difficult removal.
| | Cost | - $500-$600: exam, implants, insertion.
- $100-$200: removal.
- Some health centers charge according to income.
| | 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%
- Not effective against sexually transmitted infections. Use a condom for good protection against infection.
| | Advantages | - Protects against pregnancy for 12 weeks.
- No daily pill.
- Nothing to put in place before intercourse.
- Can be used while breastfeeding (starting six weeks after delivery).
- Can be used by some women who cannot take the Pill.
- Protects against: cancer of the lining of the uterus, iron deficiency anemia.
| | Possible Problems | - Side effects include irregular, late, and absent periods as well as other discomforts, including: weight gain, headaches, depression, and abdominal pain.
- Side effects cannot be reversed until medication wears off (up to 12 weeks).
- May cause delay in getting pregnant after shots are stopped.
| | Cost | - $30-$75 per injection. May be less at clinics.
- $35-$125: exam. Some family planning clinics charge according to income.
| | 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.
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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%
- Not effective against sexually transmitted infections. Use a condom for good protection against infection.
| | Advantages | - Nothing to put in place before intercourse.
- More regular periods.
- Less: menstrual cramping, acne, iron deficiency anemia, and premenstrual tension.
- Protects against: ovarian and endometrial cancers, pelvic inflammatory disease, and non-cancerous breast tumors.
- Fewer tubal pregnancies.
| | Possible Problems | - Must be taken daily
- Rare but serious health risks, including: blood clots, heart attack, and stroke ¾ women over 35 who smoke and those who are greatly overweight are at greater risk.
- Possible side effects include temporary irregular bleeding, depression, nausea, and other discomforts.
| | Cost | - $15-$25: monthly pill-pack at drugstores. Often less at clinics.
- $35-$125: exam.
- Some health centers charge according to income
| | 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.
- Don’t forget to take your pill.
- About one out of three users often forget to take the Pill. The Pill won't work for anyone who forgets to take it every day.
- If you choose the Pill, schedule taking it with something else you do every day—like brushing your teeth.
- If you forget ONE active combination pill, take it as soon as you remember. This means you may take two pills in one day. If you forget two or more pills, call your clinician immediately.
- Remember to take your pill whether or not you're having sex.
- Don’t share your pills.
- Prescription methods like the Pill, diaphragm, and cervical cap are personalized for each woman's use. They should not be shared.
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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%
- Latex condoms are effective against sexually transmitted infections, including HIV, the virus that can cause AIDS.
- Plastic condoms are still being tested for effectiveness against infection. Animal tissue condoms may not protect against viruses such as HIV and hepatitis B.
- Increase your protection:
- Also use spermicides.
- Do not use oil-based lubricants, like Vaseline® on latex condoms.
- Use correctly: Place rolled condom on tip of hard penis. Squeeze air out of half-inch space at tip. Pull back foreskin and roll condom down over penis. Smooth out any air bubbles. Lubricate with water-based lubricant, like K-Y® jelly.
- Hold condom against penis to withdraw.
| | Advantages | - Inexpensive and easy to buy in drugstores, supermarkets, etc.
- Can help relieve premature ejaculation.
- Can be put on as part of sex play.
- Can be used with other methods of birth control to prevent sexually transmitted infections.
| | Possible Problems | - Allergies to latex or spermicide.
- Decreased sensation.
- Breakage.
| | Cost | - 25¢ and up: dry.
- 50¢ and up: lubricated.
- $2.50 and up: plastic, animal tissue, textured.
- Some health centers give them away or charge very little.
| | 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.
- No matter how old you are, it is very important to use condoms with your other method of birth control ¾ whenever you are at risk for getting a sexually transmitted infection.
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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
- 82% - 91% ¾ cervical cap for women who have not had a child
- 64% - 74% ¾ cervical cap for women who have had a child
- Not effective against sexually transmitted infections. Use a condom for good protection against infection.
| | Advantages | - No medicinal or hormonal side effects.
- Inexpensive.
| | Possible Problems | - Can be messy.
- Allergies to latex or spermicide.
- Cannot use during vaginal bleeding or infection.
- May interrupt sex play.
- Diaphragm:
- Increased risk of bladder infection.
- Cervical Cap:
- Difficult for some women to use.
- Only four sizes. Difficult to fit some women.
| | Cost | - $13-$25: diaphragm or cap.
- $50-$125: examination.
- $8: supplies of spermicide jelly or cream.
- Some health centers charge according to income.
| | 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
- 79% - 95% pouch
- Pouch provides some protection against sexually transmitted infection, including HIV. Use condoms with all other birth control methods for protection against infection
| | Advantages | - Easy to buy in drugstores, supermarkets, etc.
- Insertion may be part of sex play.
- Erection unnecessary to keep pouch in place.
| | Possible Problems | - Can be messy.
- Allergies; may irritate vagina or penis.
- Outer ring of pouch may slip into vagina during intercourse.
- Difficulty inserting pouch.
| | Cost | - $2.50: pouch.
- $8-$18: applicator kits of foam and gel.
- $4-$8: refills, films, and suppositories.
- Some health centers charge according to income.
| | 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
- The IUD (Intrauterine Device)
- Withdrawal
- Periodic Abstinence or Fertility Awareness Methods (FAMs)
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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%.
- Not effective against sexually transmitted infections.
| 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%.
- Not effective against sexually transmitted infections.
| Reason Not Recommended
for teens | - Unless she has had a child, a young woman's uterus may be too small to hold an IUD.
- IUD users who get certain sexually transmitted infections can develop pelvic inflammatory disease and become unable to have children. Teenagers are at very high risk for these infections. One out of four teenagers has a least one of these infections.
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Withdrawal
the man pulls his penis out of the vagina before he ejaculates (comes) to keep sperm from joining egg.
| Effectiveness | - 81% - 96%.
- Not effective against sexually transmitted infections.
| Reason Not Recommended
for teens | - Some men lack the experience and self-control to pull out in time.
- Some men have been known to say they will pull out, and then they get so excited and carried away that they don’t.
- Some men cannot tell when they are going to ejaculate.
- Some men ejaculate very quickly, before they realize it.
- Before ejaculation, almost all penises leak fluid that can cause pregnancy.
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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%.
- Not effective against sexually transmitted infections.
| Reason Not Recommended
for teens | - These methods work best for women with very regular periods.
- Teen women often have irregular periods.
- Their partners may not wish to cooperate in using this method.
- A teen's relationship may not be as stable or as committed as is necessary for developing the trust and cooperation necessary for effective use of this method.
| 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:
- Emergency "morning-after" pills—Treatment initiated within 72 hours of unprotected intercourse reduces the risk of pregnancy by at least 75%.
- Emergency IUD insertion—Insertion within 5-7 days of unprotected intercourse reduces the risk of pregnancy by 99.9%.
| | Possible Problems | - Emergency hormonal contraception
- nausea
- vomiting
- breast tenderness, irregular bleeding, fluid retention, and headaches.
- Emergency IUD insertion
| | You May Want Emergency Contraception If: | - His condom broke or slipped off, and he ejaculated inside your vagina.
- Your diaphragm or cervical cap slipped out of place, and he ejaculated inside your vagina.
- He forced you to have unprotected vaginal intercourse.
- You miscalculated your "safe" days for periodic abstinence or fertility awareness methods.
- You forgot to take your birth control pill more than two days in a row.
- You weren't using any birth control.
- He didn't pull out in time.
| - 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/
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
© Revised version December 1997 Planned Parenthood® Federation of America, Inc.
Copyright PPFA 1997. All rights reserved.
PPFA Web Site © 1998, Planned Parenthood® Federation of America, Inc.
Questions? Comments? Contact the national office of the Planned Parenthood Federation of America at communications@ppfa.org
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