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Contraception: Overview of issues specific to adolescents

Mariam R Chacko, MD
Section Editor
Diane Blake, MD
Deputy Editor
Mary M Torchia, MD


This topic review will provide an overview of issues related to the provision of contraceptive services to adolescent females. Emergency contraception, choosing a contraceptive method, and individual methods of contraception are discussed separately.

(See "Emergency contraception".)

(See "Contraceptive counseling and selection".)

(See "Intrauterine contraception: Devices, candidates, and selection".)

(See "Etonogestrel contraceptive implant".)


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Literature review current through: Sep 2016. | This topic last updated: Sep 1, 2016.
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  1. Finer LB, Zolna MR. Declines in Unintended Pregnancy in the United States, 2008-2011. N Engl J Med 2016; 374:843.
  2. Kann L, McManus T, Harris WA, et al. Youth Risk Behavior Surveillance - United States, 2015. MMWR Surveill Summ 2016; 65:1.
  3. Trussell J. Contraceptive failure in the United States. Contraception 2011; 83:397.
  4. Daniels K, Daugherty J, Jones J. Current contraceptive status among women aged 15-44: United States, 2011-2013. NCHS Data Brief 2014; :1.
  5. Martinez GM, Abma JC. Sexual Activity, Contraceptive Use, and Childbearing of Teenagers Aged 15-19 in the United States. NCHS Data Brief 2015; :1.
  6. Hatcher RA, Trussel J, Nelson AL, et al. Contraceptive Technology, 20th ed, Ardent Media, Inc, New York 2012.
  7. Nelson AI, Neinstein LS. Contraception. In: Handbook of Adolescent Health Care, Neinstein LS, Gordon CM, Katzman DK, et al. (Eds), Lippincott Williams & Wilkins, 2009. p.389.
  8. Preconception Health and Health Care. Reproductive Life Plan Tool for Health Professionals. www.cdc.gov/preconception/documents/rlphealthproviders.pdf (Accessed on April 10, 2016).
  9. Preconception Health and Health Care. Reproductive Life Plan Worksheet. www.cdc.gov/preconception/documents/reproductivelifeplan-worksheet.pdf (Accessed on April 17, 2016).
  10. Kavanaugh ML, Frohwirth L, Jerman J, et al. Long-acting reversible contraception for adolescents and young adults: patient and provider perspectives. J Pediatr Adolesc Gynecol 2013; 26:86.
  11. Kavanaugh ML, Jerman J, Ethier K, Moskosky S. Meeting the contraceptive needs of teens and young adults: youth-friendly and long-acting reversible contraceptive services in U.S. family planning facilities. J Adolesc Health 2013; 52:284.
  12. Secura GM, Madden T, McNicholas C, et al. Provision of no-cost, long-acting contraception and teenage pregnancy. N Engl J Med 2014; 371:1316.
  13. Harper CC, Rocca CH, Thompson KM, et al. Reductions in pregnancy rates in the USA with long-acting reversible contraception: a cluster randomised trial. Lancet 2015; 386:562.
  14. Secura GM, Adams T, Buckel CM, et al. Change in sexual behavior with provision of no-cost contraception. Obstet Gynecol 2014; 123:771.
  15. Thompson KM, Rocca CH, Kohn JE, et al. Public Funding for Contraception, Provider Training, and Use of Highly Effective Contraceptives: A Cluster Randomized Trial. Am J Public Health 2016; 106:541.
  16. Oringanje C, Meremikwu MM, Eko H, et al. Interventions for preventing unintended pregnancies among adolescents. Cochrane Database Syst Rev 2016; 2:CD005215.
  17. Winner B, Peipert JF, Zhao Q, et al. Effectiveness of long-acting reversible contraception. N Engl J Med 2012; 366:1998.
  18. The Patient Protection and Affordable Care Act. Public Law No. 111-148 (2010). http://www.dol.gov/ebsa/healthreform/ (Accessed on March 22, 2016).
  19. Chuang CH, Mitchell JL, Velott DL, et al. Women's Awareness of Their Contraceptive Benefits Under the Patient Protection and Affordable Care Act. Am J Public Health 2015; 105 Suppl 5:S713.
  20. Society for Adolescent Health and Medicine, American Academy of Pediatrics. Confidentiality Protections for Adolescents and Young Adults in the Health Care Billing and Insurance Claims Process. J Adolesc Health 2016; 58:374.
  21. Guttmacher Institute. State laws and policies. Insurance Coverage of Contraceptives. https://www.guttmacher.org/state-policy/explore/insurance-coverage-contraceptives (Accessed on May 31, 2016).
  22. Emans SJ, Grace E, Woods ER, et al. Adolescents' compliance with the use of oral contraceptives. JAMA 1987; 257:3377.
  23. Chacko MR, Wiemann CM, Buzi RS, et al. Choice of Postpartum Contraception: Factors Predisposing Pregnant Adolescents to Choose Less Effective Methods Over Long-Acting Reversible Contraception. J Adolesc Health 2016; 58:628.
  24. Truehart A, Whitaker A. Contraception for the adolescent patient. Obstet Gynecol Surv 2015; 70:263.
  25. Gordon CM, Pitts SA. Approach to the adolescent requesting contraception. J Clin Endocrinol Metab 2012; 97:9.
  26. WHO, Department of Reproductive Health and Research, Medical eligibility criteria wheel for contraceptive use 2015. www.who.int/reproductivehealth/publications/family_planning/mec-wheel-5th/en (Accessed on April 15, 2016).
  27. Rieder J, Coupey SM. Contraceptive compliance: Personalizing an adolescent’s plan for effective birth control. The Female Patient (Suppl) 2000; :12.
  28. Curtis KM, Jatlaoui TC, Tepper NK, et al. U.S. Selected Practice Recommendations for Contraceptive Use, 2016. MMWR Recomm Rep 2016; 65:1.
  29. Clarke KE, Kraft JM, Wiener JB, et al. Factors Associated with Contraceptive Use Differ between Younger and Older African-American Female Adolescents. J Pediatr Adolesc Gynecol 2016; 29:448.
  30. Melo J, Peters M, Teal S, Guiahi M. Adolescent and Young Women's Contraceptive Decision-Making Processes: Choosing "The Best Method for Her". J Pediatr Adolesc Gynecol 2015; 28:224.
  31. Nguyen LN, Jamieson MA. Adolescent users of an online contraception selection tool: how user preferences and characteristics differ from those of adults. J Pediatr Adolesc Gynecol 2011; 24:317.
  32. Rubin SE, Felsher M, Korich F, Jacobs AM. Urban Adolescents' and Young Adults' Decision-Making Process around Selection of Intrauterine Contraception. J Pediatr Adolesc Gynecol 2016; 29:234.
  33. Brückner H, Bearman P. After the promise: the STD consequences of adolescent virginity pledges. J Adolesc Health 2005; 36:271.
  34. Ott MA, Sucato GS, Committee on Adolescence. Contraception for adolescents. Pediatrics 2014; 134:e1257.
  35. Committee on Adolescence. Contraception for adolescents. Pediatrics 2014; 134:e1244.
  36. Committee on Adolescent Health Care Long-Acting Reversible Contraception Working Group, The American College of Obstetricians and Gynecologists. Committee opinion no. 539: adolescents and long-acting reversible contraception: implants and intrauterine devices. Obstet Gynecol 2012; 120:983.
  37. Committee on Gynecologic Practice Long-Acting Reversible Contraception Working Group. Committee Opinion No. 642: Increasing Access to Contraceptive Implants and Intrauterine Devices to Reduce Unintended Pregnancy. Obstet Gynecol 2015; 126:e44.
  38. Krashin J, Tang JH, Mody S, Lopez LM. Hormonal and intrauterine methods for contraception for women aged 25 years and younger. Cochrane Database Syst Rev 2015; :CD009805.
  39. Rosenstock JR, Peipert JF, Madden T, et al. Continuation of reversible contraception in teenagers and young women. Obstet Gynecol 2012; 120:1298.
  40. Secura GM, Allsworth JE, Madden T, et al. The Contraceptive CHOICE Project: reducing barriers to long-acting reversible contraception. Am J Obstet Gynecol 2010; 203:115.e1.
  41. Sivin I, Schmidt F. Effectiveness of IUDs: a review. Contraception 1987; 36:55.
  42. Heinemann K, Reed S, Moehner S, Minh TD. Comparative contraceptive effectiveness of levonorgestrel-releasing and copper intrauterine devices: the European Active Surveillance Study for Intrauterine Devices. Contraception 2015; 91:280.
  43. Curtis KM, Tepper NK, Jatlaoui TC, et al. U.S. Medical Eligibility Criteria for Contraceptive Use, 2016. MMWR Recomm Rep 2016; 65:1.
  44. Alton TM, Brock GN, Yang D, et al. Retrospective review of intrauterine device in adolescent and young women. J Pediatr Adolesc Gynecol 2012; 25:195.
  45. Deans EI, Grimes DA. Intrauterine devices for adolescents: a systematic review. Contraception 2009; 79:418.
  46. Díaz J, Pinto Neto AM, Bahamondes L, et al. Performance of the copper T 200 in parous adolescents: are copper IUDs suitable for these women? Contraception 1993; 48:23.
  47. Birgisson NE, Zhao Q, Secura GM, et al. Positive Testing for Neisseria gonorrhoeae and Chlamydia trachomatis and the Risk of Pelvic Inflammatory Disease in IUD Users. J Womens Health (Larchmt) 2015; 24:354.
  48. Scholes D, LaCroix AZ, Ichikawa LE, et al. Change in bone mineral density among adolescent women using and discontinuing depot medroxyprogesterone acetate contraception. Arch Pediatr Adolesc Med 2005; 159:139.
  49. Black box warning added concerning long-term use of Depo-provera contraceptive injection. FDA Talk Paper. November 17, 2004. Available at: www.fda.gov/bbs/topics/ANSWERS/2004/ANS01325.html (Accessed on December 05, 2007).
  50. Cromer BA, Scholes D, Berenson A, et al. Depot medroxyprogesterone acetate and bone mineral density in adolescents--the Black Box Warning: a Position Paper of the Society for Adolescent Medicine. J Adolesc Health 2006; 39:296.
  51. Harel Z, Wolter K, Gold MA, et al. Inadequate vitamin D status in adolescents with substantial bone mineral density loss during the use of depot medroxyprogesterone acetate injectable contraceptive: a pilot study. J Pediatr Adolesc Gynecol 2010; 23:209.
  52. American College of Obstetricians and Gynecologists Committee on Adolescent Health Care. ACOG Committee Opinion No. 448: Menstrual manipulation for adolescents with disabilities. Obstet Gynecol 2009; 114:1428.
  53. Quint EH, O'Brien RF, COMMITTEE ON ADOLESCENCE, North American Society for Pediatric and Adolescent Gynecology. Menstrual Management for Adolescents With Disabilities. Pediatrics 2016; 138.
  54. Steiner RJ, Liddon N, Swartzendruber AL, et al. Long-Acting Reversible Contraception and Condom Use Among Female US High School Students: Implications for Sexually Transmitted Infection Prevention. JAMA Pediatr 2016; 170:428.
  55. National Institute for Health and Care Excellence. Contraceptive services for under 25s. March 2014. https://www.nice.org.uk/guidance/ph51/chapter/Introduction-scope-and-purpose-of-this-guidance (Accessed on March 29, 2016).
  56. Potter J, Santelli JS. Adolescent contraception: review and guidance for pediatric clinicians. Minerva Pediatr 2015; 67:33.
  57. Gold MA, Sucato GS, Conard LA, et al. Provision of emergency contraception to adolescents. J Adolesc Health 2004; 35:67.
  58. Stancil SL, Miller M, Briggs H, et al. Contraceptive Provision to Adolescent Females Prescribed Teratogenic Medications. Pediatrics 2016; 137.
  59. Braverman PK, Breech L, Committee on Adolescence. American Academy of Pediatrics. Clinical report--gynecologic examination for adolescents in the pediatric office setting. Pediatrics 2010; 126:583.
  60. Potter J, Soren K. Long-Acting Reversible Contraception and Condom Use: We Need a Better Message. JAMA Pediatr 2016; 170:417.
  61. United Stated Department of Health and Human Services. Program Guidelines for Project Grants for Family Planning Services. http://www.hhs.gov/opa/title-x-family-planning/title-x-policies/program-guidelines/2001-ofp-guidelines-complete.html#8.1 (Accessed on June 17, 2016).
  62. Grimes DA. Intrauterine device and upper-genital-tract infection. Lancet 2000; 356:1013.
  63. Rickert VI, Tiezzi L, Lipshutz J, et al. Depo Now: preventing unintended pregnancies among adolescents and young adults. J Adolesc Health 2007; 40:22.
  64. Kaunitz AM, Darney PD, Ross D, et al. Subcutaneous DMPA vs. intramuscular DMPA: a 2-year randomized study of contraceptive efficacy and bone mineral density. Contraception 2009; 80:7.
  65. Trent M, Thompson C, Tomaszewski K. Text Messaging Support for Urban Adolescents and Young Adults Using Injectable Contraception: Outcomes of the DepoText Pilot Trial. J Adolesc Health 2015; 57:100.
  66. Smith C, Gold J, Ngo TD, et al. Mobile phone-based interventions for improving contraception use. Cochrane Database Syst Rev 2015; :CD011159.
  67. Westhoff C, Heartwell S, Edwards S, et al. Initiation of oral contraceptives using a quick start compared with a conventional start: a randomized controlled trial. Obstet Gynecol 2007; 109:1270.
  68. Polaneczky M, Slap G, Forke C, et al. The use of levonorgestrel implants (Norplant) for contraception in adolescent mothers. N Engl J Med 1994; 331:1201.
  69. Lara-Torre E. "Quick Start", an innovative approach to the combination oral contraceptive pill in adolescents. Is it time to make the switch? J Pediatr Adolesc Gynecol 2004; 17:65.
  70. Castaño PM, Bynum JY, Andrés R, et al. Effect of daily text messages on oral contraceptive continuation: a randomized controlled trial. Obstet Gynecol 2012; 119:14.
  71. Hou MY, Hurwitz S, Kavanagh E, et al. Using daily text-message reminders to improve adherence with oral contraceptives: a randomized controlled trial. Obstet Gynecol 2010; 116:633.
  72. Woods JL, Shew ML, Tu W, et al. Patterns of oral contraceptive pill-taking and condom use among adolescent contraceptive pill users. J Adolesc Health 2006; 39:381.
  73. Moreau C, Bouyer J, Gilbert F, et al. Social, demographic and situational characteristics associated with inconsistent use of oral contraceptives: evidence from France. Perspect Sex Reprod Health 2006; 38:190.
  74. COMMITTEE ON ADOLESCENCE. Condom use by adolescents. Pediatrics 2013; 132:973.