Nexplanon And IUDs Recommended For Teens Not Using Abstinence: Are Condoms And The Pill Too Old-Fashioned?

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The American Academy of Pediatrics recommends an IUD or subdermal implant such as Implanon and Nexplanon (insertion pictured here), as the first-line choice for teens who choose not to be abstinent. Reuters

In 2011, nearly half (47 percent) of all high school students reported having had sex at some point in their lives, while a third (34 percent) reported having had sex in the previous three months. Taking these trends into account, the American Academy of Pediatrics (AAP) recommends a Long Acting Reversible Contraceptive (LARC), such as an IUD (intrauterine device) or subdermal implant, as the first-line choice for teens who choose not to be abstinent in its updated policy statement, “Contraception for Adolescents.” In its accompanying technical report, AAP outlines more of the sexual behavior of teens as well as typical teen contraceptive practices.

Teen Pregnancy Risk

While “contraception is a pillar in reducing adolescent pregnancy rates,” the AAP authors suggest increased understanding of behavior would benefit pediatricians and so, too, their patients. The contraception most commonly used by teens, according to the AAP technical report, is the condom with 96 percent of all young women who have ever used birth control reporting they’ve used a condom at some point. Withdrawal, reported by 57 percent of all teens surveyed, was the second most common method.

“When adhered to perfectly, sexual abstinence is 100 percent effective, making it an attractive choice for pregnancy prevention,” wrote the authors of the report, though they add that, unfortunately, many teens who practice abstinence do not always adhere to the method — in other words, abstinent teens will occasionally slip and have intercourse. In fact, the National Longitudinal Study of Adolescent Health found that among those teens who had taken virginity pledges, 88 percent had engaged in sexual intercourse (most premarital) at the six-year follow-up, while five percent had become infected with STDs.

Based on these statistics, then, the AAP has updated its 2007 guidance report which also reflects the new contraceptive methods now available to adolescents over the past decade. LARC, such as the single-rod implants known as Implanon and Nexplanon, have been recommended in particular because other methods, including “the pill” as well as abstinence, are not always reliably used by young women. Further, the AAP suggests pediatricians develop a working knowledge of birth control to help girls reduce their risk of an unintended pregnancy.

Specifically, pediatricians should conduct a sexual history, assess the risk for STDs, and provide appropriate education about safe and effective contraceptive methods. Importantly, AAP also suggests pediatricians stress that all methods of hormonal birth control are safer than pregnancy, while allowing adolescents to consent to contraceptive care.

Teen birth rates in the United States have declined in the past 10 years; however, the national rate is still much higher than those of other developed countries. To help avert the pain and health risks of an unintended pregnancy, AAP suggests pediatricians acquire information about the contraceptive methods available to teens but also a working knowledge of the teens who will be using them.

Source: American Academy of Pediatrics. Contraception for Adolescents: Policy Statement. Pediatrics. 2014.

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