Contraceptive methods in adolescence: a narrative review of guidelines

Eur J Contracept Reprod Health Care. 2023 Feb;28(1):51-57. doi: 10.1080/13625187.2022.2162336. Epub 2023 Jan 13.

Abstract

Purpose: Adolescent pregnancy, while recently in decline, remains a matter in need of addressing. Education and counselling are deemed crucial and this review aims at comparing published contraceptive guidelines, thus resolving any surrounding misconceptions.

Materials and methods: Recently published contraception guidelines regarding adolescent pregnancy were retrieved. In particular, guidelines and recommendations from ACOG, RCOG, SOCG, AAP, CPS, NICE, CDC, and WHO were compared and reviewed based on each guideline's method of reporting.

Results: Three categories of contraceptive methods are available for adolescents and recommendations on their initiation should be made based on their efficacy, according to all guidelines. Therefore, long acting reversible contraceptives (LARCs) should be highly recommended as the most effective method (typical use failure rate: 0.05%), followed by short-acting hormonal contraceptives (typical use failure rate: 3-9%). The third contraceptive option includes contraceptives used in the moment of intercourse and displays the lowest effectiveness (typical use failure rate: 12-25%), mostly due to its dependence on personal consistency, however offers protection against STI transmission.

Conclusion: Adolescents should be encouraged to initiate contraception, with LARCs being the primary choice followed by short-acting hormonal contraception. However, regardless of the chosen effective contraceptive method, the use of condom is necessary for STI prevention.

Keywords: Adolescent; adolescence; birth control; contraception; contraceptive methods; effectiveness; guidelines.

Plain language summary

Adolescent pregnancy, while recently in decline, remains a matter in need of addressing. The use of contraceptive methods such as LARCs and short-acting hormonal contraceptives should be encouraged and suggested based on effectiveness with the addition of condom for STI prevention.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Condoms
  • Contraception / methods
  • Contraceptive Agents / therapeutic use
  • Female
  • Humans
  • Pregnancy
  • Pregnancy in Adolescence* / prevention & control
  • Sexually Transmitted Diseases* / prevention & control

Substances

  • Contraceptive Agents