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Controversies in contraception.

Sarah A B Pitts1, S J Emans

  • 1Department of Medicine, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts 02115, USA. sarah.pitts@childrens.harvard.edu

Current Opinion in Pediatrics
|July 16, 2008
PubMed
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New research highlights risks of hormonal contraceptives for adolescents, including bone health impacts and increased thrombosis risk. While some effects appear reversible, providers must stay updated on emerging contraceptive care issues.

Area of Science:

  • Reproductive Health
  • Adolescent Medicine
  • Pharmacology

Background:

  • Emerging research continually updates understanding of hormonal contraceptives.
  • Contraceptive use in adolescents presents unique considerations regarding efficacy and side effects.
  • Providers require current information to effectively manage adolescent contraceptive care.

Purpose of the Study:

  • To review recent research on hormonal contraceptives and adolescent health.
  • To highlight key areas of emerging evidence and controversy in contraceptive care.
  • To inform healthcare providers about critical updates for adolescent patient counseling.

Main Methods:

  • Literature review of recent studies on hormonal contraceptives.
  • Analysis of research concerning bone health, migraines, thrombosis, hypertension, weight gain, obesity, and emergency contraception.

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  • Synthesis of findings to identify clinical implications for adolescent care.

    • Main Results:

    • Depot medroxyprogesterone acetate and low-dose oral contraceptives may adversely affect adolescent bone health, though bone loss appears reversible.
    • Estrogen-containing contraceptives are associated with migraine exacerbation, venous thromboembolism, and hypertension.
    • Depot medroxyprogesterone acetate is linked to weight gain, particularly in overweight adolescents; obesity may reduce contraceptive efficacy.
    • The mechanism of emergency contraception remains unclear, with evidence suggesting preovulatory effects.

    Conclusions:

    • Adolescent health providers must be informed about new research and controversies in contraceptive care.
    • Effective counseling and patient care depend on awareness of evolving contraceptive evidence.
    • Staying current with contraceptive research is essential for optimizing adolescent reproductive health outcomes.