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Long-Acting Reversible Contraception for Adolescents: A Review
Jenny K R Francis1, Melanie A Gold2
1Department of Pediatrics, Division of Child and Adolescent Health, Section of Adolescent Medicine, College of Physicians and Surgeons, Columbia University Medical Center, New York, New York2New York-Presbyterian Hospital, Ambulatory Care Network, New York.
JAMA Pediatrics
|May 31, 2017
Summary
Long-acting reversible contraceptives (LARCs) are highly effective for adolescents. Pediatricians should counsel teens on LARCs, like implants and IUDs, to prevent unintended pregnancies.
Area of Science:
- Adolescent reproductive health
- Contraception research
- Pediatric gynecology
Background:
- Adolescents experience high rates of unintended pregnancies.
- Long-acting reversible contraceptives (LARCs), including implants and intrauterine devices (IUDs), are highly effective.
- New LARC devices are available for adolescents, but pediatricians may need more guidance on counseling.
Purpose of the Study:
- To inform clinicians about counseling adolescents on LARC methods.
- To emphasize LARC as a first-line contraceptive option for adolescents.
- To promote effective and confidential communication regarding LARC options.
Main Methods:
- Review of current LARC methods and their efficacy.
- Discussion of counseling strategies for adolescents.
- Consideration of developmental stages and confidentiality.
Main Results:
- LARC methods should be explained in simple terms, covering hormone dose, insertion, and pregnancy prevention.
- Nuisance bleeding is the most common side effect, manageable with oral contraceptives or NSAIDs.
- Short-acting methods can bridge the gap until LARC placement.
Conclusions:
- LARC devices are first-line contraceptives for adolescents.
- Clinicians can offer LARC before less effective methods.
- Effective, confidential communication is key to normalizing LARC and improving uptake.
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