Contraception updates for adolescents

To discuss updated guidelines for the provision of contraception to adolescents, review several contraceptive methods that have entered the market in recent years, and summarize insights from the literature that can assist clinicians in providing accurate, destigmatized contraceptive counseling to patients of all sizes.

The 2024 United States Selected Practice Recommendations (US SPR) and United States Medical Eligibility for Contraceptive Use (US MEC) guidelines include changes to recommendations for contraception use in persons with various health conditions, and new advice for management of implant-associated breakthrough bleeding, pain control for intrauterine device (IUD) insertions, and counseling for patients who take testosterone. Subcutaneous Depo-Provera usage increased during the COVID-19 pandemic, and multiple studies demonstrate favorable patient experiences with it. Annovera, Miudella, Opill, Phexxi, Slynd, and Twirla are newer contraceptives which have distinct features that may make them attractive options for some patients. Contraception-related weight changes continue to be an active area of research. With the Food and Drug Administration (FDA) recommending broader BMI inclusion criteria, providers can expect more information about safety and efficacy of new contraceptives in individuals across the weight spectrum.

Updated evidence-based guidelines and several new contraceptive options should empower providers to provide patient-centered contraception counseling to patients with a variety of health conditions and contraceptive preferences.