Contraceptive methods in adolescence

D. Apter

The Sexual Health Clinic, Family Federation of Finland, Helsinki, Finland

Sexual health for adolescents is based on three components: Recognizing sexual rights, sexuality education and counselling, and confidential high quality services.

Contraception needs to include prevention of both STIs and pregnancies. The first option is condoms backed-up by emergency contraception. Emergency contraception can be taken as a single dose of 1.5 mg levonorgestrel. Later there is a switch to oral contraceptives or other hormonal contraception in a longer relationship. Breast, pelvic and genital examination, and routine laboratory tests are not necessary before starting hormonal contraception. Good counselling is most essential. Condom use should not be stopped before it is reasonable certain that the partner is STI-negative. Both the patch and the vaginal ring have become popular among adolescents. Other alternatives can be considered in special cases. Improved contraceptive methods do not automatically lead to reduced numbers of abortions. The prevention of unintended pregnancies requires a desire to use protection, a good contraceptive method, ability to obtain the contraceptive method, and ability to use it.

High quality sexual health services for adolescents calls for special clinics. Unquestionable confidentiality is important. The threshold to come to the clinic should be low. When adolescent sexuality is not condemned but sexuality education and sexual health services are provided, it is possible to profoundly improve adolescent sexual health with comparatively small costs. Each year new groups of young people mature, requiring new efforts.