Preventing Pregnancy: Contraception and Teens

The Section of Adolescent Medicine at Columbia University Medical Center features providers who have expertise in reproductive health care for teenagers and young adults. Providing contraception (otherwise known as birth control) is a big part of what we do. Read more here.

Our providers are skilled in counseling about and dispensing a wide range of methods, which vary from medications taken on a daily basis to devices that can remain inside a young women’s body for years to prevent pregnancy.

Not All Methods Are Created Equal

When it comes to contraception, not all methods are created equally. Some methods do a better job than others at preventing pregnancy. While all methods of contraception have side effects, the side effects are not the same for each method. The take-home message is that it is important for a young woman to select a method that is easy for her to use, effectively prevents pregnancy, is affordable, and doesn’t interfere with other medications or medical problems she may have. It is almost always best to use two methods of protection together – condoms, to prevent sexually-transmitted infections (STIs), and another method to effectively prevent pregnancy.
The condom, the most easily accessible and popular method of birth control for adolescent women, is the only method that protects against STIs. However, condoms do only a mediocre job at preventing pregnancy (15% failure rate with typical use) and therefore, the use of an additional, more effective method, is also recommended.

Long Term Solutions

The most effective contraceptive methods are those that can be used long term and don’t require remembering on a daily basis. The IUD (which includes the copper ParaGard® and levonorgestrel-containing Mirena®) and the contraceptive implant (Nexplanon®) both fall into this category. The Depo-Provera injection, which is given every 11 to 13 weeks, is also a method that requires less remembering. With the exception of the copper IUD, these methods all contain progesterone, a type of female hormone that is generally safe for most young women, even those who cannot tolerate estrogen due to other medical problems. The IUD and implant are devices that must be inserted by a doctor and can be used to prevent pregnancy from 3 to 10 years, depending on the device. They can be removed at any time and have no negative impact on an adolescent women’s long term fertility. There is some concern about the effects of using progesterone–only methods on bone health, but studies show that even if there are effects with prolonged use, they are reversible. The main side effects of all three of these methods are changes in menstrual bleeding patterns.
Other popular and effective contraceptive methods are birth control pills, the birth control patch, and the NuvaRing.® These options typically contain two types of hormones, estrogen and progesterone. There are many types of birth control pills available, with some perhaps having certain advantages for certain young women.  The birth control patch and NuvaRing® are preferred by some adolescent women, as there is no need to remember to take a daily pill. The patch is changed weekly and the NuvaRing is inserted (by the teen) into the vagina once a month and removed for menses.

Emergency Contraception

Plan B, often called the “morning after pill,” is a type of emergency contraception. This is a single pill that a woman can take after having unprotected intercourse to decrease the likelihood of becoming pregnant. It can be taken up until 5 days after unprotected sex, but it works best when taken as soon as possible. However, it is mainly useful as a back-up, not a primary, method of birth control.
Because there are so many contraceptive options available, adolescent and young adult women, like all women, may have questions when selecting a birth control method for the first time. Our health care providers in the Section of Adolescent Medicine can offer guidance in selecting a birth control method that meets a young woman’s needs while minimizing unpleasant side effects and maximizing safety and both medical and lifestyle benefits.
The Section of Adolescent Medicine at Columbia University Medical Center provides comprehensive health care, including reproductive health care, to adolescents at our Washington Heights outpatient practice and at our new Columbia Doctors midtown location at 51 West 51st Street, near Rockefeller Center.
About the Authors:
Dr. Julia Potter is a third year Clinical Fellow in Adolescent Medicine at the NewYork-Presbyterian Hospital, Columbia campus. She provides care to adolescents and young adults at the 21 Audubon Ambulatory Care Practice.
Dr. Karen Soren is the Director of the Section of Adolescent Medicine and Program Director of the Columbia Adolescent Medicine Training Program. She sees adolescents and young adults for both primary and consultative care at the Audubon practice and at the midtown Columbia Doctors faculty practice.