When teen pregnancy is NOT an option
We need to help our teenagers learn how to prevent an unintended pregnancy. It starts with talking ... really talking .... with your teen.
Rima Himelstein, M.D.
This is when parenting is put to the test. Tears, anger, and shock are some of the reactions parents have if they find out that their child has had sex. Parents need to understand that they have not failed as parents if their teen has decided to have sex. Their teens are still the lovable kids they have always been.
Condoms are necessary to prevent STDs. But condoms alone are not enough to prevent pregnancy: they fail about 15 percent of the time. So teenagers who might decide to have sex need to use two forms of protection: condoms to prevent STDs plus an effective contraceptive to prevent pregnancy.
Here are some options:
"The pill" is the most commonly used contraception. It is made of two hormones: estrogen and progestin. The pill works mainly by temporarily preventing ovulation and changing the lining of the uterus. The young woman takes a pill once a day for 21 days, followed by seven days of hormone-free pills.
"The patch" ('Ortho-Evra') also contains estrogen and progestin. The young woman places a new patch on her skin once a week for three weeks, followed by one week with no patch. The patch continuously releases low levels of the hormones.
"The ring" ('Nuvaring') also contains estrogen and progestin. The young woman places it into her vagina like a tampon and leaves it there for three weeks; she removes it for the fourth week. The ring continuously releases low levels of the hormones.
Who should not use the pill, the patch or the ring? Young women who cannot take estrogen, including those with: clotting disorders, undiagnosed vaginal bleeding, or migraines with aura or neurological symptoms.
Here are some options that do not contain estrogen:
"Depo" ('Depo-Provera') is given as in injection. Low levels of progestin are slowly released. The first injection is given during the first five days of a young woman's menstrual period, and then every 12 weeks (four times a year). Depo's effects are similar to the pill in preventing pregnancy.
An implant. For example, 'Implanon' is a small rod the size of a matchstick. It is inserted under the skin, and low levels of progestin are slowly released for up to three years. The effects of 'Implanon' are also similar to the pill in preventing pregnancy.
An IUD ('Mirena' or 'Paragard'). An intrauterine device (IUD) is a small, "T"-shaped device, which is placed into the young woman's uterus by a health professional. There are two types of IUDs prescribed for teens: the 'Mirena' IUD releases low levels of progestin for up to five years; 'Paragard' releases copper instead of progestin for up to 10 years. IUDs work by temporarily changing the lining of the uterus.
Emergency contraception. This is an option if a teen has had unprotected sex. It provides a short burst of hormone. It is most effective if taken as soon as possible, but it may be taken up to five days later.
My advice: talk with your teenager ... really talk. Start before you think she or he might be sexually active. Talking about sex and contraception does not mean a parent is saying "okay" to teen sex. On the contrary, providing this information in a sensitive way, along with the reasons why it would be better to wait to have sex, may encourage a teenager to delay his or her first sexual experience. And this talk may prevent an unintended pregnancy.
Have you and your teen talked ... really talked?
Rima Himelstein, M.D., is a Crozer-Keystone Health System pediatrician and adolescent medicine specialist.