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.