Long-acting contraceptives in adolescents.
OBJECTIVE
To help clinicians guide adolescent patients to sound choices regarding long-acting contraceptives. The safety, side effects and non-contraceptive benefits of injectable, implantable and intrauterine contraception are detailed.


RESULTS
The use of depot medroxyprogesterone acetate contraceptive injections has been associated with declines in teenage pregnancies in the United States. Although the US Food and Drug Administration has placed a black box warning concerning skeletal health and depot medroxyprogesterone acetate, data in adolescents confirm that declines in bone mineral density with depot medroxyprogesterone acetate are fully reversible. Concerns regarding skeletal health should not restrict the initiation or continuation of depot medroxyprogesterone acetate in adolescents. A highly effective, convenient, and easy to insert/remove single rod progestin-only contraceptive implant (Implanon) is now available in the United States. Although not widely used in adolescents, intrauterine devices offer selected adolescents convenient, highly effective, safe birth control. Use of the progestin-releasing intrauterine device (Mirena) is also associated with important non-contraceptive benefits.


CONCLUSIONS
The efficacy and convenience associated with long-acting contraceptives make them indispensable for adolescent patients. This review will help clinicians guide teenage patients towards sound contraceptive choices and the successful long-term use of injectable, implantable and intrauterine methods of birth control.
Tolaymat
Lama L
LL
Department of Obstetrics and Gynecology, University of Florida College of Medicine, Jacksonville, Florida 32207, USA. lama.tolaymat@jax.ufl.edu
Kaunitz
Andrew M
AM
D000284:Administration, Oral; D000293:Adolescent; D000295:Adolescent Medicine / Q000379:methods; D003271:Contraceptive Agents, Female / Q000009:adverse effects / Q000627:therapeutic use; D003692:Delayed-Action Preparations; D017135:Desogestrel / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006176:Gynecology / Q000379:methods; D006801:Humans; D007434:Intrauterine Devices; D017258:Medroxyprogesterone Acetate / Q000009:adverse effects / Q000627:therapeutic use*; D010349:Patient Compliance; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control*; D014481:United States
D003271:Contraceptive Agents, Female; D003692:Delayed-Action Preparations; C044815:etonogestrel; D017135:Desogestrel; D017258:Medroxyprogesterone Acetate