title: Trends in prescribing patterns of hormonal contraceptives for adolescents.
abstract: BACKGROUND
  Little is known regarding how prescribing patterns of hormonal contraceptives to adolescents in the United States have changed over time as new formulations become available and knowledge of thrombosis risk increases. Desogestrel and high-dose estrogen-containing formulations have been associated with a higher risk of thrombosis than other methods.
  
  
  METHODS
  We used the National Ambulatory Medical Care/National Hospital Ambulatory Medical Care surveys to describe trends in contraception prescriptions for 11- to 21-year-old females between 1993 and 2004.
  
  
  RESULTS
  The majority of prescriptions arose from obstetrics/gynecology clinics. The proportion of desogestrel-containing prescriptions was approximately 10% throughout the study period. Ortho Evra (transdermal norelgestromin, ethinyl estradiol) and Yasmin (oral drospirenone, ethinyl estradiol) accounted for a steadily increasing proportion of prescriptions.
  
  
  CONCLUSIONS
  With regard to contraception and thrombosis risk, a significant minority of adolescents are prescribed desogestrel-containing contraceptives, and a greater number are exposed to higher levels of estrogen from transdermal contraception. Future studies are needed to evaluate the absolute risk of thrombosis in adolescents using these formulations so clinicians have accurate safety information when prescribing to this unique population.
authors.affiliation: Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, USA. sarah.obrien@nationwidechildrens.org
authors.forename: Sarah H
authors.initials: SH
authors.lastname: O'Brien
authors.forename: Eloise E
authors.initials: EE
authors.lastname: Kaizar
authors.forename: Melanie A
authors.initials: MA
authors.lastname: Gold
authors.forename: Kelly J
authors.initials: KJ
authors.lastname: Kelleher
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000736:Androstenes / Q000009:adverse effects; D002648:Child; D003277:Contraceptives, Oral, Combined / Q000009:adverse effects; D017135:Desogestrel / Q000009:adverse effects; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D010818:Practice Patterns, Physicians'; D012307:Risk Factors; D014481:United States; D020246:Venous Thrombosis / Q000139:chemically induced
chemical_list: D000736:Androstenes; D003277:Contraceptives, Oral, Combined; D017135:Desogestrel; C035144:drospirenone