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JAMA Pediatrics Patient Page
May 2016

Long-Acting Reversible Contraception for Adolescents

JAMA Pediatr. 2016;170(5):516. doi:10.1001/jamapediatrics.2015.2526

Preventing unwanted pregnancy among adolescents is a priority for parents as well as pediatricians.

In 2014, there were 24.2 births for every 1000 female adolescents 15 to 19 years of age. Although the teen birth rate in the United States has decreased over the past 20 years, it is still higher than that of many other developed countries, including Canada and the United Kingdom.

Being an adolescent parent is associated with negative consequences for the adolescent parents, their children, and society. Children born to adolescents face many challenges, including having poorer educational, behavioral, and health outcomes compared with children born to older parents. Adolescents who have children face increased barriers to completing school, obtaining jobs, and achieving their personal goals.

Today there are 2 new and safe approaches to help prevent teen pregnancy. These methods are often referred to as long-acting reversible contraception (LARC) devices. These methods provide reliable contraception because once they are placed by a health care professional, the adolescent is protected from pregnancy. These methods have advantages over other forms of contraception that rely on adolescents to remember to take pills or get shots. These LARC devices include the following:

  • The intrauterine device (IUD) is a small, T-shaped piece of plastic that gets placed in the uterus. Having an IUD present interferes with the sperm’s ability to fertilize an egg. Many IUDs also have small amounts of hormone present to stabilize the uterine lining and further prevent pregnancy. The IUD offers years of protection, typically between 3 and 10 years depending on the type of IUD.

  • An implant is a very small rod that can be inserted under the skin of the upper arm. It is so small that it is typically not visible on the arm. The implant releases the hormone progesterone (which is normally present in a woman’s body) at a constant rate. This consistent release of progesterone prevents the ovaries from releasing an egg, so that pregnancy cannot occur. The implant can be left in place for up to 3 years.

Because these methods are newer, there can be misconceptions and myths about their use. This month’s JAMA Pediatrics includes a study describing the use of LARC devices among adolescents. Three common myths about LARC devices are as follows:

Three Common Myths About LARC Devices

  1. Long-acting reversible contraception devices are dangerous and can cause infections or infertility. Many research studies have evaluated LARC devices and found them to be safe, effective, and reversible so that teens can prevent pregnancy during adolescence and be healthy for the option of pregnancy in adulthood.

  2. Teens are too young to make a commitment to a long-acting form of contraception. One of the best things about an LARC device is that it can last for years and provide protection against pregnancy throughout adolescence. However, there is no minimum requirement for how long it has to stay in; you can have all forms of long-acting contraception removed at any time on request.

  3. Getting an LARC device placed is very painful. Pain varies from person to person, and it is hard to know how any given patient will feel. Many patients describe this pain as being similar to getting a flu shot or a Papanicolaou test. There are ways to make the placement process less painful, and you can talk to your physician if you are concerned about pain during the procedure.

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