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Abstract

Contraception in adolescent

When contraceptives are prescribed to the adolescent, more aspects have to be taken into consideration than in the adult. Beside discussing different possibilities of contraception, young women have to be educated about female reproductive physiology. Such information helps them to gain inside of their menstrual cycle and based on this to better understand the effects of different contraceptives. Charts illustrating the female menstrual cycle and different contraceptive methods should be used to support the counseling interview. Also topic-related brochures can be helpful and should be handed out to the adolescents. In addition the adolescent should be counseled about sexually transmitted diseases and preventive measures, including HPV vaccination. Finally, certain legal aspects have to be taken into consideration when prescribing contraceptives to the minor.

Combined oral contraceptives are still the common therapeutic mainstay for the adolescent, as they are well tolerated and provide beneficial secondary effects beyond their sufficient contraceptive effect, as relieve of dysmenorrhoea, acne or instability of the menstrual cycle. Up to now, data on the best fit dose of oral ethinylestradiol (EE) in young women are not conclusive. Another common contraceptive method is the vaginal ring, especially in women above 16 years of age. The EE dose of this method is listed as 15 ?g per day and hence might be non-fitting for girls below the age of 16. In the upcoming years further knowledge regarding estradiolvalerat (E2) contraceptives will be gathered. It is likely, that these medications will be used equivalently to EE-preparations. The introduction of smaller hormonal intrauterine devices with lower gestagenic index (LCS) to the German market is expected, following completion of ongoing medical trials. This could lead to a higher acceptance of hormonal intrauterine devices as an alternative for the adolescent in Germany, as already seen in other European countries.

CME Prakt Fortbild Gynakol Geburtsmed Gynakol Endokrinol 2012; 8(2): 104–120

Keywords
Contraceptive methods in adolescence, pregnancy in adolescence, adolescent sexual behavior, estrogen free contraception, hormonal contraception

Patricia G. Oppelt, Christine Schulze, Katharina Heusinger
Frauenklinik des Universitätsklinikums Erlangen

Reviewer: Ines Doll, Hamburg,
und Marlene Heinz, Berlin

Oppelt P. G. Kontrazeption ... Gynakol Geburtsmed Gynakol Endokrinol 2012; 8(2): 104–120 publiziert 31.07.2012 www.akademos.de/gyn ©akademos Wissenschaftsverlag 2012 ISSN 1614-8533