Contraception for teenagers and young women

Kristina Gemzell Danielsson (SE)

[Gemzell Danielsson] Karolinska Institutet, Stockholm

Long acting reversible contraceptive methods (LARCs) includes the subdermal contraceptive implants, and intrauterine contraception. The advantages of LARCs also for young and nulliparous women are increasingly being recognised although several barriers to their use remains. While the efficacy of short or mid-acting contraceptive methods are highly dependent on the user and tend to have a lower effectiveness in young women LARCs are equally effective in all age groups. The contraceptive efficacy of LARC methods is independent of the user and LARC methods offer long-term application. The contraceptive efficacy of LARCs is comparable to that of female sterilization but it is completely and rapidly reversible with no impact on future fertility. In addition to being highly effective contraceptive methods, LARCs offer several additional non-contraceptive benefits that include: reduced blood loss, prevention of anaemia, increase in serum ferritin and iron levels, and reduction of dysmenorrhoea as well as prevention of endometrial cancer. LARCS have proven to be the most cost-effective contraceptive methods. Despite this, there are several myths that unfortunately create barriers to the use of intrauterine contraception and exclude young and nulliparous women from the use of highly effective and acceptable contraceptive methods. Data on the use of LARC methods in nulliparous women is reassuring and should be used to update local guidelines and current practise.