Birth Control

Teens and Birth Control

Whether you are male or female, your life can suddenly be changed forever by pregnancy or a sexually transmitted infection (STI). Think for a moment what this would be like for you.

The most dependable way to prevent pregnancy and STI infection is not to have sexual intercourse. This is called abstinence.

If you do not choose abstinence and are sexually active, always be prepared. To protect yourself and your future, think ahead about birth control methods and STI protection. Never have sex without protection. Using condoms will reduce your risk of getting an STI.

Even a single act of sexual intercourse can lead to pregnancy or an STI infection. A sexually active teen (boy or girl) who is not using any birth control has a 90% chance of conceiving a pregnancy within 1 year.²

STIs are also called sexually transmitted diseases (STDs).

Take charge of your health and your future

Even if you plan not to have sex until you're older, take a little time to learn and decide about:

• Which birth control methods are available.
• Which birth control methods you know you would be able to count on every time you'd need one.
• How to use a condom to avoid getting or spreading a sexually transmitted infection, including HIV. (Some STIs can be spread through oral sex as well as through intercourse.) If you are sexually active, male or female, always have a condom with you. Don't ever depend on someone else to have a condom when you need it.
• How to use a combination of methods for the best protection against pregnancy and sexually transmitted infections.

It may not be easy to talk about sexual activity and birth control, but it is important that you know how to practise safe sex. Hopefully, you have a parent, school or church counsellor, or health professional that you feel comfortable talking to. Organizations such as the Canadian Federation for Sexual Health (CFSH) are private, confidential resources for learning how to be both sexual and responsible. See the CFSH Web site section for teens at www.cfsh.ca/ppfc/content.asp?articleid=40, or check your telephone listings for the Planned Parenthood office or sexual health clinic near you.

The best birth control methods for you are those that are easy for you to use (or are already in effect) each time you have intercourse. Follow up regularly with a health professional to make sure that your birth control method is working effectively for you. And if you have any side effects that are making it hard for you to use the method as directed, choose a different method.

If you have a long-term (chronic) illness or a disability, talk to a health professional about which birth control choices are best for you.

For teen boys and girls

Protect yourself and your partner from sexually transmitted infections and pregnancy.

• Consider the benefits of abstinence.
• If you have sex, use a condom.
• If your partner is not comfortable with using a condom, don't have sex.
• If you are not using another form of birth control, use spermicide (which is put in the vagina before intercourse) with the condom. Spermicide or another form of birth control lowers your risk of getting pregnant if the condom fails.

For teen girls

Some teenage girls are worried about visiting a health professional for birth control.

• Don't be shy about protecting yourself from sexually transmitted infections by having a condom on hand and asking your partner to use it.
• If you are concerned about having a pelvic examination or keeping your health information private, talk to your health professional or a family planning clinic counsellor.
• If you have not been sexually active before now, a pelvic examination may not be necessary.
• If you have been sexually active, it's very important that you are screened for STIs every year. Some STIs can be screened for with a urine test. You may not need a Pap test and pelvic examination until 2 to 3 years after you become sexually active. (A Pap test checks for early signs of cervical cancer, which starts from a sexually transmitted virus, a type of human papillomavirus.)
• Have emergency contraception on hand or know how to get it if a condom breaks.

Before choosing and using a birth control method, be honest with yourself. If it failed and you started a pregnancy, what would you do? Are you ready to raise a child? Is an abortion an acceptable option for you? Answering these questions can help you know how committed you are to preventing a pregnancy. For most sexually active teens, it is worth it to use the most effective birth control methods possible.

When choosing a birth control method, also consider protecting yourself against sexually transmitted infections. Condoms give the most effective STI protection for both partners, no matter what other birth control method you are using. Some studies suggest that female condoms are as effective as male condoms in preventing STIs.³ However, as birth control, condoms used alone are not highly dependable.

Birth control methods for teenagers

Method	Consideration
Abstinence	Not having sex is the most effective method of birth control and STI prevention.
Barrier methods	Condoms alone are a backup method of preventing pregnancy. When used with a spermicide or another birth control method, a condom is more likely to prevent pregnancy. You can use emergency contraception if the condom breaks. Male condoms are inexpensive and easy to get without a prescription. Male condoms give teen boys control over their STI risks and lower the risk of becoming a parent. Female condoms cost more than male condoms and can be difficult to use properly. A diaphragm, cervical cap, or Lea's Shield with a spermicidal cream, foam, or jelly can be difficult to use without first learning how to from your health professional.
Hormonal pill, skin patch, or vaginal ring	These are the most popular methods used by teenage girls. You must remember to take a pill every day at about the same time. Talk to your health professional about any side effects. Another type of hormonal birth control may be better for you if side effects are a problem. After stopping birth control pills (at the end of a full pack), you can become pregnant after your next menstrual period. The patch is changed every week, which can be easier to remember than taking a pill each day. The vaginal ring is a foldable, flexible ring of plastic that stays in the vagina for 3 weeks straight. Using a condom with these methods will help lower the risk of getting an STI.
Hormone injection (Depo-Provera)	This method is convenient and does not require use every day or with each act of intercourse. This method requires that you see your health professional every 3 months. Side effects of weight gain and irregular bleeding may be bothersome. Depo-Provera causes mild bone thinning when it is used for 2 or more years. This is of special concern during the teen years, when young women are normally building bone strength. Be sure to get enough daily calcium and weight-bearing exercise, and discuss your bone health and birth control options after 2 years of Depo-Provera use.
Intrauterine device (IUD)	The IUD is not usually recommended for teenage girls because an IUD can be uncomfortable or can come out if the uterus has not been stretched out by a pregnancy. Starting an IUD isn't an option for a teen who has a pelvic infection or a sexually transmitted infection. Inserting an IUD can carry infection up into the uterus, leading to pelvic inflammatory disease (PID).
Fertility awareness	This is not recommended, especially for teenagers, because it: Often leads to pregnancy, even with careful planning and not having sex on fertile days. Doesn't protect you from sexually transmitted infection.

Emergency contraception

Emergency contraception is the use of either a copper intrauterine device (IUD) or a certain type of birth control pill on a specific dosing schedule. The pills can prevent a pregnancy when taken up to 5 days after unprotected sex, although they are most effective when used within 72 hours. Using a copper IUD can prevent pregnancy if it is inserted within 5 to 7 days after you have had unprotected sex.

Hopefully, you'll never need to use emergency contraception. However, if you have had unprotected sexual intercourse or you think your birth control method may have failed, emergency contraception is a last-resort way to prevent a pregnancy. It is not to be used as a substitute for ongoing birth control.

In Canada, you can buy emergency contraception pills (Plan B) at a pharmacy without a prescription. Experts suggest keeping emergency contraception pills on hand so that you have them should you ever need them.¹ Talk to your health professional, family planning clinic, or pharmacist about this.

If you do use emergency contraception, be sure to follow up with your health professional to find an effective, ongoing method of birth control.

For more information, see the Canadian Federation for Sexual Health (CFSH) Web site at www.cfsh.ca. Or you can call the CFSH hotline toll-free at 1-888-270-7444 for more information.

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Author:	Merrill Hayden Carrie Henley	Last Updated: August 16, 2006
Medical Review:	Adam Husney, MD - Family Medicine Joy Melnikow, MD, MPH - Family Medicine Kirtly Jones, MD - Obstetrics and Gynecology Femi Olatunbosun, MB, FRCSC - Obstetrics, Gynecology and Reproductive Medicine
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