Long-acting contraceptives in adolescents

Tolaymat, Lama; Kaunitz, Andrew M.

doi:10.1097/gco.0b013e3282ef1cd2

Cited by 36 publications

(23 citation statements)

References 76 publications

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“…Ovulation occurs in 94% of women within 3 to 6 months of removal. 29 Both the transdermal patch and the vaginal ring are options for the adolescent patient, although they are not as effective as a LARC. A recent prospective cohort study with 9,256 participants demonstrated that there were significantly higher rates of unintended pregnancy among women using the pill, patch, or ring compared with women using an IUD, contraceptive implant, or DMPA.…”

Section: Contraceptionmentioning

confidence: 99%

Reproductive Health Care of Adolescent Women

Hayon

Dalby

Paddock

et al. 2013

The Journal of the American Board of Family Medicine

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Reproductive health care of adolescent women is focused on prevention of disease. Adolescents are at higher risk for pelvic inflammatory disease than adult women; therefore, screening regularly for sexually transmitted infections is important. Immunization for human papillomavirus is the primary means of cervical cancer prevention because new guidelines recommend not initiating Papanicolaou smears until the age of 21. Contraception for adolescents is a challenge, and clinicians should focus on longacting, reversible contraception in this group. The treatment of pelvic pain and menstrual disorders in adolescent women is distinct from adult women and is related to differing prevalence of conditions. Lastly, this article discusses the importance of confidential care when treating adolescent women. ( The reproductive health care of adolescent women is often distinct from that of adult women. This article reviews recommendations for preventive gynecologic care for adolescents and treatment of the most common gynecologic complaints seen in primary care.

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Section: Contraceptionmentioning

confidence: 99%

Reproductive Health Care of Adolescent Women

Hayon

Dalby

Paddock

et al. 2013

The Journal of the American Board of Family Medicine

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“…4 Injectable contraception (DMPA): skeletal impact in adolescents DMPA represents an appealing contraceptive method for adolescents because it is long-acting (with contraceptive effects lasting beyond the recommended 3-month schedule), private, not coital-or partner-dependent, and highly effective [30,31]. Of particular interest is DMPA's skeletal impact when used during adolescence, the time of accumulation of peak bone mass.…”

Section: Hormonal Contraceptive Optionsmentioning

confidence: 99%

Update on hormonal contraception and bone density

Isley

Kaunitz

2011

Rev Endocr Metab Disord

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Combination hormonal contraception and progestin-only contraception (including depot medroxyprogesterone acetate [DMPA]) are effective and convenient forms of reversible contraception that millions of women use worldwide. In recent years, observations of reduced bone mineral density in current users of these methods have led to concerns that this hormone-induced bone loss might translate into long-term increased fracture risk. Special focus has been placed on adolescent users who have not yet attained their peak bone mass as well as perimenopausal users. In 2004, the FDA added a black box warning to DMPA package labeling warning of the risk of significant bone loss and cautioning against long-term use (> 2 years). This article reviews evidence on the use of hormonal contraception and its effect on bone density in adolescent, premenopausal, and perimenopausal populations. Recommendations from reproductive healthcare organizations are reviewed and clinical recommendations are provided.

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“…Many clinicians recommend prescribing MPA instead of oral contraceptives specifically for adolescent patients to avoid compliance issues associated with a daily pill regimen (Cromer et al 1998, Khoiny 1996, Tolaymat & Kaunitz 2007. Between 2006 and 2008, over 270 000 adolescent girls (ages 15-19) in the United States alone were using MPA (Mosher & Jones 2010).…”

Section: Introductionmentioning

confidence: 99%

Early adolescent Depo-Provera exposure increases stillbirths in adult sooty mangabeys

Cappelletti¹,

Ethun²,

Meeker³

et al. 2015

Reproduction

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The 3-month injectable contraceptive medroxyprogesterone acetate (MPA; Depo-Provera) is a synthetic progestin that protects against pregnancy by suppressing ovulation. Studies have focused on the resumption of ovulation after MPA-treatment cessation but neglected potential long-term effects of MPA exposure on future successful reproduction. MPA is frequently administered to adolescent girls; however, long-term fertility effects of adolescent MPA exposure have not been explored. We investigated fertility after extended MPA exposure in a species of old world primate, the sooty mangabey (Cercocebus atys). Female sooty mangabeys (nZ31) received chronic MPA-treatment for 4-8 years. At MPA-treatment onset, subjects were either parous adults (nZ14) or nulliparous adolescents (nZ17), with adolescent-treated subjects being further divided into those who had reached first ovulation (nZ10) and those who had not (nZ7). After MPA-treatment cessation, adolescent-treated females had a significantly higher incidence of stillbirth than did age-matched and parity-matched controls, whereas adult-treated females did not differ from their matched controls. Females placed on MPA-treatment prior to first ovulation had a significantly higher incidence of stillbirth post-treatment than did females placed on MPA-treatment after first ovulation. Diabetic females had an increased incidence of stillbirth as compared to nondiabetic females; however, when controlling for diabetes, MPA exposure prior to first ovulation was still a significant positive predictor of stillbirth. These findings suggest that the post-treatment fertility effects of chronic MPA exposure vary with the developmental timing of treatment onset and raise concern about the use of MPA as a contraceptive for adolescent girls.Reproduction (2015) 150 497-505

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Long-acting contraceptives in adolescents

Cited by 36 publications

References 76 publications

Reproductive Health Care of Adolescent Women

Reproductive Health Care of Adolescent Women

Update on hormonal contraception and bone density

Early adolescent Depo-Provera exposure increases stillbirths in adult sooty mangabeys

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