What are the contraceptive options for a 16-year-old female?

From the Guidelines

For a 16-year-old, the most recommended birth control options are long-acting reversible contraceptives (LARCs) like IUDs and implants, due to their high effectiveness and minimal side effects. These options include hormonal IUDs (Mirena, Kyleena, Skyla, Liletta) or the implant (Nexplanon), which can last 3-10 years depending on the type and require no daily maintenance 1.

Key Considerations

• LARCs are over 99% effective and can help with period management, making them an excellent choice for teens.
• Combined hormonal contraceptives like the pill, patch, or vaginal ring are also good options but require consistent use.
• Teens can typically access birth control confidentially through healthcare providers, Planned Parenthood, or school-based health centers.
• Most states allow minors to consent to contraceptive services without parental involvement.

Important Factors

• It's essential to consider using condoms alongside hormonal methods for STI protection.
• The best choice depends on the individual's health history, preferences, and lifestyle, so consulting with a healthcare provider is recommended for personalized advice 1.
• Patients should be counseled on the potential risks and benefits of each method, including the increased risk of blood clots associated with combined hormonal contraceptives 1.

Additional Recommendations

• A routine follow-up visit 1 to 3 months after initiating birth control is useful for addressing persistent adverse effects or adherence issues.
• Patients should be informed of common transient adverse effects, including irregular bleeding, headache, and nausea.
• Neither weight gain nor mood changes have been reliably linked to use of combined hormonal contraception 1.

From the FDA Drug Label

1. 3 Acne Drospirenone and ethinyl estradiol tablets are indicated for the treatment of moderate acne vulgaris in women at least 14 years of age, who have no known contraindications to oral contraceptive therapy and have achieved menarche. 1.1 Oral Contraceptive Drospirenone and ethinyl estradiol tablets are indicated for use by females of reproductive potential to prevent pregnancy.

Birth Control Options for a 16-Year-Old:

• Drospirenone and ethinyl estradiol tablets are indicated for use by females of reproductive potential to prevent pregnancy 2.
• The patient must be at least 14 years of age and have achieved menarche to use drospirenone and ethinyl estradiol tablets for birth control or acne treatment 2. Since the 16-year-old has achieved the required age and menarche, drospirenone and ethinyl estradiol tablets can be considered as a birth control option.

From the Research

Birth Control Options for 16-Year-Olds

• Oral contraceptive pills (OCPs) are a commonly used form of prescription contraceptives among adolescents in the United States, providing safe and effective birth control with proper use 3.
• Broad categories of OCPs include progestin-only pills (POPs) and combined oral contraceptive pills (COCs), with certain types of progestins having more potent antiandrogenic properties and being more effective in treating acne, hirsutism, and polycystic ovary syndrome 3.
• A combined oral contraceptive with estetrol plus drospirenone has been recently approved in several countries, showing high tolerability, safety, and satisfaction, and may represent a viable choice for young girls in need of oral contraception 4.

Types of Oral Contraceptives

• Drospirenone/estetrol (DRSP/E4) is a combined oral contraceptive that prevents pregnancy by inhibiting ovulation, with estetrol differing from other estrogens due to its selective action in tissues 4.
• A low-dose 21-day combined oral contraceptive containing ethinylestradiol 20μg and drospirenone 3mg has been shown to be effective and well-tolerated, with an acceptable bleeding profile 5.
• An estetrol-drospirenone combination oral contraceptive has been evaluated in a North American phase 3 trial, demonstrating efficacy, predictable bleeding patterns, and low adverse event rates 6.

Efficacy and Safety

• The estetrol-drospirenone combination oral contraceptive has been shown to have a Pearl index of 2.65, method-failure Pearl index of 1.43, and 13-cycle life-table pregnancy rate of 2.1% in women aged 16-35 years 6.
• Scheduled bleeding occurred in 82.9% to 87.0% of women per cycle, with a median duration of 4.5 days, and unscheduled bleeding decreased over time 6.
• The most frequently reported adverse events were headache and metrorrhagia, with no thromboembolic events occurring 6.