Contraceptives for Teenagers?

If you've been following the news, you've probably come across the controversial reproductive health care bill now dubbed by the interwebs as the Senator Susan Kihika bill. You've also followed the tragic story of the spike in teen pregnancy since the onset of the pandemic that necessitated the tabling of the bill.

We could harp on about the morality of teenage sex and teenage pregnancies and who's to blame but it won't change the fact that very many teenagers across this country, socio-economic backgrounds notwithstanding, are engaging in sex and we need to acknowledge that and find a solution.

Including comprehensive sex education in our schools is going to go a long way in countering teenage pregnancies and STDs. Here's how they do it in the Netherlands. The Netherlands model drastically reduced unwanted teenage pregnancies and more kids even abstained from sex all together!

Part of sex ed is provision of contraceptives for teens. Yikes! Before you zone out and dismiss this, hear me out. Have the all important sex talk with your teen. Don't vilify sex, just let them know that it's great with the right person in an ADULT relationship and no one should ever coerce them to have test sex.

If they do decide to have sex, protection is paramount. Their number 1 go-to contraception should be condoms. Condoms not only protect one from sexually transmitted infections, they also prevent unwanted pregnancies.

Many parents don't feel comfortable having sexually blunt conversations or discussing contraception with their teen. If you are nodding your head in recognition, we recommend you refer your child to LVCT Adolescents and Youth Program. They have peer-to-peer counselling from thoroughly trained young people who have vast knowledge on safe sex and contraceptives.

They have a confidential one-to-one hotline 800 720 121 (toll-free) from 8 am - 10 pm Kenyan local time. If you'd like to personally counsel your teenager about birth control but don't feel confident in your knowledge, here's a list from their site:

Contraceptive Implant (Implanon or Nexplanon)

What It Is: A thin, flexible plastic implant (about the size of a matchstick) that contains a hormone and is placed under the skin of the upper arm.

Advantages:
- Provides safe and very effective long-term birth control.
- Teens don't have to remember to do anything every day, week, or month to stay protected from unintended pregnancy.
- Does not need to be replaced for 3 years.
- Contains a progestin hormone that prevents the ovary from releasing an egg.

Disadvantages:
- May have irregular bleeding.
- Less common side effects include weight gain, headaches, and acne.
- Does not protect against STDs, so should be used in conjunction with condoms.

Intrauterine Device (IUD)

What It Is: A doctor inserts the small, flexible, T-shaped birth control device into the uterus. There are two types:
- Copper T IUD (Paraguard): Does not contain hormones and does not need to be replaced for 10 years.
- Levonorgestrel IUD (Mirena, Skyla): Contains a hormone; does not need to be replaced for 3 to 5 years.

Advantages:
- Provides safe and very effective long-term birth control.
- Teens don't have to remember to do anything every day, week, or month to stay protected from unintended pregnancy.
- Options for both hormonal and non-hormonal types of IUD.
- May have less cramping and lighter periods with the levonorgestrel IUD (many teens stop having periods over time, which is perfectly healthy and often a blessing)

- Disadvantages:
  - May have pain or cramping for a short time after insertion
  - Levonorgestrel IUD: May have irregular bleeding or spotting (usually improves with time)
  - Copper T IUD: May have increased menstrual cramping, spotting, and heavier bleeding (usually improves with time)

Does not protect against STDs, so should be used in conjunction with condoms.

Progestin Injection (Depo-Provera)

What It Is: A shot containing a hormone that prevents the ovaries from releasing an egg. It lasts for 3 months.

- Advantages:
  - Only requires visits to the doctor every 3 months.
  - "The Shot" also protects against endometrial cancer and iron-deficiency anemia.
  - May have less cramping and lighter periods (many teens stop having periods after several doses which is perfectly healthy).
- Disadvantages:
  - May have weight gain.
  - May have irregular bleeding or light spotting (may improve with time).
  - Once the hormone is discontinued, fertility may take up to two years to return to normal (usually within one year).
  - Could interfere with normal increases in bone density, but this is usually restored after it is discontinued.
  - May increase the risk of blood clots.

Does not protect against STDs, so should be used in conjunction with condoms.

Contraceptive Vaginal Ring (NuvaRing)

What It Is: You place the ring in your vagina once a month. It has hormones that prevent the ovaries from releasing an egg. The ring is in place for 3 weeks, and then removed for 1 week (during that week the user gets a period). The ring does not provide protection from STDs, so it is still important to use condoms.

Advantages:
- May have lighter periods.
- May have less cramps.
- Acne may improve.

Disadvantages:
- Can be hard for some teens to remember to replace the ring each month.
- May have headaches, nausea, vaginal discharge, or breast tenderness.
- May increase the risk of blood clots.

Contraceptive Patch (Ortho Evra)

What It Is: The patch contains hormones that are absorbed through the skin and prevent the ovaries from releasing an egg. It needs to be replaced once a week for three weeks; then it is removed for a week (during that week the user gets a period). The patch doesn't provide protection from STDs, so it is still important to use condoms