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Contraception for Young People
What is birth control for teenagers? What are contraceptives?
'Birth control' is a term that describes ways to stop a woman or girl from becoming pregnant. Birth control can mean a wide range of things – from 'contraceptives' (used to reduce the chances of a woman becoming pregnant) to other ways of avoiding pregnancy, like not having sex.
Making decisions about sex and birth control
If you don’t want to have a baby, there are two main options – either don’t have sex, or if you are going to have sex, use contraception.
What is meant by 'having sex'?
Well, here we’re talking about having sexual intercourse, where a man inserts his penis into a woman’s vagina. There are other forms of having sex – like oral sex, for instance – but the only one that can get a girl pregnant is vaginal sexual intercourse.
You might be thinking ‘yeah ok, I already know that girls get pregnant through sexual intercourse’. But are you sure that you really know the facts about pregnancy? There are a lot of myths out there. Despite what you may have heard, a girl can become pregnant:
- The first time she has sexual intercourse.
- Even if she has sex before she’s had her first period.
- Even if she has sex during her period.
- Even if a boy pulls out (withdraws his penis) before he comes/ejaculates.
- Even if she has sex standing up.
- Even if she forgets to take her pill for just one day.
Take our pregnancy quiz to make sure that you really know what causes a girl to get pregnant!
Not having sex
The only 100% effective way to avoid having a baby is to not have sexual intercourse, also known as 'abstaining from sex'. Many young people around the world choose this option. For some, this means not having sex until marriage. For others, it can mean different things, like waiting until they’ve found a stable partner who they feel comfortable with. You need to decide what’s best for you personally – don’t feel pressured into having sex just because others are. It’s important to feel that you’re ready before you start having sex.
“Don’t feel pressured into having sex just because others are.”
Some people believe that you shouldn’t start having sex (be abstinent) until you’re married. People also have different views about having sex in marriage; some think you should only have sex if you want to have a baby, whilst others think that once you are married, it’s ok to use birth control if you still don’t want a baby. Many religious groups have strong views on the issue of sex and marriage.
A lot of people, on the other hand, don't think that there's anything wrong with having sexual intercourse when you don’t want a baby, and many don’t believe that you have to be married, or even in a serious relationship, before you start having sex. It's good to think about where you stand on this issue.
Having sex and using contraception
As much as abstinence is the right route for some people, a lot of teens don’t want to wait to have sex until they’re ready to have a baby. Puberty brings with it a lot of sexual feelings, and many choose to have sex for the first time during their teenage years. If you do choose to have sex (and you should only have sex when you're sure that you're ready), make sure that you use contraception. There are many types of contraception for teenagers, and you should choose one that suits you and your relationship.
Abortion (termination of pregnancy)
Some women and girls don’t want to have a baby, but become pregnant because they’ve had sex without using contraception, or because the contraception that they’ve used has failed for some reason. In these situations, women may decide to have an abortion. This is where a woman becomes pregnant, but the embryo or foetus (unborn baby) is removed, stopping pregnancy.
As with birth control in general, there are many different arguments about whether abortion is right or wrong, and whether it should be allowed. If you have sex, you need to consider how you feel about this issue, and how your life would be affected if you had to make such a decision.
It is important not to confuse arguments about whether abortion is right or wrong with facts about the medical procedure. Different countries have different laws about abortion, and in many countries it is illegal. In many places where abortion is legal, it is a safer medical procedure than childbirth, and having a safe abortion does not affect your future ability to have children. 1 Where abortion is illegal and not performed in a medical setting, it can be very dangerous.
Contraceptives for teenagers
Are there many different methods of contraception?
Yes. Contraceptives work by preventing a man’s sperm from fertilising a woman’s egg, and this can be done in several different ways.
There are two main types of contraception:
- Barrier methods - which physically prevent sperm from swimming into the uterus and fertilising the woman’s egg
- Hormonal methods - which alter a woman’s hormonal cycle to prevent fertilisation.
Other types of contraception, which are generally not used by young people, include natural methods such as only having sex at certain times of the month (these are often not effective enough to prevent pregnancy), and sterilization, which is a permanent surgical procedure.
The intrauterine device (IUD) and intrauterine system (IUS), also known as 'the coil', are generally not used by young people although in some countries, such as the UK, they are now considered suitable for all age groups.
How do you know which one to choose?
Different methods of contraception have their individual advantages and disadvantages. There’s no single ‘best’ method of contraception, so you have to decide which is most suitable for you. Whatever your situation, there should be a contraception option that works for you. For many people, barrier methods of contraception are best, because they not only prevent pregnancy, but also prevent HIV and other sexually transmitted infections (STIs) being passed on during sex.
Where do you get contraceptives from?
It depends which type of contraceptive you’re looking for. Barrier methods such as condoms and spermicides are widely available from drug stores and other shops in many countries. They’re also available from many healthcare providers. Hormonal methods are only available on prescription from doctors. You can also buy some contraceptives online.
Barrier methods of contraception
There are three main barrier methods of contraception used by teens: the male condom, the female condom, and spermicides in the form of foams or gels.
The male condom
The male condom is the only method of contraception that boys can use. It's really just a rubber tube. It's closed at one end like the finger of a glove so that when a boy puts it over his penis it stops the sperm going inside a girl's body. An advantage of using male condoms is that a boy can take an active part in using contraception – it's not just the girl's responsibility.
The female condom
The female condom is not as widely available as the male condom and it is more expensive. It is however very useful when the man either will not, or cannot, use a male condom. It’s like a male condom, except it’s bigger and worn inside the vagina.
It's a good idea to practice with condoms before having sex. You can get used to touching them, and it might help you feel more confident about using them when you do have sex.
Spermicides are chemical agents that both kill sperm and stop sperm from travelling up into the cervix (the lower part of the uterus, or womb, where babies develop). Spermicides come in different forms including creams, foaming tablets, gels and foam (which is squirted into the vagina using an applicator). Young people who use spermicide mostly choose foam.
Spermicides are not very effective against pregnancy when used on their own, but are very effective if used at the same time as a male condom. When used together, the male condom and spermicide can be a great combination for effectively protecting against both pregnancy and sexually transmitted infections such as HIV.
Some condoms also come lubricated with spermicide (Nonoxynol 9). A spermicidal lubricant aims to provide an additional level of protection if some semen happens to leak out of the condom. This can help to reduce the likelihood of pregnancy, but regular use of Nonoxynol 9 can cause an allergic reaction in some people resulting in little sores that can actually make the transmission of HIV and other sexually transmitted infections more likely. Nonoxynol 9 is only a suitable spermicide when both partners are HIV-negative. It should only be used for vaginal sex.
Hormonal methods of contraception
There are two main types of hormonal contraception which can be used by teens: the contraceptive pill, and the injectable hormonal contraceptive. If used properly, both are extremely effective in providing protection against pregnancy – but they provide no protection at all against sexually transmitted infections. For very good protection against both pregnancy and sexually transmitted infections like HIV, a hormonal method should be used at the same time as the male condom.
In some countries, contraceptive patches (that stick to the skin) and rings (that go inside the vagina) are also available.
The contraceptive pill (sometimes known as the birth control pill)
- What does 'going on the pill' mean?
People often talk about being 'on the pill'. This means they are using the oral contraceptive pill as a method of contraception. This has nothing to do with oral sex, and just means that the contraceptive is in pill form which is taken orally (swallowed).
- How does it work?
The pill contains chemicals called hormones. One type of pill called ‘the combined pill’ has two hormones called Oestrogen and Progestogen. The combined pill stops the release of an egg every month – but doesn't stop periods.
The other type of pill only has Progestogen in it. It works by altering the mucous lining of the vagina to make it thicker. The sperm cannot then get through, and as the sperm can't meet the egg, the girl can't get pregnant.
- What do you do?
Usually a girl has to take one pill every day for about three weeks. She then takes a break for seven days while she has her period, before starting the cycle again (or instead, she may take ‘sugar’ pills for those seven days, i.e. pills that don’t actually have any affect, but which are taken purely so she keeps in the routine) for seven days.
It's very important not to forget to take these pills. If this happens, protection against pregnancy is lost. The Progestogen-only pill also has to be taken at the same time every day.
- How effective is the pill?
It's a very effective method of contraception if it is taken correctly. If the pill is taken exactly according to the instructions, the chance of pregnancy occurring is practically nil. But if a girl forgets a pill, or is very unwell, its effectiveness is reduced. Another disadvantage of the pill is that it does not provide any protection against STIs. For very good protection against both pregnancy and STIs, the birth control pill should be used at the same time as the male condom.
Injectable Hormonal Contraceptive
How do you use it? How does it work?
The most popular form of this type of contraception, Depo-Provera, involves the girl having an injection once every twelve weeks. The injection is of the hormone Progestogen. The injection works in the same way in the body as the Progestogen only pill, but has the advantage that you do not have to remember to take a pill every day. It does however have the same disadvantage as the hormonal pill, in that it provides no protection against STIs. 2
The Contraceptive Implant
What is it?
The 'implant' is a newer form of contraceptive, which has become available in some countries, such as the UK. It is a small tube, a little over an inch long, which is inserted under the skin on the inside of a girl's arm.
How does it work?
The implant works in a similar way to the contraceptive pill, but instead of taking a pill every day, hormones are steadily released into a girl's body from the device. This is seen as an advantage, particularly for girls who have trouble remembering or don't like having to take a pill every day. However, the implant can cause unwanted side effects, and like the other hormonal contraceptives, the implant does not protect against STIs.
The morning after pill
If a girl has had unprotected sex, but doesn’t want to have a baby, one option is ‘the morning after pill’ – an emergency contraceptive that can prevent pregnancy, when taken after sex. The name is actually a little bit misleading, as it doesn’t necessarily have to be taken ‘the morning after’ – it can work up to 72 hours after you’ve had sex. However, it’s most effective when taken within 24 hours of sex, and the sooner you take it, the better.
In a lot of countries you can get the morning after pill for free, as a prescription from your doctor or healthcare provider. In some – including the USA, Scotland, England and Northern Ireland - you can also buy it over the counter at pharmacies. In Wales, it is available free at pharmacies.
Although the morning after pill can be an effective way to avoid pregnancy if you have had unprotected sex, you shouldn’t rely on it, or use it regularly. It’s not as effective as other methods of contraception, and can have side effects. What’s more, it won’t protect you from HIV or other sexually transmitted infections.
Contraception and HIV
Some evidence has suggested that girls/women who have the hormonal injection are at an increased risk of HIV infection. It also suggests a rise in the likelihood of HIV transmission to her partner(s). 3 4
But, unprotected sex may have been the reason for the HIV transmission; remember to always use condoms, even if you are on contraception! Only condoms will prevent HIV and STI transmission!
For more specific guidance on what type of contraception to use, see this HIV & Contraception tool.
- 1. Brook (2012) ' Abortion'
- 2. Morrison, CS et. al (2011) ' Hormonal contraception and HIV: an unanswered question' Lancet Infect Dis, Epub ahead print
- 3. Pam Belluck, New York Times (2011) ' Contraceptive Used in Africa May Double Risk of H.I.V.'
- 4. Morrison, C., & Nanda, K., (2012, January) ' Hormonal contraception & HIV.' The Lancet, Vol 12, Issue 1, Pages 2-3
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