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  • Title: Contraceptives for teenagers.
    Author: Bullough B, Bullough V.
    Journal: J Pediatr Health Care; 1991; 5(5):237-44. PubMed ID: 1919998.
    Abstract:
    The contraceptive options suitable for teenagers are presented and discussed. Condoms have the advantage of preventing the spread of sexually transmitted diseases, and oral contraceptives are probably the most effective in preventing pregnancy. Other options include the barrier contraceptives available to women, spermicides, sponges, intrauterine devices, periodic abstinence, and the morning after pill. Contraceptives for teenagers are discussed in detail by type and appropriateness for teenagers, the role of nurses, and the nature of and approach to the client. Contraceptives included are oral contraceptives currently available (24 kinds) and contraindications, condoms, barrier contraceptives such as the diaphragm and sponges, spermicides, IUDs, periodic abstinence, morning after pills, and other methods. Because of the high rates of sexually transmitted diseases (STDS), the method recommended is the condom. There are reservations, however, because some teenagers may lack the maturity to use the condom reliably. When used in conjunction with a sponge or vaginal spermicide, protection against unwanted pregnancy is improved. Females may prefer oral contraceptives, which have the disadvantage of not protecting against STDs. The choices are many, however, and can be tailored to the needs of the client. The role of the nurse practitioner or nurses providing contraceptive advice is important because the information provided by many parents and school-based sex education courses is too little too late. Clients tend to be female and are placed in the position of needing to be more responsible for sexual behavior because males do not take responsibility. The stigma attached to planned sex is a deterrent to using contraceptive protection. The media are partly responsible for enhancing the image of unplanned passionate sex as being the most desirable in relating to a teenaged client, the nurse needs to establish rapport and seek a health history which includes questions about sexual behavior and birth control. Provide guidance so that choice is given, but also state a preference and the justification for its selection. Oral contraceptives (OCs), for example, are 95% effective for 1st year users. The 28-day regimen increases compliance because there is a pill for every day. Consistent time of use (within 4 hours of the time taken the preceding day) is important information to be stressed with the low-dose OCs. Norinyl 1/35 or OrthoNovum 1/35 is recommended for teenagers because of the low dose of estrogen and the good balance. When side effects occur, the balance needs adjustment. Minipills are suggested for lactating mothers or those with headaches, edema, or breast tenderness, but are also less effective. On the other hand, condoms have a failure rate of 9-12% for 1st year use, but increased skill effectiveness is increased. Use instructions are given.
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