AAP Addresses Emergency Contraception for Teens

Policy statement encourages pediatricians to give emergency contraception Rx in advance

MONDAY, Nov. 26 (HealthDay News) -- The importance of emergency contraception for preventing unintended pregnancy among teenagers is emphasized in a policy statement issued by the American Academy of Pediatrics (AAP) and published online Nov. 26 in Pediatrics.

Krishna K. Upadhya, M.D., M.P.H., and colleagues from the AAP's Committee on Adolescence provide current data on the safety, efficacy, and use of emergency contraceptive in teenagers, focusing on pharmacologic methods of emergency contraception used within 120 hours of unprotected or underprotected intercourse.

The authors note that pediatricians should be aware of the prevalence of sexual behavior among teenagers. Noting that teenagers are at high risk of contraceptive failure, pediatricians must recognize the importance of emergency contraception, which is most effective when used as soon as possible, within 120 hours of unprotected or underprotected intercourse. For teenagers in need of emergency contraception, pediatricians should provide levonorgestrel (total treatment dose of 1.5 mg), and prescriptions should be provided in advance, which increases the likelihood of use when needed, reduces time to use, and does not decrease condom or other contraceptive use. Compared with combined hormonal emergency contraception methods, levonorgestrel has an improved adverse effect profile and increased effectiveness. Females aged 17 or older can obtain levonorgestrel without a prescription. As part of routine anticipatory guidance, counseling should be provided to all adolescents and families of disabled adolescents regarding emergency contraception. Pediatricians should advocate for increased access to nonprescription emergency contraception.

"Studies have shown that adolescents are more likely to use emergency contraception if it has been prescribed in advance of need," the authors write. "However, a majority of practicing pediatricians and pediatric residents do not routinely counsel patients about emergency contraception and have not prescribed it."

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