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Your teenage girl and sex: do you simply ignore it, or tackle this touchy subject? We give parents the facts on contraception for girls.
Most parents don't want to face the fact that their teen daughter might be sexually active. But the truth is that a great many teenagers are - possibly more so than ever before.
You could do a lot to help ensure that your daughter protects herself against an unwanted pregnancy or, worse still, sexually transmitted infections (STIs), including HIV.
Many young people don't go to clinics or doctors to learn more about contraception, because they're scared that their parents will find out. These teens are particularly vulnerable to pregnancy and STIs.
How should a teen protect herself?
Sexually active girls shouldn't only use condoms (male or female), but should also make use of another form of contraception.
Although condoms are useful in preventing STIs, they're not the most effective method to prevent pregnancy.
The following options of contraception are available:
*The Pill and hormonal injections
In many countries, both are available free of charge at clinics. The contraceptive Pill is most often used and rarely carries health risks for teens. They're available as a combination of oestrogen and progestogen, or as progestogen-only pills. The prescribing doctor would be able to determine what's best suited for your daughter.
If taken correctly, oral contraceptives are highly effective in preventing pregnancy. The combination Pill has a Pearl Index of less than one, which means that there'll be less than one pregnancy among 100 women who are using it correctly for one year. The progestogen-only Pill has a slightly higher risk for pregnancy with a Pearl Index of two.
Added advantages of oral contraceptives are that they can make periods more regular and relieve iron-deficiency anaemia, premenstrual tension and period pains. The combination Pill is also effective in treating acne.
Some medications, including antibiotics and epilepsy drugs, may cause the Pill to become less effective in which case condoms have to be used until the next period. Some teens suffer side-effects such as skin pigmentation or nausea, in which case a different pill may be prescribed.
Injectable contraceptives are 99% effective, as long as the injection is repeated at the correct intervals. This may be a better option for someone who isn't disciplined enough to use oral contraceptives. Some teens prefer this method, because they want to hide the fact that they're sexually active from their parents.
*Intrauterine devices (IUDs)
It is the highly effective (Pearl Index = 0.3 - 0.8). The advantage is that they provide immediate protection and are long-acting.
However, IUDs are usually not the preferred choice of contraceptive for teens. They're better suited for women older than 35 years and for those who have completed their families.
An IUD should never be used by someone who has multiple sexual partners because they have a higher risk of STIs and therefore of developing pelvic inflammatory disease.
*Diaphragms, cervical caps, condoms and spermicides
These are all barrier methods. They're not as commonly available and also not as effective against pregnancy as the Pill, injection or IUDs.
Condoms (male or female) are effective in preventing STIs, but shouldn't be used as the primary method of contraception.
Spermicides are sperm-killing chemicals available as gel, foam, jelly, foaming tablets, vaginal suppositories or cream which are inserted into the vagina. They should be used with diaphragms, caps or condoms. If 100 women use the diaphragm or cap together with a spermicide, five to 20 users will become pregnant within one year.
On their own, they have a higher failure rate. Some spermicides require a waiting period before becoming active inside the vagina. Others must be inserted immediately before intercourse.
*The rhythm method and withdrawal
These are both natural methods. Many teens fall pregnant because they mistakenly believe that withdrawal (coitus interruptus), or the rhythm method, protect against pregnancy. Withdrawal (removal of the penis immediately before ejaculation) is a very unreliable method (Pearl Index = 8-17) because some sperms can be deposited in the vagina before or during withdrawal. For the same reason, it doesn't protect against STIs.
The rhythm method, which involves a woman keeping a menstrual calendar to predict her most fertile period, requires accurate record-keeping and additional measurements of the basal temperature. This is definitely not a safe choice of contraception for teens, as they often don't have regular, well-established menstrual cycles.
What about the morning-after-pill?
Most teens don't plan their first sexual experience and are therefore not using contraceptives at the time. What do you do if your teen breaks the news that she has had unprotected sex the night before?
Don't panic. If you act fast, you can prevent an unwanted pregnancy.
Emergency contraceptive pills (ECPs), also called the "morning-after-pill", are a safe and effective method of birth control to prevent pregnancy after unprotected sex. ECPs prevent pregnancy by stopping or delaying an egg from being released from the ovary, by preventing the sperm from getting to the egg, or by stopping a fertilised egg from attaching to the womb. ECPs are available from clinics, pharmacies and hospitals.
Although ECPs may be used up to 120 hours (five days) after unprotected sex, they're most effective if taken 24 hours after sex.
But doctors warn that ECPs shouldn't be used as regular birth control. They're not as effective as other birth-control methods and frequent use of high doses of hormones isn't recommended.
If all else fails
For those who do fall pregnant, safe, legal termination of pregnancy up to 12 weeks of pregnancy is available in many parts of the world.
Let's talk about it
Fortunately, sexuality isn't such a taboo topic as it used to be. Nowadays most teens are exposed to sex education at schools.
But the primary responsibility still lies with the parent.
Open communication between parents and their children is important. Talking about sex doesn't encourage a child to have sex. The opposite is true: if done correctly, it could promote abstinence or, at least, more responsible sexual behaviour.
- (Health24)
