What You and Your Daughter Should Know About Birth Control
One of the many topics that parents will discuss with their children is sex. It's not an easy subject and not many parents find joy in having "the talk." But it's necessary and inevitable. When discussing sex, contraception and protection with a teen, parents should remember to cover all bases and allow the child to ask questions along the way. Discussing sex is not offering a child an open invitation to participate or become sexually active; it is a parent's way of ensuring that a teen has accurate information to make an educated decision when the time comes -- and it will come.
Most experts agree that abstinence is definitely the best option for teens. But if your child is sexually active -- and many are -- you can help your teen to be safe with the best method of protection.
Especially for teens, availability may decrease the number of choices of contraceptive methods. If a teen is taking on the responsibility alone, this can increase the difficulty of the task. "The number one aspect of choosing a contraception method is access," says Carol Carrozza, Vice President of Marketing for Ansell Healthcare, which manufactures LifeStyle condoms. "Access has to be fairly easy. A teen's access might be limited to what they can get, whether it is because of money, time, a parent's knowledge, etc., so the options may be limited on what methods they can get legally and over the counter."
Teenaged girls may not know that they must visit a clinic or an OB/GYN to get fitted for a diaphragm or IUD or to get oral contraceptives. Or they may not have the money to pay for such service. A parent's involvement and support will broaden a teen girl's resources as well as her options for methods of contraception.
"Next in importance of factors to consider would be lifestyle," Carrozza says. "If a teen has already decided to become sexually active she will need to consider the other aspects involved with her decision. For example, is her partner inclined to share in the responsibility? If so, there are simple methods available that either party can obtain. If he refuses, then she will have to look at the alternative methods that she's in control of and offer her the best protection." In addition, if a female is only sexual active once a month, resorting to a method of contraception that offers protection all month long may not be worth the time, effort or money. However, if a female is more sexually active, ensuring extended protection may be the better alternative.
Each method of contraception has some cost involved. As a young teen may not have money readily available, the price of obtaining contraception could be an important factor in deciding what method to use. "Is a 15- or 16-year-old girl going to be able to afford $20 a month [for a] supply of birth control pills or $7 dollar [for a] box of condoms, which may last longer then a month?" Carrozza asks. "It all depends upon what they have available to spend. Again, if a parent is involved, the alternatives are more readily available as the parent's medical insurance may cover the visit to the OB/GYN for the pill, IUD, diaphragm or contraceptive injections."
Methods of Contraception
The only method of birth control that is 100 percent effective each and every time it is used is abstinence. Abstinence is free, there is no medical exam needed and this method of contraception protects against both pregnancy and sexually transmitted diseases. Both males and females can practice abstinence for birth control and even though sexual intercourse is avoided, abstinence allows for other intimate contact to be continued while still providing complete protection.
"For an unmarried teenager, I believe that the best form of birth control is abstinence," says Marie Geiger, a freelance writer from western Pennsylvania. "Do I think it is the most realistic option? Not for everyone. Abstinence will only work for a teen [who] believes in the benefits of waiting to have sex. I wish someone had really emphasized this with me. My daughter is only 4 now, but I think about these things a lot. Based on my experience and from a women's health viewpoint, I will make sure that she is aware both of how her reproductive system works and what the options are that are available for preventing pregnancy once she is in a position to be worried about that. She will know her options -- all of them."
One of the most popular forms of contraception, the birth control pill -- more commonly called "the Pill" -- is an oral contraceptive that must be taken each day to prevent pregnancy. The Pill offers no protection against STDs and is 95 to 99.9 percent effective.* "The good thing about oral contraceptives is that the woman is in control," says Carrozza. "She doesn't have to rely on her partner. I find that [it] is very difficult for young teen woman is to negotiate the use of a contraceptive or having to talk their partner into doing it. They just do not have the skills to do it. There are many adult women who do not have these skills as well because they never learned them when they were younger."
Taking the Pill will offer a constant and consistent amount of protection against pregnancy when taken regularly and as prescribed. Other advantages include more regularity in menstrual periods and a decrease in menstrual cramping. The Pill has also been shown to decrease the risk of osteoporosis, cervical cancer and pelvic inflammatory disease. Remember, though, that the Pill offers no protection against any sexually transmitted diseases. Other disadvantages of the Pill include the fact that it must be taken daily -- regardless of the amount of sexual activity -- to provide proper protection, and it may cause weight gain or depression. Women older than 35 or women who smoke are at greater risk of developing blood clots, heart attack and stroke while using the Pill as their means of contraception.* The average cost of the pill ranges from $15 to $35 for one month's supply and additional costs are required for a medical exam before the Pill can be prescribed. All of these advantages and disadvantages must be weighed carefully when considering the Pill as the method of birth control.
The Intrauterine Device -- also known as the IUD -- is a small plastic device that contains either copper or hormones and is implanted directly into the uterus by an OB/GYN. The IUD offers protection against pregnancy but will not prevent STDs from being transmitted from one partner to another. The IUD is 97.4 to 99.2 percent effective in protecting against pregnancy.* "With the IUD, a woman must be educated in order for it to be effective," Carrozza says. "Women who use or have an IUD must learn the warning signs of when it has slipped out of place as well as what pain or discomfort associated with the device is cause for alarm. The IUD is beginning to gain popularity again as it offers constant protection against pregnancy. If a woman is educated on its use, the IUD could be ideal for her lifestyle."
The advantages of the IUD are that it provides consistent protection against pregnancy and can be forgotten -- providing no complications arise. But teens may not be able to consider the IUD as a method of birth control, since the uterus may be too small for proper placement of the device. In addition, there are various conditions that can prevent the use of IUDs for both adults and teens, including various pelvic infections; vaginal infections; copper allergy; abnormality of the cervix, uterus or ovaries; Wilson's Disease; AIDS; or Leukemia. The cost of the IUD can be moderate to high, ranging from $95 to $300. There are also additional costs for office visits to an OB/GYN for fitting and placement, as well as costs for removal if complications arise. If the IUD is chosen as the method of birth control, the woman should feel comfortable with the risks involved and be well informed about the signs and symptoms of complications.
One of the newer methods of birth control is Norplant. The protection of Norplant comes from the insertion of six match-stick-sized capsules placed under the skin of the upper arm. These capsules deliver a constant level of progesterone -- a female hormone -- into the body, which prevents an egg from being released and thickens the cervical tissue layer, preventing pregnancy. Norplant offers no protection against STDs and is 99.95 percent effective in protecting against pregnancy.* The Norplant device, once inserted, is effective for up to five years. The cost of the Norplant is $500 to $600 for an exam, the implants and insertion. Cost of removing the implants upon evidence of complications can be as much as $200.
Complications of Norplant can include headache, dizziness, discoloration or discomfort at the insertion site, irregular menstrual periods or absence of flow, and weight gain. Woman who have diabetes, high cholesterol or blood pressure, heart disease, seizures that require medication, serious depression, conditions that may be aggravated by fluid retention, serious liver disease, breast cancer or are breastfeeding should use caution when considering the Norplant as their method of birth control.
This category includes condoms, spermicidal creams, gels, suppositories and foams, the diaphragm and the cervical cap. Barrier methods offer protection by not allowing the sperm access to the uterus where it would fertilize the egg and result in a pregnancy. These methods offer protection against pregnancy but -- with the exception of the condom -- do not protect against STDs. The effectiveness of the barrier methods ranges from 74 to 98 percent in protecting against pregnancy. The cost for barrier methods of birth control can be as little a $3 to as much as $50. With the exception of the cervical cap and the diaphragm, all of these barrier methods can be purchased over the counter with no need to seek professional instruction or direction for their use. Both the cervical cap and diaphragm must be fitted by an OB/GYN physician for proper protection.
"Latex condoms are not impervious to everything," Carrozza says. "They are not 100 percent. Nothing is 100 percent, which is why abstinence is still so important. It's best to be sure that it is a condom that is approved by the FDA. There are tons of novelty condoms out there but none are approved and will not offer the protection against pregnancy or STDs. The easiest way to know that the condom that is approved by the FDA is to look for an expiration date and a lot control number. Only use a condom within the expiration date and use it properly."
To make the task of discussing sex with their teen easier, parents should educate themselves and keep up to date with new methods of contraception and protection. An educated parent is more likely to have the answers that their child needs and wants. Also, it's probably a good idea to tell a child "I don't know" when that's the case. "Providing an atmosphere where children can gain knowledge is important," Carrozza says. "Offer a place where a child knows they can come and ask questions and even if a parent doesn't know, the parent will help them get the answers they need and want. Keeping the lines of communication open is another aspect that is important. Talk about their body, talk about protection, talk about their choices and offer them the possibilities, ramifications and consequences for the situations they are considering. But most importantly talk, don't preach."* Information provided by Planned Parenthood.