NEW PROGESTIN ORAL-CONTRACEPTIVES AND THE FEMALE CONDOM

Recent advances in contraceptive technology offer US adolescent females the potential to reduce their risk of unwanted pregnancy and sexually transmitted diseases (STDs) without unacceptable side effects. Newly developed oral contraceptives that contain the progestins desogestrel or norgestimate (Desogen, Ortho-Cept, Ortho-Cyclen, and Ortho Tri-Cyclen) have fewer metabolic and androgen-related side effects yet maintain the progestational suppression of ovulation and the endometrium. The failure rate for these progestin pills is under 1%. A Sunday start regimen may be most appropriate for adolescents who have intercourse on weekends. To avoid discontinuation, adolescents should be counseled that breakthrough bleeding may occur for the first three cycles. Also recommended for use by adolescents is the new female condom--the only female-controlled method that confers protection against both pregnancy and STDs. With careful, consistent use, the female condom has a failure rate of 2.6% in the first six months.