OUTCOMES OF ADOLESCENTS USING LEVONORGESTREL IMPLANTS VS ORAL-CONTRACEPTIVES OR OTHER CONTRACEPTIVE METHODS

Objective: To compare outcomes among adolescents who use levonorgestrel implants, oral contraceptives, or other methods of birth control. Design: Prospective, longitudinal study of 166 females who were followed up for 6 months. Fifty-four used implants, 64 used oral contraceptives, and 48 used condoms alone or with spermicide, or no contraceptive. Outcomes were measured by patient interview and medical chart review, Setting: Inner-city, hospital-based adolescent and teenaged mother and baby clinic between April 1, 1992, and May 31, 1993. Participants: Sexually active 12- to 18-year-old females at least 1 year postmenarche who had no contraindications to use of hormonal contraceptives. Main Outcome Measures: Sexual activity, pregnancy rates, condom use, incidence of sexually transmitted disease, patient satisfaction, continuation rates, and side effects. Results: Despite similar reports of sexual activity, one subject who used the implant (2%) vs 13 subjects who used oral contraceptives (20%), and eight subjects who used other methods (17%) became pregnant (chi(2), P < .50). Condom use did not differ among groups (chi(2), P > .60). Overall, 30% of subjects contracted a new sexually transmitted disease; rates did not differ by method (chi(2), P = .92). Implant users were more likely than oral contraceptive users to continue their method (87% vs 50%; chi(2), P < .001) despite similar satisfaction scores (one-way analysis of variance, P = .52). Implant users were more likely to experience irregular menses, mood swings, acne, and hair loss (chi(2), P < .05). Conclusions: In this population, the levonorgestrel implant is an effective method of pregnancy prevention and is associated with high satisfaction and continuation rates at 6 months. Implant users are not at greater risk than others for sexually transmitted disease. Health care providers should continue to stress the use of barrier methods to all sexually active adolescents.