Is sex safe by the age of 16

Contraception in adolescents

Contrary to popular belief, young people today do not have sex any earlier than their parents' generation

Quite a few young people are consciously abstinent because they either do not fully trust contraception or because they refuse to take hormone preparations, for example. Much more common, however, is the use of a condom (71% of girls and 66% of boys use it during their first sexual intercourse) and, unfortunately, unprotected intercourse still occurs

When it comes to choosing a contraceptive, one thing is clear in adolescence: as safe and simple as possible. But only very few contraceptives do this:

  • Low-dose, multi-stage, single-phase preparations ("pill"). The advantages are reduced menstrual cramps, more regular menstruation and often an improvement in acne (for severe acne, a preparation with an anti-androgenic effect can be chosen). Growth and physical maturation are not affected. The side effects correspond to those of adult women, for example the risk of thrombosis increases. If the family is known to have thrombosis, the prescribing doctor must first check the coagulation status using laboratory tests. The same applies to adolescents: Preparations containing estrogen are not suitable for heavy smokers. Rating: Most convenient and, above all, safest form of contraception - if regular conscientious use is guaranteed.
  • An alternative is the hormone ring, a small plastic ring with estrogens and gestagens, which is inserted into the vagina during menstruation and remains there for 3 weeks, followed by a one-week break. Advantage: the ring needs a quarter of the hormone dose of the pill. Disadvantage: the ring can "slip out" with the tampon, and the ring can sometimes be felt during sexual intercourse (but it can be removed for up to 3 hours without loss of effectiveness).
  • Condoms: They are not only important for preventing infections, but are also the only contraceptive that can be quickly obtained during spontaneous sexual intercourse. Because the condom is not always used correctly, the failure rate of the condom in young people is often over 10%.

Unfortunately, practically all other contraceptive methods in adolescents often have serious disadvantages:

  • Progestin supplements (e.g. minipill): Disadvantage is poor cycle control. The side effects are also stronger, so that the minipill is only suitable for smokers and young women with blood clotting problems.
  • Hormone plaster (Evra®): Tatoo-like plaster designs provide attractive packaging that is appealing to young people. But the wearers of these patches receive an estrogen dose up to 60% higher than when taking a "pill", combined with correspondingly higher side effects.
  • Hormone IUD: Even if there are now special models for adolescents, there is a risk of fallopian tube inflammation associated with subsequent fallopian tube pregnancies or infertility, and the IUDs are also expelled more frequently. Therefore not suitable for young people.
  • Depot progesterone and subdermal hormone implants such as Implanon® are unsuitable because of the significantly higher hormone levels with sometimes severe side effects.
  • Barrier methods such as vaginal diaphragms, cervical caps or vaginal rings are not an option for young people because of the time-consuming "insertion work" involved.
  • Natural contraception methods (whether based on measuring the temperature or testing the cervical mucus) are unsuitable for adolescents because the hormonal control of the cycle is still unstable.
  • Foam suppositories are also extremely unsafe in adolescents and also favor fungal infections.
No matter which contraceptive is chosen - a condom should always be used in addition, because this is the only way to prevent the transmission of sexually transmitted diseases.

Prescription of the "pill" in adolescents

There is no medical age limit below which the pill may not be prescribed. Some gynecologists require parental consent from young people under the age of 16. According to the professional associations, the parents' consent is required if the young person is not yet "capable of giving consent" in the opinion of the doctor - the 14th birthday is often assumed, but not legally mandatory.

Prevention of sexually transmitted diseases

For teenagers, too, condoms are the only really effective means of preventing sexually transmitted diseases. After all, with the vaccination against human papilloma viruses (HPV), additional protection is now available to prevent cervical cancer. The Standing Vaccination Commission recommends this vaccination as a standard vaccination for 12 to 17-year-old girls, for which the health insurance company will cover the costs in any case. It is currently being investigated whether the vaccination will also benefit older women and men.

  • www.aufklaerungshomepage.de - Private website from Leipzig, offers a lot of information on contraception, e.g. more about the pill for young people.
  • P. Neumayer: The contraception book for girls and boys. Foitzick, 2003. Good introduction for young people.

Authors

Dr. med. Herbert Renz-Polster in: Gesundheit heute, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). | last changed on at 11:42