Talk to teens about LARCs

New recommendations by the American Academy of Pediatrics on contraception use in adolescents urge clinicians to get more involved in educating adolescents about contraception use and, in particular, to recommend the use of long-acting reversible contraceptives (LARCs) as the first-line contraceptive choice. The recommendation for the first-line use of LARCs, which includes subdermal implants and intrauterine devices, mirrors the same recommendation by the American College of Obstetrics and Gynecology (ACOG) published in 2012.

In a session on Sunday, October 12, titled “What’s new in adolescent reproductive health: long-acting reversible contraception and pap smear guidelines,” Paula J. Adams Hillard, MD, professor, Department of Obstetrics and Gynecology, Stanford University School of Medicine, California, updated practicing pediatricians on the effectiveness, safety, mechanism of action, and indications for the use of LARCs in adolescent girls. “Talk to teens about the LARC options as the top tier of methods,” she said. “These are the most effective methods, they are safe, and very easy to use.”

Hillard also discussed the barriers to clinicians and adolescents regarding use of LARCs. The main barrier for clinicians is the lack of up-to-date information on the safety of intrauterine devices for adolescent girls who have never been pregnant. For teens, the biggest barrier is that they do not know about LARCs as a contraceptive option, so they also do not have any information on their efficacy and safety.

She also provided a comprehensive review of the new guidelines for cervical cancer screening in adolescent and young adult women published separately in March 2014 by 2 organizations: the US Preventive Services Task Force and the American Cancer Society.

Along with emphasizing the safety of the human papillomavirus (HPV) vaccine and its efficacy in preventing cervical cancer, Hillard highlighted the importance of following current guidelines on regular cervical cancer screening beginning at age 21. Saying there is still some confusion among physicians regarding the new guidelines, she emphasized that the guidelines recommend screening, regular visits, and preventive measures. “The new guidelines for cervical cancer screening do not mean that regular visits with a clinician are not still important through the adolescent years, with attention to preventive measures such as HPV vaccine,” she commented.