Title: Family planning for young people
Course: Level 3 - Family Planning > Section: Overview of postpartum, post-abortion and permanent family planning methods

Young people embrace the age group 10-24 and in general, they are eligible to use any method of contraception and must have access to a variety of contraceptive choices. Age alone does not constitute a medical reason for denying any method to, and specific attributes of the different FP methods shall be discussed during counselling.

IEC messages shall be gender and age-oriented and recognise the unique needs of young people. Good counselling and support are particularly essential. Ensuring privacy and confidentiality is of particular importance. Youths that are not sexually active should get information and education on FP.

1) Combined oral contraceptives (COCs)

COCs are appropriate and safe for young people. Many young people choose a COC because this method has a low failure rate and also offers relief from dysmenorrhea (pain during menstruation). It is a straightforward method that does not interfere with sexual intercourse. This is a good method for you to recommend when it is clearly appropriate for the girl; the particular COC you would suggest will depend on what is available. Some pills are more oestrogen dominant, and others are more progestin-dominant. A COC with more progestin is helpful for girls who have painful and excessive menstrual bleeding. To decrease failure rate it has to be taken regularly. You should also encourage condom use in addition to COCs for STI/HIV protection.

2) Progestin-only pills (POPs)

POPs are appropriate and safe for young girls. But POPs must be taken daily at approximately the same time every day to be effective in preventing pregnancy because the progestin levels in the blood peak about two hours after they are taken and then rapidly decline. If a girl is three hours late taking the pill, she will not be protected, and so she should use a back-up form of contraception. POPs may not be the best choice for young girls who cannot remember to take POPs at the same time every day. POPs are a good choice for girls who cannot tolerate the oestrogen in COCs or have a medical contraindication to the use of COCs.

3) Depo-Provera (DMPA) injectable contraceptive

DMPA is a safe and appropriate method for young girls and is particularly good for those who might have difficulty remembering when to take oral contraceptives. Since it may be difficult for young people to remember to return at regular intervals, it may be helpful to use a reminder system that encourages clients to return 12 weeks after the previous injection. This allows for a two-week grace period where the injection can still be given up to 14 weeks without fear of pregnancy. DMPA does not protect against STIs/HIV; therefore, you should encourage condom use as well.

4) Implants

Implants are safe and appropriate for young girls and can be safely utilised by those who are infected with HIV or have AIDS, or are on antiretroviral (ARV) therapy. However, you should urge these women to use condoms with implants.

5) Intra-uterine contraceptive devices (IUCDs)

IUCDs are appropriate for adolescents in stable, mutually monogamous marriages. Women under the age of 20 who have not given birth appear to have a greater risk of expulsion and painful menstruation (monthly periods). After you inform them of the characteristics of IUCDs and counsel them, if adolescents who are married would like to use this method, you should refer them to the nearest health centre for further counselling and service provision.

6) Condoms

Condoms are safe and appropriate for young people. Because they are available without a prescription and provide protection against STIs/ HIV, they are a good method.