The Pediatrician and the Sexually Active Adolescent

The 1997 document addresses the complexities pediatricians encounter with sexually active adolescents, including the risks of early pregnancy and STDs due to a lack of understanding about sexual consequences. It reviews contraceptive options such as the oral contraceptive pill (OCP), depot medroxyprogesterone acetate (DMPA), and contraceptive implants like Norplant, noting their effectiveness and side effects. DMPA is highlighted for its potential to cause menstrual disruption and temporary bone density loss, with a 40% discontinuation rate among adolescents after one year. Norplant's popularity has declined due to removal issues and misconceptions, and it is associated with hair loss similar to post-pregnancy telogen effluvium. New oral contraceptives with nonandrogenic progestins are mentioned for their improved side effects but have a concern for increased risk of deep venous thrombosis. Emergency contraception is underused due to lack of awareness. The document underscores the need for pediatricians to counsel adolescents on safe sex practices and STD prevention, including condom use.