Division of Adolescent/Young Adult Medicine, Children's Hospital Boston, Harvard Medical School, USA.
Curr Opin Pediatr. 2012 Aug;24(4):439-45. doi: 10.1097/MOP.0b013e328354cc62.
This update will highlight recent research and recommendations on long-acting reversible contraception (LARC) in the teen population, in order to make primary care providers more comfortable counseling on these methods in the medical home. LARC methods, which include intrauterine devices (IUDs) and subdermal hormonal implants, are used by only a small minority of sexually active teens, despite their endorsement by professional organizations as effective and well tolerated birth control options in this population.
Recent studies show a lack of knowledge about LARC methods among young women, as well as persistent misconceptions among providers regarding who is eligible for LARC use. Existing trials of small numbers of adolescents generally show enthusiasm for its use among teens who are educated about LARC, high satisfaction rates among users of subdermal implants and IUDs, as well as varying pregnancy and continuation rates.
The existing research on LARC shows promise for these methods in the teen population. However, larger trials are needed to establish accurate data on satisfaction, continuation, and failure rates, as well as to explore other barriers to use. Medical home providers should stay informed of research on LARC in order to improve contraceptive counseling to young women.
本次更新将重点介绍青少年人群中长效可逆避孕措施(LARC)的最新研究和建议,以提高初级保健提供者在医疗保健机构中对这些方法进行咨询的舒适度。LARC 方法包括宫内节育器(IUD)和皮下埋植剂,尽管专业组织认可这些方法是该人群中有效且耐受良好的避孕选择,但只有极少数有性行为的青少年使用这些方法。
最近的研究表明,年轻女性对 LARC 方法的了解有限,而且提供者对谁有资格使用 LARC 存在持续的误解。针对少数青少年进行的现有试验一般显示,接受 LARC 教育的青少年对其使用持热情态度,皮下埋植剂和 IUD 的使用者满意度高,妊娠率和续用率也各不相同。
现有的 LARC 研究表明,这些方法在青少年人群中具有应用前景。然而,需要更大规模的试验来确定满意度、续用率和失败率的准确数据,并探索其他使用障碍。医疗保健提供者应及时了解 LARC 的研究进展,以便改善对年轻女性的避孕咨询。