Contraceptive Choices for Young People

Question 1

Contraceptive Choices for Young People

The Faculty of Sexual and Reproductive Health (FRSH) produced guidelines in 2010 concerning the provision of contraception to young people. Much of the following is based on those guidelines. Please see the link for more details.

Legal and ethical issues

Answer 1

• the age of consent for sexual activity in the UK is 16 years. Practitioners may however provide advice and contraception if they feel that the young person is ‘competent’. This is usually assessed using the Fraser guidelines (see below)
• children under the age of 13 years are considered unable to consent for sexual intercourse and hence consultations regarding this age group should automatically trigger child protection measures

Question 2

Contraceptive Choices for Young People

The Fraser Guidelines state that all the following requirements should be fulfilled:

Answer 2

• the young person understands the professional’s advice
• the young person cannot be persuaded to inform their parents
• the young person is likely to begin, or to continue having, sexual intercourse with or without contraceptive treatment
• unless the young person receives contraceptive treatment, their physical or mental health, or both, are likely to suffer
• the young person’s best interests require them to receive contraceptive advice or treatment with or without parental consent

Question 3

Contraceptive Choices for Young People

Sexual Transmitted Infections (STIs)

Answer 3

• young people should be advised to have STI tests 2 and 12 weeks after an incident of unprotected sexual intercourse (UPSI)

Question 4

Contraceptive Choices for Young People

Choice of contraceptive

Answer 4

• clearly long-acting reversible contraceptive methods (LARCs) have advantages in young people as this age group may often be less reliable in remembering to take medication
• however, there are some concerns about the effect of progesterone-only injections (Depo-provera) on bone mineral density and the UKMEC category of the IUS and IUD is 2 for women under the age of 20 years, meaning they may not be the best choice
• the progesterone-only implant (Nexplanon) is therefore the LARC of choice is young people