More Teen Girls Using Contraceptives: CDC

THURSDAY, May 3 (HealthDay News) -- More teenage girls are using contraceptives, which may explain part of the dramatic drop in the U.S. teen pregnancy rate, federal health officials reported Thursday.

The teen birth rate has dropped 44 percent since 1990, to 34 births for every 1,000 females. In 2010, about 368,000 infants were born to teen mothers, according to the U.S. Centers for Disease Control and Prevention.

"We know there have been declines in teen pregnancy, which is wonderful, and increases in abstinence among teens, which is really wonderful also," said report author Crystal Pirtle Tyler, a CDC health scientist. "There has also been increases in contraceptive use."

Tyler noted that there has been a 16 percent decline in teens who say they are sexually active. "The majority of teens report never having had sex," she said.

To keep teen pregnancy rates declining, teens and their doctors need to have talks about delaying having sex, Tyler said. "It would be great if teens know that the majority of teens have never had sex," she added.

Even teens who are sexually active can be counseled to stop having sex, Tyler noted.

Tyler also said she thinks doctors have become less adverse to offering contraceptive advice to teens. "They are more comfortable providing contraceptive information than they were before," she said.

The new findings were published in the May 4 issue of the CDC's Morbidity and Mortality Weekly Report.

Using data from the National Survey of Family Growth, the researchers found that about 60 percent of sexually active teens said they used effective contraceptive methods. Contraceptives included intrauterine devices, implants, pills, patches, rings or injectable contraceptives.

That represents a 47 percent increase in contraceptive use since 1995, the researchers said.

Contraceptive use varied by race and ethnic group, the researchers found. More white teens (66 percent) than black (46 percent) or Hispanic teens (54 percent) used contraceptives.

Although these findings are seen as progress in reducing teen pregnancy rates, meeting the Healthy People 2020 goal of reducing teen pregnancy rates by 10 percent will require "a comprehensive approach to sexual and reproductive health that includes continued promotion of delayed sexual debut and increased use of highly effective contraception among sexually experienced teens," the CDC said.

However, "we are on target to meet that goal," Tyler added.

Dr. Lawrence Friedman, director of adolescent medicine at the University of Miami Miller School of Medicine, said that, "It's good news that young people are using more contraceptives when they are sexually active, and that there are more young people that are delaying the onset of sexual activity."

However, Friedman doesn't think that the apparent decrease in sexual activity means that teens are having less sex, just that they may be having less intercourse. "So, it does not indicate that teenagers are really less sexually active, maybe they are not choosing intercourse," he explained.

The fact that the pregnancy rate is down could mean that fewer teens are having intercourse, but perhaps more teens are choosing oral sex or mutual masturbation instead of intercourse, Friedman added.

More information

For more information on contraception, visit the U.S. Centers for Disease Control and Prevention.

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Clot Risk Higher in Some Contraceptives

Women who use non-oral hormonal contraceptives, like patches and vaginal rings, may be at higher risk of blood clots than those who take oral forms of birth control, according to a new Danish study published in the journal BMJ.

Researchers from the University of Copenhagen analyzed national data from more than 1.6 million healthy women ages 15 to 49 who took various forms of birth control. They found that women who took birth control pills were at three times the risk of blood clots than those who did not use any type of hormonal birth control, but those who used other types of non-oral hormonal contraceptives were at higher risk. Women who used skin patches were at eight times an increased risk of blood clots and those who used vaginal rings had a 6.5 percent increased risk.

Patches and vaginal rings continuously releases hormones into the body to prevent pregnancy. The study suggests that some women talk with their doctor about switching from non-oral hormone contraceptives if they are already at high risk for blood clots.

People who are overweight, inactive, those who smoke and have a family history of blood clots are all at increased risk. Certain medical conditions also increase a person's risk.

"The important thing is that women are informed about the risk of VT for different product types," said Øjvind Lidegaard of the University of Copenhagen and lead author of the study. "Then I think they can decide themselves whether they want to continue of switch to another product. For young women, the most obvious alternative is a low-dose second-generation pill with levonorgestrel."

Almost half of all pregnancies in the U.S. are unintended, according to the Centers for Disease Control and Prevention. About 10.7 million women in the U.S. use birth control pills.

But experts noted the limitations of the study, pointing out that the research did not account for excess fat and smoking habits, both recognized risk factors of blood clots.

Dr. Paula Hillard, professor of obstetrics and gynecology at Stanford University School of Medicine, noted that the risk of venous thrombosis during pregnancy can be much higher than the numbers tallied in the study.

"The combined hormonal contraceptives, even those that the authors found to have an increased risk of venous thrombosis compared to other specific combination oral contraceptives, are associated with a higher risk than an individual would experience if she were pregnant," said Hillard. "Thus, preventing unintended pregnancy is health promoting."

While non-oral hormonal contraceptives did indeed show a higher risk of blood clots, Hillard said individuals must consider which option is best and most effective.

"The patch and the ring are methods that may be more effective at preventing pregnancy compared to methods that require daily use of a pill, which is difficult to take correctly and consistently day in- and day out," said Hillard.

Of note, authors found that intrauterine devices, or IUDs, a T-shaped plastic or copper device that is placed in a woman's uterus to prevent pregnancy, was not associated with blood clots. In fact, researchers said they were associated with a reduced risk and may have a protective effect against blood clots.

"Thus when discussing contraceptive options with women who might consider switching, the option of an IUD offers not only a method that is as effective as sterilization at preventing unintended pregnancy, and which lasts five or 10 years, but that also has a lower risk of venous thrombosis," said Hillard.

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Blood Clot Risk Linked to Some Non-Pill Contraceptives

THURSDAY, May 10 (HealthDay News) -- Some women using hormonal contraceptives other than birth control pills may have an increased risk for serious blood clots, Danish researchers report.

These alternate hormone-releasing birth control methods include skin patches, implants and vaginal rings. To reduce the risk, women who use these should consider switching to the pill, the researchers said.

Deep vein thrombosis is a kind of clot that typically originates in the legs and can travel to the lungs, where it becomes an often deadly pulmonary embolism. Both types of clots combined are called venous thrombosis, according to the study. Symptoms include leg pain, chest pain or sudden shortness of breath.

"The transdermal patch and vaginal ring confer at least a sixfold increased risk of venous thrombosis as combined pills with desogestrel or drospirenone, a risk which is about twice the risk among women using second-generation pills with levonorgestrel," said lead researcher Dr. Ojvind Lidegaard, a professor of obstetrics and gynecology at the University of Copenhagen.

However, hormone-releasing intrauterine devices (IUDs) do not increase the risk of venous thrombosis, he said.

"Women should be informed about these risks in order to be able to choose the most appropriate hormonal contraceptive product," Lidegaard said. "There are hormonal contraceptive alternatives which confer less or no risk of venous thrombosis."

Common implants include Implanon and the newer Nexplanon; Ortho Evra is the patch and the ring is NuvaRing. These products gradually release hormones into the body to prevent pregnancy.

Methods like the sponge (Today Sponge), which uses a spermicide rather than hormones, were not addressed in the study.

The findings were published May 10 in the online edition of the BMJ.

For the study, Lidegaard's team collected data on incidents of venous thrombosis in Danish women using methods of birth control other than the pill. All the women were aged 15 to 49, and none were pregnant.

The researchers found that between 2000 and 2010 there were more than 3,400 diagnoses of venous thrombosis.

For women who did not use any type of hormonal contraceptive, two women developed clots for every 10,000 (combined) years they used contraceptives.

For women taking the pill containing the hormone levonorgestrel, the risk for a clot was three times higher, or 6.2 clots for every 10,000 years they took the pill, the researchers found.

The risk to women who used a skin patch was about eight times higher, or 9.7 clots per 10,000 exposure years.

Women who used a vaginal ring had a 6.5 times higher risk, or 7.8 events per 10,000 exposure years).

For women who used an implant that contained only progestogen, the increased risk for clots was very small. There was no risk for women using a progesterone-only IUD and it may have has a protective effect, the researchers noted.

There was no reduction in risk with the long-term use of a patch or vaginal ring, they added.

"For the majority of young women, the recommendation is second-generation combined pill with levonorgestrel, and for women who have given birth, that a hormone-releasing intrauterine device is an attractive option, because it at the same time does not increase the risk of venous thrombosis, perhaps even protects against them, and reduces menstrual complaints," Lidegaard said.

To cut the number of women who develop clots from these riskier birth control methods, the authors advised that more women choose the pill.

Dr. Elizabeth Poynor, a gynecologist and pelvic surgeon at Lenox Hill Hospital in New York City, commented that "over the past years, newer versions of combined hormonal contraception have been developed."

"While these types of transdermal hormonal contraceptives may be more convenient for some women and lead to better compliance with appropriate use, they have their own set of medical side effects and concerns," she said.

"This highlights the importance of reviewing the risks, benefits and alternatives among differing types of medications within the same broad category," Poynor added.

For some women, these types of medications are extremely useful, but their potentially elevated risk of thrombosis should be reviewed before prescribing them, Poynor stressed.

More information

To learn more about contraceptives, visit the Planned Parenthood.

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