Statistics show teens start having sex at 17. As a parent, it's a great idea to talk to them about staying protected. Here are the most effective birth control options for teens and how they work.

By Lisa Heffernan
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America's teen birth rate is at a record low. There were 194,377 babies born to teens aged 15-19 years in 2017, according to the Centers for Disease Control and Prevention (CDC). That's a 7 percent drop from the previous year. The reason? "These declines are due to more teens abstaining from sexual activity," says Shanna Cox, MSPH, associate director for science for the CDC's Division of Reproductive Health. "And among the ones who are sexually active, they're using more effective methods of birth control."

The U.S. Department of Health and Human Services (HHS) has also identified a variety of diverse evidence-based teen pregnancy prevention programs related to sex education, clinics, youth development, and abstinence. These programs were designed to reach teens of both sexes through school, Job Corps, churches, and community colleges.

But parents should also try and be actively involved in their teen's sexual and reproductive health, especially since birth control is not one size fits all.

Starting the Conversation about Safe Sex

On average, young people in the U.S. start having sex at 17, and parents can make sure their teens are prepared to protect themselves and their partners, when they do.

"Don't be afraid to talk about sex," says Rachael Phelps, M.D., the medical director for Medical Students for Choice, a program aiming to educate medical students and trainees about reproductive health care, and the former medical director of Planned Parenthood of Central and Western New York. "Talking about sex won't make your teens have it, but not talking about sex may lead them to have it in unsafe and unprotected ways."

If a teen isn't comfortable talking to you about sex, you should encourage them to speak to a health care provider, school nurse or counselor, suggests Cox.

Parents can also play a key role in helping their teens get information about the various types of birth control. Don't know where to start? Experts weigh in on the four best birth control options below and how they work.

Condoms

When used perfectly, the widely available and inexpensive condom is about 98 percent effective in preventing pregnancy. But in reality they can be about 85 percent effective. Remind your teen they should be used in addition to each of the following methods below to protect against sexually transmitted diseases (STDs). Even if your teen has had the HPV vaccine, there are many other infections that can be transmitted during sex.

Intrauterine Devices (IUDs)

The IUD is available in both hormonal and non-hormonal forms. A small, T-shaped device placed into the uterus, it can stay in place for 3-12 years, depending on the type. IUDs are about 99 percent effective at preventing pregnancy and work by blocking sperm from reaching the egg—either physically by thickening the cervical mucous, or by killing and immobilizing the sperm.

Hormonal IUDs usually improve menstrual issues by decreasing heavy bleeding and cramps. They can also decrease the risk of several gynecological cancers, including ovarian and cervical. Side effects for the hormonal IUD can include irregular periods, while the non-hormonal IUD can cause heavier periods. They both involve a little cramping during and after insertion, and can cost up to $800 depending on your health care coverage.

Implants

A plastic rod about the size of a match goes under the skin of your upper arm. The implant has a failure rate of .01 percent, and prevents pregnancy for up to 3-5 years by releasing progestin into the body to block ovulation.

An implant can help decrease heavy bleeding and cramps. It also decreases the risk of certain cancers, including ovarian. Side effects can include acne, breast tenderness, and/or irregular periods. There can be pain at the insertion site, and it can also cost up to $800 depending on your insurance.

Often described as long-acting reversible contraceptives (or LARCs), IUDs and implants are the most effective forms of birth control. But only about 7 percent of teens aged 15-19 years are using them. "Most teens aren't using LARCs because they don't know about them, and they aren't offered by their health care providers," says Dr. Phelps. "But we know that when teens are offered a LARC without access barriers, the majority of them will choose it."

The Pill

There are two types of birth control pills: combination (estrogen and progestin) and the minipill (progestin only). The pill must be swallowed at the same time each day in order to work properly (it's about 98 percent effective), and it works by preventing ovulation and/or preventing sperm from entering the uterus by thickening cervical mucous. It can also shorten, lighten, or regulate menstrual cycles.

Oral contraceptives have a higher satisfaction rate amongst teens than the patch or ring, and they're a good choice for those who do not like invasive methods like LARCs. You also avoid the pain of shots, which can lead to weight gain and depression. Side effects of the pill can include nausea and breast tenderness. It costs up to $50 per month, depending on your health plan.

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