Providing Contraception for Young People During a Pandemic
Adolescent and young adult reproductive health care needs are not diminished during pandemics. Health care professionals (HCPs) caring for adolescent and young adult patients need to acknowledge that contraception is an essential need and adopt new approaches to providing this crucial care. Pills, transdermal patch, and vaginal rings can be refilled or initiated on the day of the telehealth encounter and a 12-month supply should be provided. After initiation, use of a backup method for 7 days is recommended. Progestin-only contraceptive pills (norethindrone and drosperinone) are an option for those with a medical contraindication to estrogen.

Depot medroxyprogesterone acetate is a progestin-only method available as a 150-mg intramuscular or 104-mg subcutaneous injection. Traditionally, it is administered every 3 months in a clinical setting. However, during pandemic times, HCPs can consider extending the dosing interval to 15 weeks and exploring creative approaches to intramuscular delivery (eg, curbside).

Counseling patients about using emergency contraception pills (ie, levonorgestrel, 1.5 mg, and ulipristal acetate, 30 mg) and offering an advanced prescription may be particularly beneficial now to reduce patient cost and access barriers. Ulipristal acetate is more effective than levonorgestrel, particularly for those who have a body mass index (calculated as weight in kilograms divided by height in meters squared) above 30 or who had sex more than 72 hours ago. Patients who take ulipristal acetate for emergency contraception should wait 5 days to take a hormonal contraceptive and use condoms until their next menses. It is also important to encourage consistent condom use for sexually transmitted infection prevention, backup for birth control, and dual protection.

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