Hormonal Implants, A Once Unpopular Birth Control, Surge Among Teens

The findings of the C.D.C.’s report echo those of a 2011 study, called the CHOICE project, in which younger teenagers, aged 14 to 17, were found to be more likely to choose an implant than an intrauterine device, or IUD — another long-acting reversible contraceptive. Older teenagers, aged 18 to 20, preferred the latter.

A big draw of the implant is that getting it is far less painful than an IUD and “no pelvic exam is required,” said Dr. Paula Castano, an associate professor of obstetrics and gynecology at Columbia University. It is also easier to train more health care providers to place an implant than an IUD, she added. “That may help expand availability to other clinicians that teenagers may interact with” — a pediatrician or a nurse practitioner can insert the implant, she said, whereas an IUD “requires someone who is much more familiar with pelvic anatomy.”

Another benefit is that the implant is what is known as a “forgettable method,” Dr. Amies Oelschlager said; once it is inserted, it can last for three years and requires no other action. Other contraceptive methods, like the pill, patch or vaginal ring, require upkeep. The pill, for example, needs to be taken every day at the same time and “adolescents have a lower rate of perfect use compared to older people,” she said. Many also “don’t have money, they don’t have transportation to get to the pharmacy, they don’t have the ability to make doctor’s appointments and get to doctor’s appointments for refills.” Studies have found that adolescents who use either an implant or an IUD are more likely to continue to use it and be satisfied with it, compared to those who use other methods, like condoms, the pill or withdrawal.

The implant, however, may not address heavy, painful periods, Dr. Castano said, which is a common complaint among adolescents. It is less likely to completely stop periods than other hormonal methods, she said. In fact, one of the most common side effects of the implant is irregular and unpredictable bleeding, “which can be difficult for patients to adjust to.”

But, Dr. Castano added, against the backdrop of restricted access to abortions, “it’s good to see that we’re already on a trajectory of an increase of use of these more effective contraceptive methods.”