Progestin-Only Pills in Adolescent Females

Safety and Efficacy

The American Academy of Pediatrics confirms that progestin-only pills (POPs) are appropriate for adolescents who have contraindications to estrogen-containing methods, such as history of venous thromboembolism, hypertension, or migraine with aura 3
POPs do not increase the risk of venous thromboembolism in healthy women, making them safer than combined hormonal contraceptives for patients with thrombotic risk factors 3
The Centers for Disease Control and Prevention, as reported in MMWR Recommendations and Reports, states that POPs are medically safe for adolescents with no age-related contraindications and can be initiated at any time without requiring any physical examination 4

The American College of Obstetricians and Gynecologists, as referenced in Pediatrics, notes that POPs are less effective than other progestin-only methods, including IUDs, implants, and injectables 1, 2
With typical use, approximately 9 out of 100 women become pregnant in the first year using POPs 3
The American Academy of Pediatrics, as reported in Pediatrics, recommends that for a healthy adolescent without contraindications to estrogen, better first-line options include combined oral contraceptives and long-acting reversible contraceptives (LARC) such as the etonogestrel implant or levonorgestrel IUD, which are more effective than POPs 1, 2

The Centers for Disease Control and Prevention, as reported in MMWR Recommendations and Reports, advises that no examination is required before initiating POPs and they can be started anytime if reasonably certain the patient is not pregnant 4
If started more than 5 days after menses (traditional POPs) or more than 1 day after menses (drospirenone POP), backup contraception is needed for 2-7 days respectively 4
The patient should be counseled that POPs do not protect against sexually transmitted infections (STIs) and condoms should always be used concurrently for STI protection 1, 2