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Long-acting reversible contraception (LARC), which include progestin implants and intrauterine devices (IUDs), should be considered first-line choices for adolescents, according to.

An accompanying was released to support the use of LARCs as efficacious, safe, and easy to use.

The statement updates , which encourage latex condoms but no other specific form of birth control.

The recommendations echo those of the American College of Obstetricians and Gynecologists in 2012, which stated that contraceptive implants and IUDs gave the best protection against unintended pregnancy in adolescents.

Only 4.5% of sexually active adolescents between 15 and 19 years used LARCs in 2009.

Short-acting forms of contraception were more popular among teens: over 95% of them had used male condoms and 55% had used oral contraceptive pills.

A whopping 57.3% of female adolescents had used the withdrawal method, which has a 22% failure rate among all users.

"The most effective methods rely the least on individual adherence," according to the AAP statement authors, who were led by , of Indiana University in Indianapolis, and , of the University of Pittsburgh.

"For these methods, typical use effectiveness approaches perfect use effectiveness," they added.

The percentage of women with an unintended pregnancy after one year was 0.05% with both typical and perfect use of progestin implants.

For women with a levonorgestrel or copper IUD, those numbers were also less than 1%.

Three IUDs are currently approved for use in the U.S.: 2 levonorgestrel-releasing ones (Mirena and Skyla, with 52 mg and 13.5 mg of levonorgestrel, respectively), and a copper-containing one (ParaGard).

The copper IUD can also be used as emergency contraception within 5 days of unprotected intercourse.

Modern IUDs are designed differently from the maligned Dalkon Shields in the 1970s that caused fatal bacterial infections. The Dalkon Shield had a porous, multifilament string that allowed bacteria to ascend into the uterus.

Today's IUDs use monofilament strings, which do not pose that risk. The only risk of pelvic infection occurs during IUD insertion.

Despite a good safety profile, IUDs come with disadvantages for adolescents. IUD expulsion, which occurs in fewer than 5% of women, may occur more frequently in younger women.

Additionally, over half of young nulliparous women report moderate to severe pain with IUD insertion.

Skyla is approved for 3-year use, Mirena for 5-year use, and Paragard for 10-year use.

Single-rod progestin implants, which include the etonogestrel-containing Implanon and Nexplanon, are inserted into the inside of the upper arm and remain in place for 3 years.

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