Contraception and sexual health: are we on the right track?

In surveying the prescription of oral contraceptive pill to girls aged 10–16 inclusive, the authors of an interesting paper in this edition note a low overall prescription rate of combined oral contraception.1 This low overall prevalence should be interpreted recognising that those using progesterone only or injectable contraception were not included. Further, prescription rates increase two hundredfold between those under 13 (nearly half the denominator) compared to those of 16, and approximately double between 15 and 16; an age when significant numbers of girls become sexually active and increasingly adopt hormonal contraception in longer relationships with more frequent intercourse. While it is proper to address ways to improve uptake of hormonal contraception by young women at risk of unplanned pregnancy, I suggest that concentrating effort here at the expense of alternative strategies may lead to a “feel good” factor, but is not be the best use of scarce resources.

THE CRISIS OF SEXUAL HEALTH

Teenage pregnancies have remained roughly static in England and Wales since 1975 and in Scotland since 1985,2 in spite of the fact that many more teenagers are using contraception. Further, emergency contraception possibly now prevents up to 15% of all pregnancies in this age group (calculated from the fact that …