Contraception for Adolescents Paper
Case Study
When used appropriately, modern contraceptives are highly effective. Therefore, adequate counseling on contraception options and the provision of sufficient resources to improve contraceptives access are crucial components of adolescent health. Despite the patient’s age or past sexual activity, the obstetrician or gynecologist should address the patient’s need for contraceptives, expectations, or any concerns (Kavanaugh & Jerman, 2018). These professionals must be prepared to address any misconceptions concerning contraceptives in an age-appropriate manner adequately. They must also consider the client’s health literacy level to ensure that information is passed in a way that the client understands. In light of this, this essay discusses Tammy’s case study, a 16-year-old client presenting to the clinic requesting birth control. Specifically, the essay discusses the approach of obtaining a sexual history from Tammy, additional information required on Tammy’s sexual and social account, types of examinations performed and tests that should be ordered, and two differentials. The essay also highlights the type of education, counseling, and follow-up that Tammy should provide.Contraception for Adolescents Paper
To obtain a sexual history from Tammy, the health professional should start by creating an adolescent-friendly environment as adolescent clients require additional explanations and clarifications compared to adult patients. Here, they should only begin the assessment by establishing rapport with the client. The health professional should ask Tammy Questions based on the following concepts to obtain her sexual history. These are partners, practices, protection from STIs, history of STIs, and pregnancy prevention.
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Partners
The health professional should inquire whether Tammy is sexually active and the number of sexual partners she has had in recent months. Asking for the genders of sexual partners would also be essential in obtaining her sexual history.
Practices
The health provider should explicitly ask Tammy about the sexual relations she has recently had to understand better whether the client is at a high risk of sexually transmitted infections.
Protection from STIs
Here, the health provider should inquire whether the client and her partner use any form of protection, the types, and the rationale behind them choosing these protection forms. Tammy has stated that she does not wish to get pregnant at the clinic, and her boyfriend hates using condoms. The physician should also ask Tammy any concerns related to sexually transmitted infections that she would like to discuss.
History of STIs
The healthcare profession should gather Tammy’s history of sexually transmitted infections by asking whether she has ever been diagnosed with STIs, when, how she was treated, recurring symptoms, and whether her partner has ever been tested. Tammy has reported that she has been experiencing a smelly vaginal discharge for the past four days, which could indicate a sexually transmitted infection.Contraception for Adolescents Paper
Pregnancy
Lastly, the health professional should ask Tammy her views on pregnancy and the need for birth control to prevent an undesired pregnancy.
Using the above five approaches, the health professional would obtain a complete sexual history of the client. During the interaction, the healthcare staff must establish procedures and routines that endeavor to safeguard the adolescent’s privacy and confidentiality. Additional information required on Tammy’s sexual and social history includes drug and substance abuse, education level, relationship with parents, and self-image or perception. These factors will help the health professional understand the client’s social history and its potential impact on her sexual life. A pelvic examination may be required only if the client is seeking hormonal contraception. Although the pelvic is no longer needed while seeking birth control, it is useful in some cases if the client experiences abdominal pain, bleeding, or abdominal, vaginal discharge. The World Health Organization posits that a pelvic examination is no longer required to prescribe oral hormonal contraceptives. Other tests that should be ordered are a basic medical examination and checking the client’s blood pressure.
Among sexually active women, vaginal discharge is a common complaint that is perceived as trivial. Alone, it is inadequate in making an accurate diagnosis. Significant differentials for Tammy’s sexual discharge are candidiasis, bacterial vaginosis, and trichomoniasis. Of the three, trichomoniasis is the only sexually transmitted disease.
Candidiasis
It is a yeast infection caused by a fungus known as candida Albicans. Individuals do not catch the disease as the yeast is already in the body in an inactive form. The disease’s risk factors are obesity, pregnancy, steroids, birth control pills, a humid environment, and tight clothing. All these create a conducive environment for candida to flourish. Notably, the disease is not transmitted sexually. However, if the infection keeps on recurring, the sexual partner should also be treated. Smelly vaginal discharge is a common symptom of candidiasis.
Bacterial Vaginosis
It is the overgrowth of bacteria in the vagina, ultimately affecting the vagina’s natural balance. The condition tends to affect women in their reproductive ages. Frequent douching and unprotected sexual intercourse increases a person’s risk of developing bacterial vaginosis. While some cases are asymptomatic, common bacterial vaginosis symptoms are smelly vaginal discharge, itching, and odor.Contraception for Adolescents Paper
Trichomoniasis
Trichomoniasis is a sexually transmitted disease caused by a parasite. It is among the highly common sexually transmitted infections. Having multiple sexual partners and not using condoms during sex are two common risk factors for trichomoniasis. The most common symptom of the disease is a foul-smelling vaginal discharge and genital itching.
To prevent an accurate diagnosis using a smelly vaginal discharge as the primary complaint, the health professional should inquire from the patient the consistency, color of the discharge, and whether pruritus or a fishy order accompanies it. Importantly, the health staff should ask whether the client experiences the fishy order after unprotected sexual intercourse, which could be a characteristic of bacterial vaginosis.
Education provided to Tammy should center on increasing her knowledge of sexually transmitted infections and other risks of unprotected sexual intercourse. According to Todd and Black (2020), contraceptive education for teenagers effectively reduces teen pregnancies and rates of abortion. During the education session, the health professional should educate Tammy on the increased risk of pregnancy and sexually transmitted infections associated with unprotected sex. Tammy would also be educated on the dangers of having multiple partners.
Counseling for Tammy should be based on confidentiality and privacy. As Tammy is still developing physically, cognitively, and emotionally, it would be crucial for the healthcare provider to ensure that contraceptive counseling is sensitive based on the developmental concept it occurs. During the process, the care provider should demonstrate expertise, trust, and accessibility. The provider should also address the concept of confidentiality and the role of Tammy in decision making. Additionally, the provider should provide the client with adequate resources to improve her understanding of contraceptives. Most importantly, the healthcare provider should address all four facets of contraceptives use. These are the choice of the appropriate method, correct use, consistent utilization, and method switching.
The most appropriate birth control for Tammy is dual protection, comprising condoms use and a suitable contraceptive. Condoms are effective in preventing sexually transmitted infections, while contraceptives avoid unwanted pregnancies. Notably, a common objection to dual protection is the concern of double protection implies sexually transmitted diseases to a partner. Research suggests that the dual method is highly advocated for as an evidence-based strategy and a cost-effective mechanism in protecting an individual against unwanted pregnancy, sexually transmitted infections, and HIV/AIDS (Munsakul et al., 2015). Using this strategy is an effective way for Tammy to prevent STIs and pregnancy, primarily since she reports no desire to be pregnant.
The care provider should encourage Tammy to follow –up with the clinic after her contraceptives initiation. Follow-up visits after initiation of contraceptives are vital in determining correct use and method continuation. During follow-up visits, the client can seek any concerns on the contraceptives and decide to continue or switch contraceptive methods.Contraception for Adolescents Paper
Conclusion
In summary, the essay discusses the case of Tammy, an adolescent seeking contraceptive advice. It notes that counseling and educating adolescents on contraceptives should be based on rapport and therapeutic alliance. Adolescents should be educated on the risks of unprotected sexual intercourse, and the provider should recommend appropriate contraceptive methods. In Tammy’s case, dual protection is the most suitable as she is at high risk of contracting sexually transmitted infections. The provider should encourage her to follow-up with the clinic to determine the effectiveness and the need for continuation or switch the contraceptive method.
References
Kavanaugh, M. L., & Jerman, J. (2018). Contraceptive method use in the United States: Trends and characteristics between 2008, 2012 and 2014. Contraception, 97(1), 14-21. https://doi.org/10.1016/j.contraception.2017.10.003
Munsakul, W., Lolekha, R., Kowadisaiburana, B., Roongpisuthipong, A., Jirajariyavej, S., Asavapiriyanont, S., Hancharoenkit, U., Baipluthong, B., Pattanasin, S., & Martin, M. (2015). Dual contraceptive method use and pregnancy intention among people living with HIV receiving HIV care at six hospitals in Thailand. Reproductive Health, 13(1). https://doi.org/10.1186/s12978-016-0123-2
Todd, N., & Black, A. (2020). Contraception for adolescents. Journal of Clinical Research in Pediatric Endocrinology, 12(1), 28-40. https://doi.org/10.4274/jcrpe.galenos.2019.2019.s0003
Contraception for Adolescents Paper