Robert J. Woolley, MD
To the Editors: Among their otherwise excellent observations, Fielding and Williams (1) erroneously advise physicians to tell teenagers that "oral contraceptives and barrier methods (with spermicides) are the most effective methods" of birth control. This is simply not correct.
Intramuscular depot medroxyprogesterone acetate (Depo-Provera, Upjohn, Kalamazoo, Michigan) is comparable or superior to oral contraceptives in method-effectiveness, whereas subcutaneous levonorgestrel implants (Norplant, Wyeth Laboratories, Philadelphia, Pennsylvania) are more effective than any other method available, including surgical sterilization (2). The superiority in use-effectiveness of these two methods is even more pronounced (2), an especially important consideration for teenagers, who are notoriously unreliable
Woolley RJ. Contraception for Teenagers. Ann Intern Med. ;115:159. doi: 10.7326/0003-4819-115-2-159_1
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Published: Ann Intern Med. 1991;115(2):159.
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