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According to the obstetrician-gynecologist Ž. Bumbulienė, girls start their sex life in Lithuania at the age of 16-17 years. In this regard, according to the doctor, Lithuania is no different from other European countries.
“We look worse than other countries when we compare teenage pregnancies and abortions. The most painful part is abortions for girls under the age of 14, but of course these cases are isolated. The older the girls, the more of those cases. There are no clear statistics on the number of abortions among adolescents, but we are talking about hundreds – 100-200, “said the obstetrician-gynecologist in a remote conference.
When asked if young people have enough information about ways to protect themselves, Ž. Bumbulienė stated that the efforts made in Lithuania to introduce adolescents to sex education at school is a program prepared by the Ministry of Education, Science and Sports, published by its “Tips for Teachers”. and doctors.
In Lithuania, girls start their sex life at the age of 16-17 years.
“I think we are trying to provide information to young people. Another question is, do the students give them enough? I would say no. It depends on the school if the teacher can pass it on, if they want or dare to talk about those topics. Surveys show that teens trust doctors more and would like them to provide this information.
And teens themselves find information on the Internet, but it’s not always real, or sometimes not so understandable. And they seem to know everything, but when you start to explain how to use contraceptives, it turns out that there is a lack of knowledge, “said the doctor.
Emergency contraception: only in exceptional cases
Speaking of contraception, the doctor highlighted long-term reversible contraception, which she says is quite effective: they are pills, rings, patches, and emergency contraception – pills.
123RF.com Photo / Birth Control Pills
When asked if the latter is safe for girls, Ž. Bumbulienė said: “Looking at the safety that we are talking about: if you already have to choose an abortion or an emergency contraceptive pill, of course we choose a pill. Delays ovulation, in other words, it won’t happen. However, if ovulation and fertilization have already taken place, the pregnancy will continue to develop.
I don’t think anything terrible will happen once I use the emergency contraceptive pill. These are the only tablets that are sold over the counter. So if a condom broke during a relationship, the girl does not know what to do, she can go to the pharmacy and buy this pill. However, it is only for those very rare cases. If you use both cycles, you will completely unbalance the hormonal system. And then we’ll talk about the damage, because the cycle will have to be rebuilt, and treatment may be necessary. “
When asked if the fact that emergency contraceptive pills are so readily available is not an incentive for teenage girls to have early sex, the OB / GYN believes that if a teenage girl is serious about a relationship, she knows about contraception. , you will choose a safer method.
“And I think before the relationship, if you look at her responsibly, you will go to the doctor and discuss which method would be the most ideal for her. That is why sexual education is needed to develop responsibility for oneself and his partner ”, the doctor is convinced.
Proposed to offset the most effective method selected
The Lithuanian Society of Obstetricians and Gynecologists (LAGD) has submitted a proposal to the Ministry of Health to include a hormonal spiral in the list of reimbursable drugs, which would be reimbursed to girls 15-20 years old seeking contraception from a gynecologist.
According to LAGD board member obstetrician-gynecologist Ž. Bumbulienė, this group was chosen not by chance: “Abortions at this age are very harmful, because before the eyes are still alive, and pregnancy is risky, because the body is too young.”
There is no ideal contraceptive method that provides 100% protection.
According to the doctor, all contraceptive methods can be used in adolescents, but the best and safest were chosen.
Ž. Bumbulienė, speaking about youth at a remote conference, compared today’s to what it was a hundred years ago. According to her, at that time a girl, when she married, started having sex, only then was a boy born. He could have been 16 and 20 years old.
“Now girls start having sex at the age of 16-17, and they marry and give birth to their first child at the age of 27-28. So the question is, what can be done in those ten years to keep the girl healthy and fertile? ”said the specialist.
According to the doctor, there is no ideal contraceptive method that is 100% effective, 100% effective, regardless of the doctor, you can start, suspend, or use it yourself at any time, and so on.
“It just came to our attention then. If there is no one that guarantees 100 percent efficiency, you choose the one that provides 99 percent. And these are long-term, user-independent methods. For example, the doctor introduces a Spiral, and nobody depends on the user, it already is. Another possible option is a subcutaneous implant, but there is no such method in Lithuania.
Let’s compare contraceptive pills: we must take them at the same time every day. Women who have taken them will confirm that one day they will still forget to drink it. Not to mention teenagers who are unfamiliar with medications, so they make mistakes. In numbers, for teens, IUD insertion can lead to 2 pregnancies out of 1,000, and taking the pill can lead to 8 pregnancies out of 100, because, as I said, women still forget to take that pill on time, the obstetrician-gynecologist.
– And another aspect – security. A study was conducted in Scandinavia where spirals were introduced in girls aged 12 to 17 years. This is the main study we trust. Doctors said the IUD was easy enough to insert, and when asked about pain during the procedure, they said they felt about 10 percent. Girls.
In numbers, for teens, 2 pregnancies out of 1,000 are possible with the IUD and 8 pregnancies out of 100 with the pill.
It is clear that pain is a bit like that, we also have to talk about how to manage it. However, in another study, girls were asked if the pain they felt would affect their choice of remedy next time, and the girls replied that they were not comfortable with the spiral. “
Hormonal coil: benefits and side effects.
Asked whether the compensated hormonal spiral will not be an incentive for adolescents to start having sex earlier, the obstetrician-gynecologist Ž. Bumbulienė said: “We do not advertise that spiral. We started talking about it because there was interest in society. Another thing, that opportunity will only be for the girl who will turn to us for contraception. There aren’t many of those girls and it won’t be that they’re heading out the door here and we’ll put those spirals all in a row.
Believe me, they come with mothers who also ask, wouldn’t it be better for your daughter to go into a spiral instead of the pills that need to be taken all the time? And I don’t see any problem here. We don’t even talk about it with someone who doesn’t care, “said the OB / GYN.
The working principle of the hormonal helix.
The hormonal IUD is inserted into the uterus, according to the doctor, its effects are local, in contrast to contraceptive pills or patches, which, according to her, affect the entire body.
When asked what the possible side effects of the hormonal coil are, the OB / GYN said that inserting the coil can hurt and require removal. It’s not uncommon for the coil to fall off – the body rejects it, and according to the doctor, teenage girls happen more often than older women. After the introduction of the coil, the first menstrual periods can be prolonged: it is possible to bleed up to three months and, according to the literature, even up to half a year.
It’s not uncommon for the coil to fall off – the body rejects it, and according to the doctor, teenage girls happen more often than older women.
“Before entering the spiral, the full history and risk factors must be collected. For example, when prescribing birth control pills for the first time, we feared venous thromboembolism, in which case the IUD would be suitable even for patients with cardiovascular disease. When it comes to safety, I would say that spiraling is really a safe method, said J. Bumbulienė, adding that, despite everything, they, the doctors, are also scared on their part.
– I have been taught myself that the IUD is only a contraceptive for women who have given birth and that it cannot be used for those who have not given birth. Gynecologists also needed to change our thinking. We, as a society as a whole, are conservative enough, but we have to rely on scientific evidence. And if American and European societies talk about that spiral being the first choice method for teens, I think you have to believe that, because those are the conclusions. “
The package leaflet indicates that the possible side effects of this measure are bad mood and depression. Can the spiral really cause this?
“For hormonal contraception to work, it contains a progestin, a synthetic substance similar to natural progesterone that provides contraceptive effects. That substance is naturally in our body in the second phase of the cycle after ovulation. How do we feel before the Menstruation? Mood is bad for someone with PMS, who doesn’t want to see anything at all. That hormone is in all contraceptives, both the pill and the IUD.
The hormonal helix does not protect against sexually transmitted infections.
Therefore, with a risk factor, no matter which contraceptive you use or use, you may experience depression and depression. But if we compare the amount of progestin entering the bloodstream, it is significantly less in this case than in any other contraceptive method. “
The obstetrician-gynecologist warned that despite the insertion of the IUD, the condom should be considered since the hormonal IUD does not protect against sexually transmitted infections. And before inserting the IUD, according to the doctor, you should have a test for chlamydia and gonorrhea.
She also said that the risk of an ectopic pregnancy is lower compared to women who do not consume or use anything, but if the pregnancy has already occurred, it can be ectopic. “There are cases described in the literature that a woman conceives with a spiral, transmits very normally and gives birth to a healthy baby,” said the obstetrician-gynecologist.
When asked when it is possible to plan a pregnancy if an IUD is used, the OB / GYN replied that immediately after the IUD was removed.
According to Ž. Bumbulienė, to launch a hormonal spiral, girls under the age of 16 need parental consent and participation. Starting at age 16, a teenager can sign the documents herself, but according to the doctor, most gynecologists would like parents to also participate in the event.
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