Provided that there are no medical contraindications, a girl should be enabled to use her chosen method of contraception.

• From menarche to 17 years of age:
• Combined hormonal contraception (the pill, vaginal ring, or patch), the progestogen-only pill or implant, and barrier methods can be used.
• The benefits of long-acting reversible contraception should be highlighted.
• Depot medroxyprogesterone acetate or an intrauterine device or system can be used in young women under the age of 18 years, after consideration of other methods.
• Before menarche:
• Sexually active girls who have not yet started menstruating should be advised against regular hormonal contraception.
• Advocate the use of condoms — as a contraceptive and to prevent sexually transmitted infection.
• Give advice about prevention of sexually transmitted infections.
• The correct and consistent use of condoms should be advised to reduce the risk of sexually transmitted infections.
• Young people should be advised to get tested for sexually transmitted infections 2 and 12 weeks after unprotected sexual intercourse.
• Concerns about possible effects — reassure girls and young women that:
• Bone mineral density is influenced by normal pubertal development, exercise, diet, smoking, and some hormonal contraception.
• The use of depot medroxyprogesterone acetate is associated with a small loss of bone mineral density which is usually recovered after discontinuation.
• However, this should not deter a girl should she choose a progestogen-only injectable over other contraceptive methods, provided that she is not at increased risk for osteoporosis.
• Risk of cancer — combined oral contraceptives (COC) use is not associated with an overall increased risk of cancer.
• COCs reduce the risk of ovarian and endometrial cancer and, with less than 5 years' use, do not increase the risk of cervical cancer.
• Depot medroxyprogesterone acetate does not appear to have any effect on the risk of ovarian, endometrial, or cervical cancer.
• Any increase in risk of breast cancer associated with hormonal contraception is small, and there is no effect of duration of use.
• Acne — COCs may improve acne vulgaris. The occurrence of acne can be a reason for discontinuing progestogen-only implants and progestogen-only injectables. Co-cyprindiol is indicated to treat severe acne which has not responded to oral antibiotics. The incidence of venous thromboembolism is about 4 times higher in women using co-cyprindiol than in women using low-dose oestrogen COCs. It should be withdrawn 3–4 months after the treated condition has resolved. If there is no improvement after 6 months consider withdrawing it. For more information see the CKS topic on Acne vulgaris.
• Venous thromboembolism — the risk of venous thromboembolism is increased with use of COCs, but the absolute risk is very low. Progestogen-only contraceptives do not appear to increase the risk of venous thromboembolism.
• Weight gain — there is no evidence of weight gain with use of COCs or patch. Weight gain may occur with depot medroxyprogesterone. However, weight gain is common in all women, and may simply reflect the normal increase in weight expected during the early reproductive years, and with changes in eating habits and activity levels.
• Mood — it is unclear whether hormonal contraception has an adverse effect on mood.
• Bleeding patterns and dysmenorrhoea — young women should be informed that altered bleeding patterns can occur with hormonal contraception use. However, dysmenorrhoea may improve with use of combined hormonal contraception.

• These recommendations are based on guidelines published by the Faculty of Sexual and Reproductive Healthcare (FSRH), formerly the Faculty of Family Planning and Reproductive Healthcare (FFPRHC) [FFPRHC, 2004b; FFPRHC, 2007b; FSRH, 2010b], and those issued by the Committee on the Safety of Medicine regarding the use of cyproterone acetate and its risk of venous thromboembolism [CSM, 2002].