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[Contraception for adolescents and its effect on menstruation].


 The beginning of sex life is occurring at an ever younger age in industrial countries with the result of frequently unexpected and unwanted pregnancies. In primitive societies puberty starts later because protein-rich nutrition is lacking. The recommendation of contraceptive methods for young people in Western countries serves the same purpose of lengthening the period until sexual maturity. The extent to which contraceptive methods influence the menstrual cycle of young women depends on the level of maturity of their cycle: IUDs and hormonal contraceptives affect it, but natural methods do not. Barrier methods do not influence it either, but the condom promoted against AIDS is not reliable enough as a contraceptive. The intrauterine pessary is rarely used owing to the increased risk of genital inflammation. Effects on the cycle produce symptoms of stronger and longer bleeding and amenorrhea possibly linked to coagulation. In animal experiments corpus luteum insufficiency was demonstrated. Hormonal contraception is also the safest for young people. The degree of the suppression of the gonadal axis depends on the dose of the components and the chemical structure of the gestagens used as well as on the endocrine maturity level and ovarian susceptibility of the user. The so-called postpill amenorrhea does not occur more often than secondary amenorrhea in the general population. When using micropills sufficient suppression of the gonadal axis has to be watched, otherwise clinical symptoms of delayed ripening of the ovaries develops with additional endogenic estrogen secretion: lower abdominal pain, breast complaints, and bleeding disorders. The longterm effect of increased estrogen concentrations is characterized by oligomenorrhea and corpus luteum insufficiency in the menstrual cycles of young women.
