20 - Contraception For Medically Complex Teens

Dr. Susan Kaufman and  Dr. Bianca Allison take on contraception for teens whose chronic conditions and medications make standard options unsafe or ineffective. They discuss how we protect confidentiality, apply CDC guidance, and still center teen autonomy.• assessing pregnancy-related risks tied to chronic disease and treatment• protecting confidentiality with evolving minor consent laws and careful charting• using the Guttmacher resource for state-by-state consent rules• reviewing the full method range including IUDs and implants for adolescents• counseling lupus patients with and without antiphospholipid syndrome• addressing epilepsy pregnancy risks plus teratogenic anticonvulsants• spotting anticonvulsant interactions that can reduce hormonal efficacy• managing lamotrigine level changes with continuous combined regimens• defining migraine with aura and why estrogen raises stroke risk• framing VTE risk with estrogen and when progestin-only is preferred• taking a family history for possible thrombophilias• treating heavy menstrual bleeding with continuous regimens and LNG-IUD• discussing BMI effects on the patch and emergency contraception choices• counseling on depo-related weight gain and follow-up timing• contraception considerations for cancer survivors and hormonally sensitive cancers• managing hypertension categories with MEC-guided method selection• weighing bone health with depo and combined hormonal contraceptionWhat is PAG?Pediatric and Adolescent Gynecology is a subspecialty of OBGYN (2 year fellowship) focusing on reproductive healthcare for children and young adults. It fills the overlap between general gynecologists and pediatricians. It is a multi-disciplinary field involving work with pediatric endocrinology, dermatology, hematology, surgery, ect. Go to NASPAG.org for more PAG educational resources.Want to test your knowledge?PAG WebEd cases are a great way to review our podcast content.