
The Cribsiders S7 Ep158: Plan A, B and C: Counseling Adolescents on Contraception
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Nov 5, 2025 In this chat, Dr. Tracy A. Wilkinson, an assistant professor of pediatrics specializing in adolescent reproductive health, dives into empowering general pediatricians to discuss contraception with young patients. She emphasizes the importance of starting these conversations early and uncovering what adolescents already know. Dr. Wilkinson addresses common myths, reproductive coercion, and tailors counseling based on patient priorities. She also highlights the importance of confidentiality and the need to include all genders in reproductive health discussions.
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Explain Estrogen Options And Quick Start
- Frame estrogen-containing options by how they affect periods and dosing frequency (pill daily, patch weekly, ring monthly).
- Offer quick-start same-day initiation and provide written handouts for missed-dose actions.
Check Key Contraindications For Estrogen
- Screen for hypertension and migraines with aura before prescribing estrogen.
- Use the CDC Medical Eligibility Criteria/app when in doubt about contraindications.
Offer Progestin‑Only Alternatives
- Offer progestin-only options for patients with estrogen contraindications: mini‑pill, DMPA injection, implant, or IUD.
- Note some progestin methods require stricter dosing or periodic clinic visits.
