Adolescent Contraception in the Emergency Department: Abnormal Uterine Bleeding and Beyond

Abstract

The emergency department (ED) is a frequent and important site for gynecologic care, and many women present to the ED for reproductive health concerns such as abnormal menses. Due to early menstrual age and increased incidence of sexually transmitted infections, adolescents are particularly prone to abnormal menses, but are also disproportionately affected by unintended pregnancy. While EDs have long been used for the evaluation and initial management of abnormal uterine bleeding, general contraceptive provision in the ED is a novel approach to addressing unmet contraceptive needs among adolescent women. We review normal menstruation and the evaluation and management of abnormal uterine bleeding in adolescents, including the use of combined oral contraceptives. Expanding on this established indication for contraceptive use in the ED, we present attitudes, barriers, and approaches to ED provision of contraceptives for adolescent pregnancy prevention.