Teenagers and condoms vs. the pill

Condoms are absolutely the best birth control for teenagers. They protect against pregnancy and disease. They are used at the time, so there is no need to fret over whether you forgot to take your pill last Tuesday. They are relatively inexpensive, and easily available (regardless of your age). Both genders can take responsibility for procuring and using them. There are, of course, a few drawbacks, but they are relatively small.

Hormonal birth control, which includes the pill and the DepoProvera shot, are the other common methods out there. The first big drawback, as I see it, of these methods, is that they do not protect against STIs. Teenagers need to form the habit of using condoms every time, regardless of their partner’s STI status. This is just a good sexual health supporting habit. However, there is a second big drawback. Hormonal birth control has serious emotional repercussions for some women: depression. It may be that as many as 50% or more women on hormonal birth control experience some level of depression which was brought on by the hormonal birth control. The third drawback here is that it is primarily through hormonal birth control that teenagers learn to think of birth control as something in the women’s realm. Rather, it should be thought of as something that both genders think of as their responsibility.

So what birth control method(s) do you use? What did you use as a teenager? There are, of course, pro’s and con’s of every method. What are the pro’s and con’s that you live with on a daily basis?

About Karen Rayne

Dr. Karen Rayne has been supporting parents and families since 2007 when she received her PhD in Educational Psychology. A specialist in child wellbeing, Dr. Rayne has spent much of her career supporting parents, teachers, and other adults who care for children and teenagers.


  1. (hope it’s okay to repost a little in case folks didn’t read my other comment)

    As a teenager: abstinence.

    In my first sexual relationship: Condoms, sporadically; withdrawal; the pill. The pill made me so depressed I could hardly get out of bed in the morning for, like, a year. It was more awful than I can describe.

    After that: Condoms. Inexpensive, easy to use, effective, protect against STDs. The only con is that some guys complain about them. But, as one ex-boyfriend put it, “Good things tend to happen to me when I put on a condom.”

    With my husband, before having a baby: Condoms, then fertility awareness with condoms during the fertile phase. I can’t say enough good things about fertility awareness if your partner is someone with whom you eventually want to have children anyway. It worked exceedingly well for three years with no hormones or side effects, it was practically free, and it taught us both a lot about my body. Read Taking Charge of Your Fertility by Toni Weschler.

    With my husband, after having a baby: Abstinence (ouch), then lactational amenorrhea, then vaginal contraceptive film (I recommend this only as a backup to another kind of contraception), condoms, and finally I got a copper IUD, known as a Paragard. One thing about fertility awareness is that you have to be getting enough sleep in order for it to be accurate, and sleep is a joke for me. Also, psychologically to me there’s a difference between wanting to postpone pregnancy and wanting to prevent it entirely. The cons of an IUD are that it is a lot of money up front and it’s uncomfortable during the first couple of months. The pros are that it allows a monogamous, STI-free couple to have unlimited amounts of spontaneous sex (provided their kid doesn’t walk in on them), it’s inexpensive in the long run, it’s highly effective, and, well, I really like it. I don’t even have increased cramping and bleeding with periods like they said I would. My husband can’t feel it at all. It’s pretty nifty.

  2. Thanks for sharing, Alice! It’s always nice to get more perspectives on alternative safe sex methods.

    I want to take this opportunity to point out that fertility awareness and IUDs are not really appropriate choices for teenagers.

    The requirements of what it takes to do fertility awareness correctly are generally far and above what a teenager is willing to do. (If you have questions about the specifics, let me know and I’ll fill you in.)

    And both fertility awareness and IUDs have the same negative side effect of making birth control entirely in the women’s realm, which is not a good habit to be in. Nor do either of them protect against disease.

    So I can’t reinforce this enough: condoms, condoms, condoms!

  3. First abstinence, then withdraw (not really a good idea, but we were withdrawing WAY before he had any chance of coming), then condoms, then condoms with withdraw and an awareness of my cycle. (I was an unusually regular teenager and kept track of my cycles every month. I would have sex with condoms, have him pull out before ejaculation, and also not have sex during the 5 days where I was most likely fertile.)

    One thing I’ve never understood is why there’s so little discussion and research on stacking forms of birth control and the efficacy of using multiple forms. Yeah, withdraw or some form of menstrual cycle awareness may be crappy forms of BC on their own, but combine them with condoms, and they’re pretty good. I just wish I had some hard statistics to back that up.

  4. Oh, I’ve forgotten to put what I use now. Since I’m ethically non-monogamous, I always use condoms (and dental dams and gloves) no matter the sex or the activity, even when I’ve been on other forms. Have to stay safe.

    I’ve used Lunelle, the Nuva Ring, and some form of mini-pill/POP/progesterone only pill before and they’ve always had what I’ve found to be unacceptable side effects, including a complete lack of sex drive. When I went off the progesterone pills, I completely lost my sex drive. It also takes my body well over a year to get back to normal again.

    I’ve used EC/Plan B before with good results. However, after it went OTC, I once had to use it 2x in 3 months, and it really affected my chemistry for months after that. I had bad mood swings, especially tying in with my monthly cycle, and I had times where I would have moments (well, more like up to hours) of absolute blind rage. I’m still getting back to normal.

    So, yeah, hormones do NOT play well with my body. I’ve found it best to leave well enough alone on that front.

    I tried to get a copper IUD, but the cramping was so bad that I almost passed out and my uterus wasn’t big enough to hold it. (You’d think they’d make them in multiple sizes).

    After discussing it with my doctor, we realized that a cervical cap or a diaphragm would not be good choices due to 1.) my not being very good at fitting things directly over my cervix and 2.) the lack of spontaneity it would give me (having to wait 6 hours to remove the device and then put it back in again to have sex? Yeah, not so much.)

    So, right now, condoms and EC as a backup. I’m all for birth control research so that I can use 2 types of BC at once.

  5. As a teenager I used BC pills, rather sporadically because I wasn’t good at taking it regularly. Then I switched to the sponge when it became available. After I had my daughter I tried BC pills again but developed bad side effects and was taken off. I went back to the sponge because I wasn’t permitted any other method, including sterilization which is what I wanted. Everything was fine until the sponge was yanked from the market. We tried fertility awareness for a while but that just freaked me out to the extent that I couldn’t enjoy sex anymore. That eventually led to a vasectomy because my fear was killing the relationship. Even after that I still attempted sterilization but have been denied every time though I think I might finally have found a doctor that will do it.

    My daughter uses depo provera but is considering switching to nuva ring. We have drilled condom use in her since we began talking about sex, love and relationships with her. And also made sure that she knows that certain medications will interfere with a hormonal method and made sure she knows what those medications are and to ask the doctor when she is prescribed something. I am amazed that doctors still do not tell women (let alone teen girls) that some medications will interfere with hormonal contraception.

  6. I do think teenagers should use fertility awareness, but they should use condoms every time as well, and perhaps a second barrier method in addition on the “dangerous” days. Fertility awareness is a fantastic method of learning about your body that will serve you well for the rest of your life.

  7. Being aware of your fertility cycle is different than “using fertility awareness” as a birth control method. And every woman should be aware of her fertility cycle. But I don’t want to send mixed messages here. Teenagers should use condoms. Every time. Every where.

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