Effective contraception for teenagers requires a change in medical culture

Papers p 486

Whether you give weight to the philosophy of a divine human spirit or to the elegant chemistry of evolution, or to both, there is no argument about humankind's drive to reproduce. The strength of that drive manifests in many ways: physically, as the millions of spermatozoa launched with each ejaculation; behaviourally, as the early onset and frequency of sexual activity; institutionally, as the papal preclusions of contraception and abortion; and professionally, as the trivialisation of sexual medicine and fertility control. It was no accident that the first drug to be overtly rationed by the NHS was sildenafil (Viagra). Sexual function was dismissed as a “lifestyle option” rather than an issue of health and wellbeing. But, while sexual intercourse occurs less often, the proportion of humans who will have sex during their lives approaches the proportion that will breathe.1

Typically, young women who are adequately nourished are fertile. Globally, increasing numbers of young women are becoming sexually active long before they form durable partnerships.2 Access to contraception is essential but it may not …