I have a 17 year old friend who recently has become sexually active. She told me that she was using condoms as her only protection, sut she was interested in using something else. She would like to ask her family doctor, but she has not taken the time to do so in months. What is the best female contraception for a young girl who has type 1 diabetes and uses an insulin pump 24 hours a day?

The only sure method of contraception is ABSTINENCE–no sex. Otherwise, the most effective method is an oral contraceptive pill that must be taken daily, although the skin patch seems to work quite well, too. Other options include Depo-Provera given by shot every three months. All hormone replacement can affect glucose levels. For someone on the pump, she may need to adjust her basal and bolus rates. She should confer with her own diabetes team.

Remember that these hormone contraception strategies do NOT protect against sexually transmitted diseases such as syphilis, gonorrhea, hepatitis, herpes, AIDS, chlamydia, etc. Therefore, in addition to hormone contraception, a condom worn by the male is required. Condoms by themselves are less reliable, although they can be very effective contraception.

DS