The Rafael Ángel Calderón Guardia Hospital’s Adolescent Clinic announced today that it is implementing contraceptive implants in adolescents. The campaign is aimed at adolescents with current insurance and is aimed at providing free subdermal contraceptive implants to patients between 13 and 19 years and 11 months of age across the country.
Contraceptives in Adolescents
According to Dr. Rita Peralta Rivera, gynecologist and clinic coordinator, the goal of this campaign is to prevent unplanned pregnancies in the young population. She indicated that the campaign, which began in June, has been quite successful, and more spots will be available for the remainder of 2025. To apply, participants simply fill out a digital form and select a date from those indicated on the form to attend the course, which is an essential requirement of the process. During the process, they must have up-to-date insurance and not be under psychiatric or anticonvulsant treatment. The latter is important, even though Peralta describes the method as “safe, effective, and long-lasting.”
However, for Dr. Sadie Morgan:
What’s happening at the CCSS is very worrying, as it depends on what is meant by safety. First, there is no monitoring mechanism for the girl to go with her father or mother. This can lead to inappropriate relationships, or worse, an adult forcing her to go to hide the pedophilia.
On the other hand, there are studies that indicate a link between these contraceptives and depression, psychiatric problems, and even suicidal thoughts. There are also physical effects such as bleeding, headaches, weight gain, among others, which are usually what lead girls to remove the implant.
For her part, Vivian Leal, a family specialist, asserts that:
At these ages, science has shown that girls and boys are not fit to have sexual relations and therefore should not be encouraged by giving them “permission” such as the implant. Instead, health authorities should be educating women about all the negative physical and mental consequences of sexual relations at these ages.
Contraceptives do not prevent sexually transmitted diseases
Something that is often not known, due to a lack of education, is that contraceptives do not prevent sexually transmitted diseases (STDs). In Costa Rica, STDs are a major health problem for adolescents, with a high percentage of new cases among young people between the ages of 15 and 25. The most common STDs in adolescents include gonorrhea, syphilis, HPV, HSV, and trichomoniasis.
Prevention and early treatment are crucial to avoid long-term complications. The only sure way to prevent this is to have a single sexual partner who hasn’t had any other partners, so this campaign of contraceptive implants for adolescents does no good, Morgan asserts.
According to Vivian Leal:
The contraceptives administered to these adolescents over the age of 13 at the Rafael Ángel Calderón Guardia Hospital do NOT prevent STIs and instead provide them with a false sense of security. Furthermore, this practice of giving contraceptives to adolescents can be encouraged by family members who sexually abuse them and bring them to the clinic to avoid the consequences of pregnancy.
Some contraindications
The Spanish Agency for Medicines and Medical Devices notes that some women who use hormonal contraceptives such as Implanon NXT have reported depression or depressed mood.
“Depression can be severe and can sometimes lead to suicidal thoughts,” the agency states, recommending that women experiencing mood swings and depressive symptoms contact a doctor for advice.
According to Mayo Clinic studies, this type of contraceptive is not suitable for everyone, especially because of its active ingredient, etonogestrel. Women with a history of blood clots, heart attacks, strokes, liver tumors or disease, or a history of breast cancer and bleeding outside of normal periods should not use it.
Dr. Morgan asks:
Is the adolescent’s ability to understand sexual intercourse and its short-, medium-, and long-term consequences being assessed prior to implant placement? Is her cognitive development assessed?
Mental Health Impact
According to the Perinatal Psychology Commission of the College of Psychology Professionals of Costa Rica (CPPCR), depression is one of the adverse reactions reported in the product information sheets for contraceptives, whether oral, injected, or intrauterine.
Several studies, such as the 2016 study on the association of hormonal contraception with depression, involving more than 1 million women in Denmark, whose results indicate the relationship between different types of contraceptives and changes in mood or mental health. Mental health was analyzed nationwide and it was determined that those who use hormonal contraceptives are more likely to be diagnosed or treated for depression.
Another publication from the United States National Library of Medicine (NIH), entitled “Safety and Efficacy of Implanon, a Single-Rod Implantable Contraceptive Containing Etonogestrel,” covers the results of a study involving women who used the Etonogestrel implant for up to two years. In total, 14% of them reported mood changes, and 7% admitted to having depression attributed to the implant. All of these studies conclude that implants may increase the likelihood of receiving treatment for depression.
Suicide among the leading causes of death among adolescents
In Costa Rica, data from the Ministry of Health reveal that, in the last five years, suicide attempts have increased considerably. In the first half of 2024 alone, more than 1,800 suicide attempts were recorded.
In this regard, Leal indicated that it is worrying that these contraceptive implants are being placed without in-depth studies, which is almost impossible given how saturated the CCSS is with mental and psychosocial illnesses.
