Problem: You are seeing a 15-year-old female patient for a gynecological exam and to explore birth control options. The patient states her mother is not aware she is sexually active or that she is starting birth control. The patient has admitted to multiple acts of unprotected intercourse. The patient is current with all immunizations, including Gardasil, and has no significant health history that would contraindicate the use of birth control.
1. This is the patient's first gynecological exam, and she expresses feeling nervous and embarrassed about having an exam. What exam components are necessary for a patient this age?
2. As you begin asking questions to determine the patient's gynecological history, the patient asks you if you must notify her parents that she is getting birth control and STI testing. She is adamant her parents must not know that she is having sex. What are the guidelines related to minors receiving birth control and STI testing without their parent's consent? Does this pose any ethical concerns for you as a provider?
3. Choose 3 birth control methods that may be appropriate for this patient. Please provide the mechanism of action, side effects, and patient education for the 3 methods you have chosen.