Contraception

Methods

  • Surgical
  • Barrier (condoms, sponge, spermicide, diaphragm, female condom)
  • Hormonal (OCP, Depoprovera, patch, Nuvaring)
  • IUD (copper, Mirena)
  • Physiological (withdrawal, rhythm, chance, abstinence)
  • Emergency (Plan B, Yuzpe, IUCD)

OCP

Failure user rate is 3%.  OCP works by inhibiting ovulation and causing endometrial atrophy.

Benefits: decrease in ovarian ca, uterine ca, colon ca, benign breast disease, acne and hair growth, PID, decrease dysmenorrhea and anemia, regulates cycles

Side effects: BTB, mood changes, vaginal infections, abN pap, increased clotting

Contraindications: pregnancy, undiagnosed bleeding, DVT/PE, FHx of clots, Smoker >35yo, HTN, <6wk PP if breast feeding, IHD/CVA, migraine with focal symptoms, breast ca, diabetes with sequelae, cirrhosis, liver tumor

Discontinued due to BTB, nausea, weight gain, mood changes, breast tenderness, hair growth



 

Emergency contraception

Pills – 2 Ovral (2 doses 12 hours apart) or 1 Plan B (2 doses 12 hours apart within 120hr)

IUCD – up to 7 days

Depo Provera

3/1000/yr failure

Decreases flow, ovarian and uterine ca, decreased PID

Weight gain!

IUD

Copper or L-norg

Risks: PID, ectopic, expulsion/penetration/perforation

Confidentiality

  • This is more of an issue for teenagers. You do not need to tell their parents or partners.

STI protection

  • Hormonal methods of contraception do not protect you against STIs
  • Condoms offer STI protection (except against viruses like Herpes and HPV)

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