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)