Birth control resident survival guide: Difference between revisions
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{| style="border: 0px; font-size: 90%; margin: 3px;" align="center" | {| style="border: 0px; font-size: 90%; margin: 3px;" align="center" | ||
! rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Condition}} | ! rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Condition}} | ||
! rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|1}} | ! rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|1}} | ||
! rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|2}} | ! rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|2}} | ||
| Line 287: | Line 285: | ||
''<21 days postpartum'' | ''<21 days postpartum'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Implants | | style="padding: 5px 5px; background: #F5F5F5;" |Implants | ||
| Line 301: | Line 297: | ||
''With other risk factors for VTE '' | ''With other risk factors for VTE '' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Implants | | style="padding: 5px 5px; background: #F5F5F5;" |Implants | ||
| Line 315: | Line 309: | ||
''Without other risk factors for VTE'' | ''Without other risk factors for VTE'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Implants | | style="padding: 5px 5px; background: #F5F5F5;" |Implants | ||
| Line 329: | Line 321: | ||
''With other risk factors for VTE'' | ''With other risk factors for VTE'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Implants | | style="padding: 5px 5px; background: #F5F5F5;" |Implants | ||
| Line 343: | Line 333: | ||
''Without other risk factors for VTE'' | ''Without other risk factors for VTE'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Implants | | style="padding: 5px 5px; background: #F5F5F5;" |Implants | ||
| Line 355: | Line 343: | ||
|- | |- | ||
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''>42 days postpartum'' | | rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''>42 days postpartum'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Implants | | style="padding: 5px 5px; background: #F5F5F5;" |Implants | ||
| Line 369: | Line 355: | ||
''<21 days postpartum'' | ''<21 days postpartum'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Implants | | style="padding: 5px 5px; background: #F5F5F5;" |Implants | ||
| Line 386: | Line 369: | ||
''With other risk factors for VTE'' | ''With other risk factors for VTE'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Implants | | style="padding: 5px 5px; background: #F5F5F5;" |Implants | ||
| Line 402: | Line 383: | ||
''Without other risk factors for VTE'' | ''Without other risk factors for VTE'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Implants | | style="padding: 5px 5px; background: #F5F5F5;" |Implants | ||
| Line 416: | Line 395: | ||
''>42 days postpartum'' | ''>42 days postpartum'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |CHCs | | style="padding: 5px 5px; background: #F5F5F5;" |CHCs | ||
| Line 434: | Line 411: | ||
''Breastfeeding'' | ''Breastfeeding'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | | style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | ||
| Line 447: | Line 422: | ||
''Nonbreastfeeding'' | ''Nonbreastfeeding'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | | style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | ||
| Line 459: | Line 432: | ||
(breastfeeding or nonbreastfeeding) | (breastfeeding or nonbreastfeeding) | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | | style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | ||
| Line 469: | Line 440: | ||
|- | |- | ||
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |≥4 weeks (breastfeeding or nonbreastfeeding) | | rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |≥4 weeks (breastfeeding or nonbreastfeeding) | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | | style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | ||
| Line 479: | Line 448: | ||
|- | |- | ||
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Postpartum sepsis'' | | rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Postpartum sepsis'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
| Line 491: | Line 458: | ||
''for atherosclerotic cardiovascular disease '' | ''for atherosclerotic cardiovascular disease '' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | | style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | ||
| style="padding: 5px 5px; background: #F5F5F5;" |LNG-IUD | | style="padding: 5px 5px; background: #F5F5F5;" |LNG-IUD | ||
| Line 508: | Line 473: | ||
Varicose veins | Varicose veins | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | | style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | ||
| Line 528: | Line 491: | ||
''Superficial venous thrombosis (acute or history)'' | ''Superficial venous thrombosis (acute or history)'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | | style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | ||
| Line 546: | Line 507: | ||
Nonmigraine (mild or severe) | Nonmigraine (mild or severe) | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | | style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | ||
| Line 567: | Line 526: | ||
''Without aura (includes menstrual migraine)'' | ''Without aura (includes menstrual migraine)'' | ||
<br /> | <br /> | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | | style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | ||
| Line 585: | Line 542: | ||
|- | |- | ||
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Migraine With aura'' | | rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Migraine With aura'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | | style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | ||
| Line 603: | Line 558: | ||
''With prolonged immobility'' | ''With prolonged immobility'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | | style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | ||
| Line 621: | Line 574: | ||
''immobility'' | ''immobility'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | | style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | ||
| Line 639: | Line 590: | ||
''Uterine size first trimester'' | ''Uterine size first trimester'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | | style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | ||
| Line 661: | Line 610: | ||
''Uterine size second trimester'' | ''Uterine size second trimester'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Implants | | style="padding: 5px 5px; background: #F5F5F5;" |Implants | ||
| Line 682: | Line 629: | ||
''Undetectable/nonpregnant β-hCG levels'' | ''Undetectable/nonpregnant β-hCG levels'' | ||
<br /> | <br /> | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | | style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | ||
| Line 701: | Line 646: | ||
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Decreasing β-hCG levels'' | | rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Decreasing β-hCG levels'' | ||
<br /> | <br /> | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (continuation) | | style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (continuation) | ||
| Line 724: | Line 667: | ||
''with no evidence or suspicion of intrauterine disease'' | ''with no evidence or suspicion of intrauterine disease'' | ||
<br /> | <br /> | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (continuation) | | style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (continuation) | ||
| Line 746: | Line 687: | ||
''with evidence or suspicion of intrauterine disease'' | ''with evidence or suspicion of intrauterine disease'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Implants | | style="padding: 5px 5px; background: #F5F5F5;" |Implants | ||
| Line 770: | Line 709: | ||
or chlamydial infection or gonococcal infection | or chlamydial infection or gonococcal infection | ||
<br /> | <br /> | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Implants | | style="padding: 5px 5px; background: #F5F5F5;" |Implants | ||
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(including ''Trichomonas vaginalis'' and bacterial vaginosis) | (including ''Trichomonas vaginalis'' and bacterial vaginosis) | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Implants | | style="padding: 5px 5px; background: #F5F5F5;" |Implants | ||
| Line 811: | Line 746: | ||
|- | |- | ||
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |High risk for HIV | | rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |High risk for HIV | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Implants | | style="padding: 5px 5px; background: #F5F5F5;" |Implants | ||
| Line 832: | Line 765: | ||
|- | |- | ||
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''HIV infection'' | | rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''HIV infection'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Implants | | style="padding: 5px 5px; background: #F5F5F5;" |Implants | ||
| Line 851: | Line 782: | ||
''Clinically well receiving ARV therapy'' | ''Clinically well receiving ARV therapy'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation) | | style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation) | ||
| Line 869: | Line 797: | ||
''Not clinically well or not receiving ARV therapy'' | ''Not clinically well or not receiving ARV therapy'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (continuation) | | style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (continuation) | ||
| Line 881: | Line 807: | ||
|- | |- | ||
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Cystic fibrosis'' | | rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Cystic fibrosis'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | | style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD | ||
| Line 899: | Line 823: | ||
''Nucleoside reverse transcriptase inhibitors (NRTIs)'' | ''Nucleoside reverse transcriptase inhibitors (NRTIs)'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation) | | style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation) | ||
| Line 915: | Line 837: | ||
|- | |- | ||
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Nonnucleoside reverse transcriptase inhibitors (NNRTIs)'' | | rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Nonnucleoside reverse transcriptase inhibitors (NNRTIs)'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation) | | style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation) | ||
| Line 942: | Line 862: | ||
''atazanavir (ATV/r)'' | ''atazanavir (ATV/r)'' | ||
''Ritonavir-boosted darunavir (DRV/r)'' | ''Ritonavir-boosted darunavir (DRV/r)'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation) | | style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation) | ||
| Line 969: | Line 887: | ||
|- | |- | ||
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" | | | rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" | | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
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|- | |- | ||
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" | | | rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" | | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
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Revision as of 01:38, 18 September 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Huda A. Karman, M.D.
Overview
Contraception or birth control is the prevention of unwanted pregnancy intentionally by using one of many different methods including devices, sexual practices, chemicals, drugs or surgical procedures. Contraception methods can also be used for other purposes such as prevention of sexual transmitted infection, treatment of different conditions as acne, polycystic ovary syndrome, endometriosis, amenorrhea, dysmenorrhea, premenstrual syndrome, primary ovarian insufficiency, and heavy menstrual periods.
Birth Control Options
Female birth control options
Long acting reversible contraception (LARC): are 99% effective, high rate of satisfaction, long-term use, quick return to fertility when discontinued and include the following:[1]
- Intrauterine device (IUDs) (> 99% effective)[2]
- Copper IUD: Effective for up to 10 years, used for patients with light menstrual periods, patients who desire long-term contraception without using hormonal contraception
- Progestin-releasing IUD: Effective for up to 5 years, used for patients with heavy menstrual bleeding and dysmenorrhea
- Subdermal implant (> 99% effective): Effective for up to 3 years[3]
Injectable contraception[4]
- Depot-Medroxyprogesterone: (94% effective), IM injection is given every 3 months
Combined hormonal contraceptives[5]
- Oral contraceptive (estrogen/progestin pills) (OCPs) (91% effective)
- Contraceptive patch (91% effective)
- Vaginal Ring (91% effective)
Barrier and chemical Methods[6][7]
- Female Condom
- Diaphragm
- Cervical Cap
- Sponge
- Spermicide (80% failure rate if used alone). Should be used with cervical cap or diaphragm, may damage the genital epithelium and increase risk of acquiring SDIs[8]
Traditional options/Natural contraception[9]
- Fertility awareness[10]
- Lactational Amenorrhea Method (LAM) (Breastfeeding can help with child spacing)[11]
- Abstinence or withdrawal
- Rhythm Method
Surgical options
- Permanent Sterilization (Tubectomy/tubal ligation)[12][13]
Note:
- You can use IUD in a nulliparous female
- Progestin subdermal implant is more effective that IUD (failure rate .2-.8%) and female fertilization (.5% failure rate)
Male birth control options
Male contraception includes the following:[15]
- Condoms (80% effective), the only type of contraception that prevent sexually transmitted infections[16]
Male Sterilization
Coitus Interruptus or Withdrawal (75% effective)[19]
- Testosterone in combination with other hormones under research and development[21]
- Testosterone enanthate: intramuscular short-acting testosterone formulations suppresses sperm concentration to very low levels[22]
- Long-acting intramuscular testosterone undecanoate[23]
Hormonal contraceptive injectable regimes using testosterone combined with other molecules
- Testosterone plus progestin[24]
- Testosterone plus Gonadotropin Releasing Hormone (GnRH) antagonists[25]
- Hormonal contraceptive transdermal regimes using testosterone and Nestorone: gel-gel combination[26][27]
- Oral formulations: the male pill [28]
Indications
- Prevention of unwanted pregnancy
- Treatment of different conditions (non-contraceptive use) such as:[29]
- Acne
- Amenorrhea
- Dysmenorrhea
- Endometriosis
- Heavy menstrual periods
- Premenstrual syndrome (PMS)
- Primary ovarian insufficiency (POI)
- Polycystic ovary syndrome (PCOS): OCPs are used for menstrual regulation
Contraindications
Combined hormonal contraceptives
- Pregnancy
- Less than 6 wks postpartum
- Smoking (age ≥ 35, and ≥15 cigarettes per day)
- Hypertension (systolic ≥ 160mmHg or diastolic ≥100mmHg)
- Venous thromboembolism (VTE) (current of past history)
- Prior history of throboembolic event or stroke
- Thrombophilia (factor V Leiden, APLS)
- Ischemic heart disease
- Cerebrovascular accident history
- Complicated valvular heart disease (pulmonary hypertension, atrial fibrillation, history of subacute bacterial endocarditis)
- Migraine headache with aura or focal neurological symptoms
- Breast cancer (Active)
- History of an estrogen-dependent tumor
- Diabetes with retinopathy/nephropathy/neuropathy
- Severe cirrhosis (active or severe decompensated liver disease) (impair steroid metabolism)
- Liver tumor (adenoma or hepatoma)
- Hypertriglyceridemia
- Age ≥ 35 and smoking < 15 cigarettes per day
- Adequately controlled mild hypertension
- Hypertension (systolic 140 - 159mmHg or diastolic 90 - 99mmHg)
- Migraine headache over the age of 35
- Currently symptomatic gallbladder disease
- Mild cirrhosis
- History of combined OCP-related cholestasis
- Medications that interfere with OCPs: Lamotrigine, Rifampin
- Inherited thrombophilia carrier and family member with thrombophilia plus thromboembolism
IUDs
- Uterine anomalies or severe distortion
- Active pelvic infection
- Wilson disease
- Complicated organ transplant failure
Subdermal implant
- Progesterone receptor-positive breast cancer
Emergency contraception
| Contracetion option | Hours after intercourse | Efficacy |
|---|---|---|
| Copper containing IUD | 0 to 120 hour/5 days | >99% |
| Ulipristal | 0 to 120 hour/5 days | 98-99% |
| Levonorgestril | 0 to 72 hour/3 days | 59-94% |
| Oral contraceptive pills | 0 to 72 hour/3 days | 47-89% |
Side effects
| Contraceptive method | Side effects |
|---|---|
| Combined hormonal contraceptives
(OCPs, patch, ring) |
Breakthrough menstrual bleeding
Breast Tenderness Nausea Weight gain Rare side effects: Cardiovascular events (heavy smoker, over age 35 years)
|
| Subdermal implant | Unscheduled bleeding,
Weight gain Headache Ovulation and fertility occur within one month after removal |
| DMPA | Amenorrheah
Initial irregular bleeding Reversible bone loss, delayed return to fertility, +/- weight gain |
| Progestin IUD | Amenorrhea
Irregular bleeding |
| Copper IUD | Heavy menses
Menestrual and intermenestrual pain Dysmenorrhea |
| Spermicide | May damage the genital epithelium and increase risk of acquiring SDIs |
U.S. Medical Eligibility Criteria for Contraceptive Use (MEC), 2016 [33]
Abbreviations: BMI: body mass index; CHC: combined hormonal contraceptive; COC: combined oral contraceptive; Cu-IUD: copper-containing intrauterine device; ECP: emergency contraceptive pill; IUD: intrauterine device; LNG: levonorgestrel; POC: progestin-only contraceptive; STD: sexually transmitted disease; UPA: ulipristal acetate
Women, men, or couples should consider the following elements when choosing the most appropriate contraceptive method:
- Safety
- Effectiveness
- Availability (including accessibility and affordability)
- Acceptability
- Categories of medical eligibility criteria for contraceptive use
| Catgory | Characterestics |
|---|---|
| 1 | A condition for which there is no restriction for the use of the contraceptive method |
| 2 | A condition for which the advantages of using the method generally outweigh the theoretical or proven risks |
| 3 | A condition for which the theoretical or proven risks usually outweigh the advantages of using the method |
| 4 | A condition that represents an unacceptable health risk if the contraceptive method is used |
The following table focuses on the safety of the use of contraceptive method for a person with a particular characteristic based on CDC guidance and recommendations:
| Condition | 1 | 2 | 3 | 4 |
|---|---|---|---|---|
| Breastfeeding
<21 days postpartum |
Implants
DMPA POP |
CHCs | ||
| 21 to <30 days postpartum
With other risk factors for VTE |
Implants
DMPA POP |
CHCs | ||
| 21 to <30 days postpartum
Without other risk factors for VTE |
Implants
DMPA POP |
CHCs | ||
| 30–42 days postpartum
With other risk factors for VTE |
Implants
DMPA POP |
CHCs | ||
| 30–42 days postpartum
Without other risk factors for VTE |
Implants
DMPA POP |
CHCs | ||
| >42 days postpartum | Implants
DMPA POP |
CHCs | ||
| Postpartum (nonbreastfeeding women)
<21 days postpartum |
Implants
DMPA POP |
CHCs | ||
| Postpartum (nonbreastfeeding women)
21–42 days postpartum With other risk factors for VTE |
Implants
DMPA POP |
CHCs | ||
| Postpartum (nonbreastfeeding women)
21–42 days postpartum Without other risk factors for VTE |
Implants
DMPA POP |
CHCs | ||
| Postpartum (nonbreastfeeding women)
>42 days postpartum |
CHCs
Implants DMPA POP |
|||
| Postpartum (including cesarean delivery)
<10 minutes after delivery of the placenta Breastfeeding |
Cu-IUD | LNG-IUD | ||
| Postpartum (including cesarean delivery)
a. <10 minutes after delivery of the placenta Nonbreastfeeding |
Cu-IUD
LNG-IUD |
|||
| 10 minutes after delivery of the placenta to <4 weeks
(breastfeeding or nonbreastfeeding) |
Cu-IUD
LNG-IUD |
|||
| ≥4 weeks (breastfeeding or nonbreastfeeding) | Cu-IUD
LNG-IUD |
|||
| Postpartum sepsis | Cu-IUD
LNG-IUD | |||
| Multiple risk factors
for atherosclerotic cardiovascular disease |
Cu-IUD | LNG-IUD
Implants POP |
CHCs
DMPA
|
CHCs |
| Superficial venous disorders
Varicose veins |
Cu-IUD
LNG-IUD Implants DMPA POP CHCs |
CHCs | ||
| Superficial venous disorders
Superficial venous thrombosis (acute or history) |
Cu-IUD
LNG-IUD Implants DMPA POP |
CHCs | ||
| Headaches
Nonmigraine (mild or severe) |
Cu-IUD
LNG-IUD Implants DMPA POP CHCs |
|||
| Migraine
Without aura (includes menstrual migraine)
|
Cu-IUD
LNG-IUD Implants DMPA POP
|
CHCs | ||
| Migraine With aura | Cu-IUD
LNG-IUD Implants DMPA POP |
CHCs | ||
| Multiple sclerosis
With prolonged immobility |
Cu-IUD
LNG-IUD Implants POP |
DMPA | CHCs | |
| Multiple sclerosis
Without prolonged immobility |
Cu-IUD
LNG-IUD Implants POP |
DMPA | ||
| Suspected Gestational trophoblastic disease
(immediate postevacuation) Uterine size first trimester |
Cu-IUD
LNG-IUD Implants DMPA POP CHCs |
|||
| Suspected Gestational trophoblastic disease
(immediate postevacuation) Uterine size second trimester |
Implants
DMPA POP CHCs |
Cu-IUD
LNG-IUD |
||
| Confirmed gestational trophoblastic disease
(after initial evacuation and during monitoring) Undetectable/nonpregnant β-hCG levels
|
Cu-IUD
LNG-IUD Implants DMPA POP CHCs |
|||
| Decreasing β-hCG levels
|
Cu-IUD (continuation)
LNG-IUD (continuation) Implants DMPA POP CHCs |
Cu-IUD (initiation)
LNG-IUD (initiation) |
||
| Persistently elevated β-hCG levels or malignant disease,
with no evidence or suspicion of intrauterine disease
|
Cu-IUD (continuation)
LNG-IUD (continuation) Implants DMPA POP CHCs |
Cu-IUD (initiation)
LNG-IUD (initiation) |
||
| Persistently elevated β-hCG levels or malignant disease,
with evidence or suspicion of intrauterine disease |
Implants
DMPA POP CHCs |
Cu-IUD (continuation)
LNG-IUD (continuation) |
Cu-IUD (initiation)
LNG-IUD (initiation) | |
| Sexually transmitted diseases
or chlamydial infection or gonococcal infection
|
Implants
DMPA POP CHCs |
Cu-IUD (continuation)
LNG-IUD (continuation) |
Cu-IUD (initiation)
LNG-IUD (initiation) | |
| Vaginitis
(including Trichomonas vaginalis and bacterial vaginosis) |
Implants
DMPA POP CHCs |
Cu-IUD (initiation)
LNG-IUD (initiation)
LNG-IUD (continuation) |
||
| High risk for HIV | Implants
DMPA POP CHCs |
Cu-IUD (initiation)
LNG-IUD (initiation)
LNG-IUD (continuation) |
||
| HIV infection | Implants
DMPA POP CHCs |
|||
|
Clinically well receiving ARV therapy |
Cu-IUD (initiation)
LNG-IUD (initiation)
LNG-IUD (continuation) |
|||
| HIV infection
Not clinically well or not receiving ARV therapy |
Cu-IUD (continuation)
LNG-IUD (continuation) |
Cu-IUD (initiation)
LNG-IUD (initiation) |
||
| Cystic fibrosis | Cu-IUD
LNG-IUD Implants POP CHCs |
DMPA | ||
| Antiretroviral therapy
Nucleoside reverse transcriptase inhibitors (NRTIs) |
Cu-IUD (initiation)
Cu-IUD (continuation) LNG-IUD (initiation) |
Cu-IUD (initiation)
LNG-IUD (initiation) LNG-IUD (continuation) |
||
| Nonnucleoside reverse transcriptase inhibitors (NNRTIs) | Cu-IUD (initiation)
Cu-IUD (continuation) LNG-IUD (initiation) DMPA |
Cu-IUD (initiation)
LNG-IUD (initiation) LNG-IUD (continuation) Implants POP CHCs |
||
| Ritonavir-boosted
atazanavir (ATV/r) Ritonavir-boosted darunavir (DRV/r) |
Cu-IUD (initiation)
Cu-IUD (continuation) LNG-IUD (initiation) DMPA |
Cu-IUD (initiation)
LNG-IUD (initiation) LNG-IUD (continuation) Implants POP CHCs
|
||
Do's
- Increase the levothyroxine dose in patients with hypothyroidism who started taking OCPs. OCPs (estrogen) increases the liver synthesis of thyroxin-binding globulin (TBG) and hence decreases the effect of levothyroxine. Oral contraceptives (estrogen) alter the transport and tissue delivery of thyroid hormone by increasing the synthesis of throxine-binding globulin relative hypothyroid state in patients with hypothyroidism. Increase the dose of levothyroxine when starting OCPs.
- Consider increasing the dose of warfarin when the patient use OCPs
- Give two forms of contraceptives and take monthly pregnancy tests for sexually active women who use Isotretinoin for acne
- Give non-oral form of contraception (IUD, implant) for one year to patients who underwent bariatric surgery to achieve weight loss goals and stabilize nutritional status
Don'ts
- Don't give CHC for a patient of age ≥ 35 who smokes ≥15 cigarettes per day
- Don't give CHC for a patient with history of Migraine headache with aura or focal neurological symptoms
References
- ↑ Stoddard A, McNicholas C, Peipert JF (2011). "Efficacy and safety of long-acting reversible contraception". Drugs. 71 (8): 969–80. doi:10.2165/11591290-000000000-00000. PMC 3662967. PMID 21668037.
- ↑ Blumenthal PD, Voedisch A, Gemzell-Danielsson K (2011). "Strategies to prevent unintended pregnancy: increasing use of long-acting reversible contraception". Hum Reprod Update. 17 (1): 121–37. doi:10.1093/humupd/dmq026. PMID 20634208.
- ↑ Jacobstein R, Stanley H (2013). "Contraceptive implants: providing better choice to meet growing family planning demand". Glob Health Sci Pract. 1 (1): 11–7. doi:10.9745/GHSP-D-12-00003. PMC 4168562. PMID 25276512.
- ↑ Kaunitz AM (1992). "Injectable contraception: the USA perspective". IPPF Med Bull. 26 (6): 1–3. PMID 12346920.
- ↑ 5.0 5.1 Rager KM, Omar HA (2005). "Hormonal contraception: noncontraceptive benefits and medical contraindications". Adolesc Med Clin. 16 (3): 539–51. doi:10.1016/j.admecli.2005.05.003. PMID 16183538.
- ↑ Gilliam ML, Derman RJ (2000). "Barrier methods of contraception". Obstet Gynecol Clin North Am. 27 (4): 841–58. doi:10.1016/s0889-8545(05)70174-1. PMID 11091990.
- ↑ Craig S, Hepburn S (1982). "The effectiveness of barrier methods of contraception with and without spermicide". Contraception. 26 (4): 347–59. doi:10.1016/0010-7824(82)90102-0. PMID 6759027.
- ↑ Harwood B, Meyn LA, Ballagh SA, Raymond EG, Archer DF, Creinin MD (2008). "Cervicovaginal colposcopic lesions associated with 5 nonoxynol-9 vaginal spermicide formulations". Am J Obstet Gynecol. 198 (1): 32.e1–7. doi:10.1016/j.ajog.2007.05.020. PMC 4332520. PMID 18166301.
- ↑ Ajayi AI, Adeniyi OV, Akpan W (2018). "Use of traditional and modern contraceptives among childbearing women: findings from a mixed methods study in two southwestern Nigerian states". BMC Public Health. 18 (1): 604. doi:10.1186/s12889-018-5522-6. PMC 5941455. PMID 29739372.
- ↑ Peragallo Urrutia R, Polis CB, Jensen ET, Greene ME, Kennedy E, Stanford JB (2018). "Effectiveness of Fertility Awareness-Based Methods for Pregnancy Prevention: A Systematic Review". Obstet Gynecol. 132 (3): 591–604. doi:10.1097/AOG.0000000000002784. PMID 30095777.
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|pmc=value (help). PMID 26457821. - ↑ Patil E, Jensen JT (2015). "Update on permanent contraception options for women". Curr Opin Obstet Gynecol. 27 (6): 465–70. doi:10.1097/GCO.0000000000000213. PMC 4678034. PMID 26406934.
- ↑ Bartz D, Greenberg JA (2008). "Sterilization in the United States". Rev Obstet Gynecol. 1 (1): 23–32. PMC 2492586. PMID 18701927.
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- ↑ Kumar V, Kaza RM, Singh I, Singhal S, Kumaran V (1999). "An evaluation of the no-scalpel vasectomy technique". BJU Int. 83 (3): 283–4. doi:10.1046/j.1464-410x.1999.00934.x. PMID 10233495.
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- ↑ Gava G, Meriggiola MC (2019). "Update on male hormonal contraception". Ther Adv Endocrinol Metab. 10: 2042018819834846. doi:10.1177/2042018819834846. PMC 6419257. PMID 30899448.
- ↑ Cheng CY, Mruk DD (2010). "New frontiers in nonhormonal male contraception". Contraception. 82 (5): 476–82. doi:10.1016/j.contraception.2010.03.017. PMC 4381878. PMID 20933122.
- ↑ Steinberger E, Smith KD (1977). "Testosterone enanthate a possible reversible male contraceptive". Contraception. 16 (3): 261–8. doi:10.1016/0010-7824(77)90025-7. PMID 913115.
- ↑ Gu YQ, Wang XH, Xu D, Peng L, Cheng LF, Huang MK; et al. (2003). "A multicenter contraceptive efficacy study of injectable testosterone undecanoate in healthy Chinese men". J Clin Endocrinol Metab. 88 (2): 562–8. doi:10.1210/jc.2002-020447. PMID 12574181.
- ↑ Meriggiola MC, Farley TM, Mbizvo MT (2003). "A review of androgen-progestin regimens for male contraception". J Androl. 24 (4): 466–83. doi:10.1002/j.1939-4640.2003.tb02695.x. PMID 12826683.
- ↑ Pavlou SN, Brewer K, Farley MG, Lindner J, Bastias MC, Rogers BJ; et al. (1991). "Combined administration of a gonadotropin-releasing hormone antagonist and testosterone in men induces reversible azoospermia without loss of libido". J Clin Endocrinol Metab. 73 (6): 1360–9. doi:10.1210/jcem-73-6-1360. PMID 1955518.
- ↑ Sitruk-Ware R, Nath A (2010). "The use of newer progestins for contraception". Contraception. 82 (5): 410–7. doi:10.1016/j.contraception.2010.04.004. PMID 20933114.
- ↑ Ilani N, Roth MY, Amory JK, Swerdloff RS, Dart C, Page ST; et al. (2012). "A new combination of testosterone and nestorone transdermal gels for male hormonal contraception". J Clin Endocrinol Metab. 97 (10): 3476–86. doi:10.1210/jc.2012-1384. PMC 3462927. PMID 22791756.
- ↑ Meriggiola MC, Bremner WJ, Costantino A, Pavani A, Capelli M, Flamigni C (1997). "An oral regimen of cyproterone acetate and testosterone undecanoate for spermatogenic suppression in men". Fertil Steril. 68 (5): 844–50. doi:10.1016/s0015-0282(97)00363-4. PMID 9389813.
- ↑ Fraser IS (2010). "Non-contraceptive health benefits of intrauterine hormonal systems". Contraception. 82 (5): 396–403. doi:10.1016/j.contraception.2010.05.005. PMID 20933112.
- ↑ "Emergency contraception". Paediatr Child Health. 8 (3): 181–92. 2003. doi:10.1093/pch/8.3.181. PMC 2792670. PMID 20020019.
- ↑ Hubacher D, Chen PL, Park S (2009). "Side effects from the copper IUD: do they decrease over time?". Contraception. 79 (5): 356–62. doi:10.1016/j.contraception.2008.11.012. PMC 2702765. PMID 19341847.
- ↑ Sanders JN, Adkins DE, Kaur S, Storck K, Gawron LM, Turok DK (2018). "Bleeding, cramping, and satisfaction among new copper IUD users: A prospective study". PLoS One. 13 (11): e0199724. doi:10.1371/journal.pone.0199724. PMC 6221252. PMID 30403671.
- ↑ "www.cdc.gov" (PDF).