By Eve Espey MD MPH
This factor of Clinics will concentrate on concepts in birth control in addition to scientific and public health and wellbeing boundaries to decreasing unintentional being pregnant. defined during this factor are a few contraceptive ideas constructed over the past few years, together with the contraceptive patch and ring in addition to the hormonal intrauterine process and hormonal implants. The very potent techniques, together with the IUD and hormonal implants, have appealed to girls who formerly didn't use birth control or used much less powerful tools. different contraceptive thoughts defined contain novel ways to birth control: Treating the necessity for birth control as an emergency, utilizing "quick start"methods of starting up contraceptives, increasing the profile of ladies thought of sturdy applicants for IUDs, and utilizing prolonged dosing regimens for hormonal contraceptives. on the platforms point, this factor will study laws, rules and investment of birth control, elements that experience a tremendous influence on entry and use. the decade has obvious either advancements in contraceptive utilization and endured obstacles to superior entry. we recommend how one can enhance contraceptive use and entry through the years to come back.
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Additional resources for Contraception, An Issue of Obstetrics and Gynecology Clinics (The Clinics: Internal Medicine)
Example text
Fam Plann Perspect 1998;30:89–92, 104. [25] Tessler SL, Peipert JF. Perceptions of contraceptive effectiveness and health effects of oral contraception. Womens Health Issues 1997;7:400–6. [26] Steel JM, Duncan LJ. Contraception for the insulin-dependent diabetic woman: the view from one clinic. Diabetes Care 1980;3:557–60. [27] ACOG practice bulletin. No. 73: Use of hormonal contraception in women with coexisting medical conditions. Obstet Gynecol 2006;107:1453–72. [28] Hubacher D, Lara-Ricalde R, Taylor DJ, et al.
Concerns that a higher estrogen dose may increase the risk of venous thomboembolism (VTE) have led to a proliferation of media reports and lawsuits that appear out of proportion to the potential increased absolute risk. Only two studies have examined the actual risk of VTE and the contraceptive patch 26 LEEMAN compared with combined oral contraceptives. 5) [47a]. If this study is accurate then the risk of thromboembolism increases from a 1 in 10,000 baseline to 3 to 4 per 10,000 with use of oral contraceptives [48] compared with an estimated 7 to 10 per 10,000 with the contraceptive patch compared with an estimated 1 to 2 per 1000 incidence in pregnancy [49].
Recommendation The level of contraceptive efficacy for the patch is excellent, and return to fertility is usually within 2 months. There is no demonstrated increased risk for a cardiovascular event in a female smoker who is under 35 years of age. The patient’s history of venous thrombosis and uncontrolled hypertension are significant risk factors that argue against an unplanned pregnancy and the use of estrogen-containing hormonal contraception. If this patient weighs more than 90 kg, the patch may be less effective for her.
