Contraception
Penny Wilson, MD, and Heidi James, MD
Background
- When selecting contraception
- Align method with patient preferences
- Consider symptoms that may be ↑ or ↓ by certain contraceptives
- First-line contraception
- Long-acting reversible contraceptives (LARCs)
- Intrauterine device (IUD)
- Injection
- Implant
- ↓ rates of unintended pregnancies compared with short-acting methods
- Contraceptive pills
- Patch
- Vaginal ring
- Barrier contraception
- Permanent sterilization
Management
- Check BP
- Ensure Pap smear is up to date
- Offer sexually transmitted infection screen
- Offer education re:
- Side effects
- Impact on menstrual cycle
- Managing missed doses
- Be familiar with indications and contraindications
- Eg, patient with migraine with aura should not be on estrogen-containing contraception
- Quick-start method
- Start contraception on any day of cycle
- Does not apply to IUDs
- Requires pregnancy be ruled out
