Contraception
Hormonal
OCPs
Combination
Liver cancer
DVT/Stroke
Most common reversible method
Progestin-only Minipill
40% will ovulate
Irregular bleed
Take at same time everyday
Injectables / Implants
Depo-Provera
Medroxyprogesterone acetate
3 mo.
Implanon
3 years
Vaginal Insert
3 wks on, 1 wk off
Same as Combo-OCPs
Transdermal Patch
Decreased efficacy in females >= 90 Kg
Same as Combo-OCPs
Barrier / Vaginal Methods
Diaphragms
Requires fitting
Requires prescription
Leave in for 6 h after sex
Adv
Gonorrhea
DisAd
UTIs
Toxic Shock
Condoms
Male
Female
Cumbersome to use
Spermicides / Foams
Nonoxynol-9
Yeast infxn
Other
IUDs
Adv
Reversible, no delay in fertility
Cost-effective long-term
Disad
No STI protection
risk of PID
Sterilization
Permanent
Regret
Technical skill
Periodic Abstinence
Rhythm or Calendar
Predict ovulation
Cervical mucus
Abstain when cervical mucus sticky/moist
Symptothermal
Cervical mucus & Basal body temperature
Avg: 17 days of abstinence
Emergency Contraception
Combo pill (Estradiol & Norgestrel)
75% effective
Nausea common
Plan B (Levonorgestrel)
Prevent ovulation
Prevent implantation
RU-486 (Mifepistrone)
Antiprogestin
Not indicated in US
IUD
Not good option for nulliparous women
Lactational Amenorrhea
MOA
Depress GnRH
Inh. Dopamine
Prolactin
Guidelines
Remain amenorrheic
Exclusively breastfeed
1st 6 mo post-partum