Contraception

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Contraception

Other

Lactational Amenorrhea

1st 6 mo post-partum

Guidelines

Exclusively breastfeed

Remain amenorrheic

MOA

Inh. Dopamine

Prolactin

Depress GnRH

Emergency Contraception

IUD

Not good option for nulliparous women

RU-486 (Mifepistrone)

Not indicated in US

Antiprogestin

Plan B (Levonorgestrel)

Prevent implantation

Prevent ovulation

Combo pill (Estradiol & Norgestrel)

Nausea common

75% effective

Periodic Abstinence

Avg: 17 days of abstinence

Symptothermal

Cervical mucus & Basal body temperature

Cervical mucus

Abstain when cervical mucus sticky/moist

Rhythm or Calendar

Predict ovulation

Sterilization

Technical skill

Regret

Permanent

IUDs

Disad

risk of PID

No STI protection

Cost-effective long-term

Reversible, no delay in fertility

Barrier / Vaginal Methods

Spermicides / Foams

Yeast infxn

Nonoxynol-9

Condoms

Female

Cumbersome to use

Male

Diaphragms

DisAd

Toxic Shock

UTIs

Adv

Gonorrhea

Leave in for 6 h after sex

Requires prescription

Requires fitting

Hormonal

Transdermal Patch

Decreased efficacy in females >= 90 Kg

Vaginal Insert

Same as Combo-OCPs

3 wks on, 1 wk off

Injectables / Implants

Progestin-only

Implanon

3 years

Depo-Provera

3 mo.

Medroxyprogesterone acetate

OCPs

Progestin-only Minipill

Take at same time everyday

Irregular bleed

40% will ovulate

Combination

Most common reversible method

DVT/Stroke

Liver cancer