contraceptives

• Contraceptive methods


  • Pericoital
  • Hormonal
  • Long acting reversible
  • Permanent contraception (permanent sterilization)
• Pericoital


  • Non-hormonal, safe, many forms for female, reusable, inexpensive, immediately effective/reversible
  • Failure rate is highest, don't protect from STIs, require motivation/skill, no noncontraceptive benefits
• Hormonal


  • More effective
• Long acting reversible


  • Copper IUD has no hormones, you keep your bleed pattern, long term use and need for emergency contraception
  • Hormonal IUD has higher efficacy, reduction of menstrual bleed/anemia, amenorrhea, dec dysmenorrhea, tx endometriosis related pelvic pain
• Permanent contraception (permanent sterilization)


  • Normally highly effective
  • Irreversible for females and potentially irreversible for males
• Pregnancy risk


  Higher in pericoital methods
• Appropriate contraceptive counseling strategies

  1. Pt/partner adherence to medication/contraceptive choice

  2. Convo w open ended questions, informed preferences, preg wants, PATH (preg attitudes, timing, how important is prevention)
• Emergency contraception methods


  • IUD (copper or levonorgestrel)
  • Ulipristal acetate
  • Levonorgestrel
• IUD (copper or levonorgestrel)

  • Effective up to 5days out; very effective current and future
• Ulipristal acetate


  • Effective until LH surge begins; effective up to 5days out
• Levonorgestrel


  • Effective until LH surge begins; can only use 3 days after