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Counseling women considering combined hormonal contraception

INTRODUCTION

Contraception plays an enormous role in enabling women to plan their families. Modern contraceptives are highly effective at preventing pregnancy when used consistently and correctly, and they can be used safely by the vast majority of reproductive age women. Hormonal contraception methods are the most commonly used reversible methods in the United States; almost one-third of female contraceptors use oral contraceptive pills and many of the remainder use a hormonal injection, implant, transdermal patch, vaginal ring, or intrauterine system [1]. Although some special considerations are warranted when prescribing hormonal contraception for women with chronic medical disorders, most such women can safely use many of the current array of hormonal contraceptive methods [2-5]. Nevertheless, many women and some clinicians have misperceptions about the health risks of contraceptive hormones [6].

Many unplanned pregnancies occur in women who are not using contraception because of barriers to ready access, concerns about adverse events, or dissatisfaction with a method’s side effects, lack of convenience, or other bothersome characteristics. Therefore, it is important for health care providers to appropriately counsel women about contraception, with attention to: the woman’s values, preferences, and expectations; both contraceptive and noncontraceptive benefits of the method; strategies for dealing with side effects; and strategies for a hassle-free switch to another method when desired by the woman.

Dialogue about contraception is conversation between two experts: the health care provider and the woman. The health care provider is the medical, technical expert who can provide basic information about contraceptive methods; the woman is the expert about her needs, her life circumstances, her previous contraceptive experiences, and her expectations for a contraceptive method [7-9]. Women report that they want to be treated as equal partners during this dialogue [10].

BASIC INFORMATION ABOUT CONTRACEPTIVE CHOICES

Prior to making decisions about contraceptive methods that might work well for them, women usually want to understand the method's [7]:

Efficacy

                 

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Literature review current through: Sep 2014. | This topic last updated: Feb 20, 2014.
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