1: Contraception Advantages

Question 1

1. User-controlled.
2. Nonhormonal contraceptive methods that are needed only at the time of intercourse.
3. They are washable and reusable.

Answer 1

Diaphragms

Question 2

• Simpler dosing than pill taking.
• Bypass first-pass effect.
• Less opportunity for user error.

Answer 2

1. The Patch (OrthoEvra [discountinued], Xulane)
2. Ring (NuvaRing)

Question 3

• Readily available.
• Free.
• Can be used immediately postpartum.

Answer 3

Lactational Amenorrhea (Breastfeeding)

Question 4

• Good for 10 years.
• Not coitus-dependent.
• No daily requirements.
• Great effectiveness.
• Reversible protection.
• Available to those who can’t use estrogen.

Answer 4

Copper IUD (T380A, Paragard)

Question 5

• Readily available.
• Requires no supplies or cost.
• User controlled.
• Couples can use intermittently when other methods are unavailable.

Answer 5

Coitus Interruptus

Question 6

• They are coitus dependent and may be appropriate for women who do not want or cannot use hormonal contraception.
• The latex-free one is appropriate for women who have, or whose partners have, latex allergies.
• Should last 2 years.

Answer 6

Cervical Caps

Question 7

• Nonhormonal.
• Do not require daily action.
• Widely available on an over-the-counter basis, without the need for clinician visit or prescription.

Answer 7

1. Male Condoms
2. Female Condoms
3. Vaginal Sponges
4. Spermicides

Question 8

• Readily available and completely effective.
• Prevents sexually transmitted infections (STIs).

Answer 8

Abstinence

Question 9

Good for 3 years.

Answer 9

1. Skyla
2. Liletta
3. Implants (Nexplanon)

Question 10

• Highly effective permanent method of contraception.
• Well suited to women who do not desire future fertility.

Answer 10

Female Sterilization

Question 11

• Only 1 type of pill (less confusion).
• Safe method for many women who cannot take estrogen for medical reasons.
• Similarly, women who are sensitive to even lowestrogen pills, as manifested by nausea, breast tenderness, or hypertension, but who still want an oral contraceptive, may do well.
• Preferable for lactating women because they do not cause adverse effects on the volume or quality of breastmilk.

Answer 11

Progestin-Only Pills (POPs)

Question 12

• 104-mg SQ version can be self-administered.
• High degree of efficacy and long-term nature and its noninterference with coitus.
• For women who want to keep their contraceptive choice private, there is no visible evidence.
• It has long been used to achieve amenorrhea in women with mental disabilities who cannot manage their menses.

Answer 12

Depot medroxyprogesterone acetate injection (DMPA or Depo-Provera)

Question 13

• Simple, in office procedure.
• It is reversible (best results within 10 years of procedure).

Answer 13

Male Sterilization

Question 14

Good for 5 years.

Answer 14

Mirena

Question 15

• Women may have to pay for training or supplies, but there is no ongoing cost unless a barrier contraceptive is used during the fertile window.
• These methods are user controlled.
• May be the only acceptable form of contraception for members of some religions and cultures.

Answer 15

Fertility Awareness Based (FAB)

Question 16

• Unrelated to coitus.
• Familiar with the instructions for use.
• Widely available in pharmacies and clinics.
• Confidence in the product is high due to the fact it has been on the market for more than 50 years and has been continually researched.
• More than 30 different formulations are available, allowing for individualization based on response to the products.

Answer 16

Combined Oral Contraceptives (COCs)

Question 17

• Good for 3-5 years.
• Not coitus-dependent.
• No daily requirements.
• Great effectiveness.
• Reversible protection.
• Available to those who can’t use estrogen.
• Reduced bleeding.

Answer 17

Progestin / Levonorgestrel (Mirena, Skyla, Liletta)

Question 18

• Simpler dosing than pill taking.
• Bypass first-pass effect.
• Provides a steady delivery of hormones, which leads to a very low serum concentration—approximately half of the serum concentration found with a 35-mcg COC.
• There is less opportunity for user error.
• The exact placement is not critical to its efficacy.
• Lack of visible evidence of use.

Answer 18

Vaginal Ring (NuvaRing)

Question 19

• After removal, etonogestrel levels are undetectable in most women within 1 week, and ovulation generally returns within 6 weeks.
• Highly effective contraception following a single insertion procedure.
• Immediately reversible upon removal of the device.
• It is discreet but palpable, providing reassurance to the woman that it is in place and has not migrated.

Answer 19

Subdermal Implant (Implanon, Nexplanon [newer])