Contraception E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Serie: GIP - Gynaecology in Practice
• Sprache: Englisch

Seitenzahl: 546

Veröffentlichungsjahr: 2011

Beschreibung

Which method of contraception best suits your patient's needs? Contraceptive technology has exploded at breakneck speed. The options now available can bewilder patients who need practical advice for family planning. Contraception provides just that practical advice. Divided into three sections covering selection and cost comparison, individual methods of contraception, and risks and benefits for various patient groups, the editor presents a clear pathway to help your patients decide which method is best for them. The book covers all available contraceptive methods with WHO Medical Eligibility Criteria of contraceptives and CDC modifications. It gives sound advice on selecting contraceptive methods for women with bleeding problems, previous ectopic pregnancy, mood and depressive disorders, hirsutism and acne, perimenopausal women, women with HIV and other STIs. Provides an essential guide to all gynecologists, family medicine physicians and health care workers who provide contraceptive advice. Part of the new practical Gynecology in Practice series.

Leseprobe

Table of Contents

Cover

Table of Contents

Title page

Copyright page

Series Foreword

Preface

Contributors

Section 1: Overview

1 Contraceptive Use: Guidelines and Effectiveness

Introduction

Evidence-based guidelines

Development of WHO evidence-based guidance for contraceptive use

CDC adaptation of WHO evidence-based guidance for contraceptive use

Sources of evidence-based guidelines

Contraceptive effectiveness

Disclaimer

2 Cost and Availability of Contraceptive Methods

Selecting the right contraceptive method

Condoms and other barrier methods

Natural family planning

Contraceptive pills and other hormonal methods

Intrauterine devices/systems

Female and male sterilization

Birth control methods in development

Cost saving of contraceptive methods

Section 2: Individual Contraceptive Methods

3 Combination Oral Contraceptives

Mechanism of action and effectiveness

Good candidates

Poor candidates

Medical eligibility criteria

Advantages of low-dose oral contraceptives

Noncontraceptive health benefits

Risks associated with the use of oral contraceptives

Patient counseling

Selecting the right oral contraceptive: type of formulation

Drug interactions

Supplying the method

New products

Management of problems

4 Progestin-only Oral Contraceptive Pills

Method of action

Effectiveness

Good candidates

Poor candidates

Medical eligibility criteria

Advantages

Metabolic effects

Noncontraceptive benefits

Risks and side effects

Key history and physical elements

Patient counseling

Available options

New products

Supplying the method: counseling points

Management of problems

5 Contraceptive Implants

Introduction

Method of action

Good candidates

Poor candidates

Medical eligibility criteria

Advantages

Noncontraceptive benefits

Risks and side effects

Potential risks

Patient counseling

Available options

New products

Supplying the method

Management of problems

6 Ins and Outs of the Contraceptive Vaginal Ring

Method of action and effectiveness

Good candidates

Poor candidates

Medical eligibility criteria

Advantages

Noncontraceptive benefits

Risks and side effects

Key history and physical elements

Patient counseling

Available options

New products

Supplying the method: counseling points

Management of problems

7 Contraceptive Patch

Introduction

Methods of action and efficacy

Good candidates

Poor candidates

Medical eligibility criteria

Advantages

Noncontraceptive benefits

Risks and side effects

Key history and physical examination

Patient counseling

Other consultation tips

Available options

New products

Managing problems: what ifs …?

Summary

8 Progestin Injectables

History of DMPA in the United States

Mechanism of action

Efficacy of DMPA

Good candidates

Advantages

Noncontraceptive benefits

Risks and side effects

Patient counseling

Available options

Supplying the method

Management of problems

Conclusions

9 Intrauterine Devices

Introduction

Mechanism of action

Efficacy

Good candidates

Poor candidates

Medical eligibility criteria

Advantages

Noncontraceptive benefits

Risks and adverse effects

Complications related to pregnancy

Patient counseling

Available options

Supplying the method

Managing problems

10 Spermicides

Method of action

Efficacy

Good candidates

Poor candidates

Medical eligibility criteria

Advantages

Disadvantages

Risks and side effects

Key history and physical elements

Patient counseling

Available products

New products

Supplying the method

Management of problems

11 Vaginal Barriers: Diaphragm, Cervical Cap, and Female Condom

Introduction

Method of action

Good candidates

Poor candidates

Medical eligibility criteria

Advantages

Disadvantage

Noncontraceptive benefits

Risks and side effects

Key history and physical elements

Patient counseling

Available options

New products

Supplying the method: counseling points

Management of problems

12 Male Condoms

Method of action and estimates of efficacy

Good candidates

Poor candidates

Medical eligibility criteria

Advantages

Noncontraceptive benefits

Risks and side effects

Key history and physical examination elements

Patient counseling

Available options

New products

Supplying the methods

Management of problems

Conclusions

13 Emergency Contraception

Introduction

Relationship to high-risk sex and pregnancy terminations

Effectiveness

Mechanism of action

Good candidates

Medical eligibility criteria (WHO MEC)

Advantages of emergency contraceptive methods

Risks and side effects

Noncontraceptive benefits

Patient counseling

Available options

New products

Supplying the method

Management of problems

14 Tubal Sterilization

Failure rates

Good candidates

Medical eligibility criteria

Noncontraceptive benefits

Advantages

Risks and side effects

Patient counseling

Available options

Reversal of sterilization

Investigational procedures

Conclusion

Section 3: Guidelines for Use in Selected Populations

15 Postpartum Contraception

Introduction

The postpartum visit

Lactation and contraception

Contraceptive efficacy of lactation: using LAM

Considerations for use of hormonal contraception in lactation

Intrauterine contraception

Postplacental IUD placement

Nonhormonal methods

Sterilization

Postpartum contraception in nonlactating women

Summary

16 Adolescents: Compliance, Ethical Issues, and Sexually Transmitted Infections

Introduction

When to initiate

Barriers to access

Education

Contraceptive counseling

Abstinence

Barrier methods

Combination estrogen/progestin contraceptives

Progestin-only contraception

Intrauterine devices and systems

Emergency contraception

Summary

17 Women 35 Years and Older: Safety Issues

Introduction

Contraceptive choices

Benefits of hormonal contraceptives in older women

Risks

18 Perimenopausal Contraception

The perimenopausal woman

Health issues

Medical eligibility criteria

Actual perimenopausal contraceptive use

Contraceptive options for perimenopausal women

Health concerns/side effects

Barrier contraceptives

Contraception use and compliance

19 Medical Eligibility Requirements

Introduction

Clinical judgment

US Medical Eligibility Criteria for Contraceptive Use

20 Hormonal Contraception and Mood

Introduction

Background

Effect of hormonal contraceptives on mood in women without mood disorders

Effect of hormonal contraceptives on mood in women with mood symptoms or disorders

Conclusions

21 Contraception in Women with Abnormal Uterine Bleeding

Introduction

Need for uniform terminology

Types of abnormal uterine bleeding symptoms

Underlying causes of HMB and HPMB

Investigations prior to starting contraception

Contraceptive choices for women with AUB

Contraceptive options for women with IMB and PCB

Adverse effects of hormonal contraceptives on bleeding patterns

Roles of other nonpreferred methods of contraception in women with HMB or other types of AUB

Acute and severe HMB

Role of surgery for HMB or IMB before contraception

Benefits associated with long-term contraceptive use

Switching contraception in women with persistent HMB or IMB

22 Hirsutism and Acne

Introduction

Causes of hirsutism and acne in women

Patient evaluation

Which conditions should be ruled out before treating hirsutism and acne?

Laboratory studies

Diagnosis

Treatment

Are there other contraceptive methods that work for hirsutism and acne?

Conclusions

23 HIV and Other Sexually Transmitted Infections

Contraception in HIV-infected women

Other sexually transmitted infections

Antibiotics for STIs and other indications

24 Contraception Following Ectopic Pregnancy, and Induced or Spontaneous Abortion

Introduction

Induced abortion

Spontaneous abortion

Ectopic pregnancy

Contraceptive considerations

IUDs and ectopic pregnancy

Conclusion

Index

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Library of Congress Cataloging-in-Publication Data

Contraception / edited by Donna Shoupe, Division of Reproductive

Endocrinology, Keck School of Medicine, University of Southern California.

p. ; cm.—(Gynecology in practice)

 Includes bibliographical references and index.

 ISBN 978-1-4443-3351-0 (pbk. : alk. paper)

 ISBN 978-1-4443-4263-5 (ebk)

 1. Contraception. I. Shoupe, Donna, editor. II. Series: Gynecology in practice.

 [DNLM: 1. Contraception–methods. 2. Contraceptive Agents. 3. Contraceptive Devices. 4. Fertilization–drug effects. WP 630]

 RG136.C557 2011

 613.9′43–dc22

2010047407

A catalogue record for this book is available from the British Library.

Series Foreword

In recent decades, massive advances in medical science and technology have caused an explosion of information available to the practitioner. In the modern information age, it is not unusual for physicians to have a computer in their offices with the capability of accessing medical databases and literature searches. On the other hand, however, there is always a need for concise, readable, and highly practicable written resources. The purpose of this series is to fulfill this need in the field of gynecology.

The Gynecology in Practice series aims to present practical clinical guidance on effective patient care for the busy gynecologist. The goal of each volume is to provide an evidence-based approach for specific gynecologic problems. “Evidence at a glance” features in the text provide summaries of key trials or landmark papers that guide practice, and a selected bibliography at the end of each chapter provides a springboard for deeper reading. Even with a practical approach, it is important to review the crucial basic science necessary for effective diagnosis and management. This is reinforced by “Science revisited” boxes that remind readers of crucial anatomic, physiologic or pharmacologic principles for practice.

Each volume is edited by outstanding international experts who have brought together truly gifted clinicians to address many relevant clinical questions in their chapters. The first volumes in the series are on Chronic Pelvic Pain, one of the most challenging problems in gynecology, Disorders of Menstruation, Infertility, and Contraception. These will be followed by volumes on Sexually Transmitted Diseases, Menopause, Urinary Incontinence, Endoscopic Surgeries, and Fibroids, to name a few. I would like to express my gratitude to all the editors and authors, who, despite their other responsibilities, have contributed their time, effort, and expertise to this series.

Finally, I greatly appreciate the support of the staff at Wiley-Blackwell for their outstanding editorial competence. My special thanks go to Martin Sugden, PhD; without his vision and perseverance, this series would not have come to life. My sincere hope is that this novel and exciting series will serve women and their physicians well, and will be part of the diagnostic and therapeutic armamentarium of practicing gynecologists.

Aydin Arici, MD

Professor

Department of Obstetrics, Gynecology, and Reproductive Sciences

Yale University School of Medicine

New Haven, USA

Preface

When scanning for topics related to world population it is not surprising that family planning is the first entry. This entry, however, is followed by overpopulation, overconsumption, water crisis, sustainable development, food security, green revolution, world energy resources and consumption. An article entitled “The Day of Six Billion” reviews the world population that reached 1 billion in 1804, 2 billion in 1927, 3 billion in 1960, 4 billion in 1974, 5 billion in 1987, and 6 billion in 1999. Some estimates project that the world will reach 7 billion in 2011–12, 8 billion in 2025, 9 billion in 2040, and 10 billion in 2061. These enormous growths in population would place tremendous strains on world energy and food supplies and incite economical and political conflict.

There is evidence, however, that efforts to curb the population explosion have been effective and that another scenario may instead unfold. The global population growth rate, which reached a peak in 1963 (2.2%), has since been steadily slowing and by 2008 was cut by half. While growth rates remain high in Latin America, the Middle East and Sub-Saharan Africa, some countries, especially in central and eastern Europe, have a negative population growth. Within the next 10 years, Japan and some countries in western Europe are expected to have a negative population growth. If these trends continue, the world growth rate may diminish to zero. Addressing these very different possible scenarios, the United Nation’s projections for world population in 2050 ranged from 8 billion to 10.5 billion.

Developed countries have traditionally had much lower fertility rates than developing countries, due to a combination of factors relating to greater wealth, education, and urbanization. Although mortality rates are generally lower in developed countries, birth control options are well known and accessible. Many reproductive-aged women in these countries are motivated to use contraceptive methods as they pursue education or job goals or wish to control spacing and number of children. A variety of private and public sector programs help defray the costs of contraceptives for those with limited financial means, and a barrage of mass media advertisements help educate the general public on contraceptive options.

Advances in contraceptive technology, worldwide availability, and effective dissemination of information regarding contraceptive options will continue to play a vital role in the world’s economic and political wellbeing. This book is dedicated to those individuals and organizations that have tirelessly advanced these goals around the world. Over the next decade, the impact of their hard work and dedication will continue to show impact and will help to determine which of the scenarios presented above will unfold.

This book is also dedicated to the authors who were willing to take the time to share their expertise. The authors were asked to write a clinically pertinent chapter and include a list of references at the end of the chapter that could be used by interested readers to further expand their knowledge on particular topics. These authors represent a variety of titles, practices, academic backgrounds, and areas of expertise.

The book is divided into three sections. The first section includes chapters on appropriate selection of contraceptive options and cost comparison of contraceptives. Chapter 1 introduces the new Centers for Disease Control and Prevention medical eligibility criteria adaptation for the United States (the US MEC). Chapter 2 presents a comparison of the 1-, 5-, and 10-year present values of the contraceptives available in the United States. These values include the cost of the method, the medical costs of obtaining the method, and the cost of pregnancy as a result of method failure.

The second section of the book includes chapters on the contraceptive options currently available in the United States, with sections on method of action, good candidates, poor candidates, medical eligibility criteria, advantages, noncontraceptive benefits, risks and side effects, patient counseling, available options, new products, supplying the method, and management of problems. Each of the following methods is addressed separately:

oral contraceptivesprogestin only contraceptivescontraceptive implantscontraceptive vaginal ringcontraceptive patchprogestin injectablesintrauterine devicesspermicidesvaginal barriers: diaphragm, cervical cap, and female condommale condomsemergency contraceptiontubal sterilization

The third section of the book includes chapters on various medical conditions and the risks and benefits associated with various contraceptive options:

postpartumadolescents: compliance, ethical and STD issueswomen 35 years and older: safety issuesperimenopausal contraception—staging of reproductive aging in womenmedical eligibility criteria—WHO MEC and US MEChormonal contraception and mood—depressive disorders, PMDD and PMS, major depressive disorders, postpartum depression, schizophrenia, bipolar, anxiety and panic disorderabnormal uterine bleeding—uniform terminology, structural and nonstructural etiologieshirsuitism and acne—causes and patient evaluation, diagnosis and treatmentHIV and other sexually transmitted infections—antiretroviral interactions with hormonal contraceptives, reducing transmission to partners and fetuscontraception following ectopic pregnancy or spontaneous or induced abortion.

This book is designed to highlight the important issues surrounding contraceptive technology including safety, lifestyle, costs of method, costs of method failure, noncontraceptive benefits, interaction with various medical conditions, and managing side effects. There is an important emphasis on the WHO MEC and CDC modifications as these are the guidelines important to clinicians.

A final tribute is given to those who excel in contraceptive technology and in all areas of human endeavors.

This comprehensive book includes topics on:

All of the currently available contraceptive methods in the US including those recently introducedWHO Medical Eligibility Criteria for contraceptives and CDC modificationsSelecting contraceptive methods for women with bleeding problems, previous ectopic pregnancy, mood and depressive disorders, hirsutism and acne, perimenopausal women, women with HIV and other STIs.

An important and useful reference for:

Contraceptive Healthcare ProvidersGynecologistsFamily Medicine PhysiciansNurse practitionersInternistsPhysician Assistants

Donna Shoupe

Los Angeles

Contributors

Susan A. Ballagh, MD Department of Obstetrics and Gynecology, Harbor-UCLA Medical Center, Torrance, CA, USA

Paula H. Bednarek, MD, MPH Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR, USA

Nerys Benfield, MD Department of Obstetrics Gynecology and Reproductive Sciences, University of California, San Francisco and San Francisco General Hospital, San Francisco, CA, USA

Timothy Campbell, PhD Economics and Finance, Marshall School of Business, University of Southern California, USA

Catherine Cansino, MD, MPH Department of Obstetrics and Gynecology, The Ohio State University, Colombus, OH, USA

Mitchell Creinin, MD Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine and Magee Research Institute Hospital, Pittsburgh, PA, USA

Kathryn M. Curtis, PhD Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA

Philip D. Darney, MD, MSC Department of Obstetrics Gynecology and Reproductive Sciences, University of California, San Francisco and San Francisco General Hospital, San Francisco, CA, USA

Alison B. Edelman, MD, MPH Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR, USA

Ian S. Fraser, AO, MD Department of Obstetrics, Gynaecology and Neonatology, Queen Elizabeth II Research Institute for Mothers and Infants, University of Sydney, NSW, Australia

Jeffrey T. Jensen, MD, MPH Department of Obstetrics and Gynecology and Department of Public Health and Preventive Medicine, Oregon Health and Science University, Portland, OR, USA

Ronna Jurow, MD, MS Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, USA

Andrew M. Kaunitz, MD Department of Obstetrics and Gynecology, University of Florida College of Medicine, Jacksonville, FL, USA

Charles M. March, MD Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, USA

Polly A. Marchbanks, PhD Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA

Susanna Meredith, MD Department of Obstetrics and Gynecology, University of Florida College of Medicine, Jacksonville, FL, USA

Daniel R. Mishell Jr, MD Division of Reproductive Endocrinology and Infertility, Keck School of Medicine, University of Southern California, USA

Anita L. Nelson, MD Department of Obstetrics and Gynecology, David Geffen School of Medicine at ULCA and Harbor-UCLA Medical Center, Torrance, CA, USA

Melanie Ochalski, MD Department of Obstetrics and Gynecology and Reproductive Sciences, Center for Fertility and Reproductive Endocrinology, University of Pittsburgh Physicians, Magee-Womens Hospital, Pittsburgh, PA, USA

Andrea Rapkin, MD Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

Matthew F. Reeves, MD, MPH Medical Affairs, WomanCare Global, Chapel Hill, NC, USA

Regina-Maria Renner, MD, MPH Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA

Frans J.M.E. Roumen, MD, PhD Department of Obstetrics and Gynaecology, Atrium Medical Centre Parkstad, Heerlen, The Netherlands

Jennefer A. Russo, MD Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh Medical Center, Magee-Womens Hospital, Pittsburgh, PA, USA

Joseph S. Sanfilippo, MD, MBA Department of Obstetrics and Gynecology and Reproductive Sciences, Center for Fertility and Reproductive Endocrinology, University of Pittsburgh Physicians, Magee-Womens Hospital, Pittsburgh, PA, USA

Jill L. Schwartz, MD, MPH Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Arlington, VA, USA

Donna Shoupe, MD Division of Reproductive Endocrinology and Infertility, Keck School of Medicine, University of Southern California, CA, USA

Sarita Sonalkar, MD Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, MA, USA

Stephanie B. Teal, MD, MPH Department of Obstetrics and Gynecology, University of Colorado Denver School of Medicine, Aurora, CO, USA

Naomi K. Tepper, MD, MPH Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA

Alice Stek, MD Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

DeShawn L. Taylor, MD, MSc Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

Section 1: Overview

1

Contraceptive Use: Guidelines and Effectiveness

Kathryn M. Curtis, Naomi K. Tepper, and Polly A. Marchbanks

Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, USA

Introduction

Clinicians are now able to rely on evidence-based guidelines to efficiently incorporate scientific evidence into clinical practice regarding appropriate selection and use of specific contraceptive methods.

Contraceptive effectiveness is also an important factor in contraceptive choice; tools are available to assist providers in communicating contraceptive effectiveness to family planning patients.

Evidence-Based Guidelines

As the volume of scientific literature rapidly expands, it has become increasingly difficult for individual clinicians to keep up with finding, reading, and interpreting new evidence to put into practice. A PubMed search using the terms “contraception” and “family planning” yielded an average of 130 new articles per month in 2010. Many clinicians rely on evidence-based guidelines to efficiently use the best scientific evidence when making decisions about patient care.

EVIDENCE AT A GLANCE

The World Health Organization’s evidence-based guidance on contraceptive use (WHO Medical Eligibility Criteria for Contraceptive Use (MEC)) is used around the world and has been adapted by several countries, including the United States.The Centers for Disease Control and Prevention (CDC) has recently adapted the WHO MEC for use in the United States (US MEC). While the vast majority of the CDC recommendations are identical to the WHO recommendations, some adaptations were made to more accurately focus on methods currently available in the USA, and to better reflect the surgical and medical practices of the USA