Contraception today

Practitioner. 1983 May;227(1379):747-55.

Abstract

PIP: All reversible contraceptive methods are reviewed with particular focus on the practical aspects of contraceptive care. Discussion covers barrier methods, the combined oral contraceptive (OC) pill, the progestogen only pill, IUDs, depot progestogens, natural family planning methods, and postcoital methods. The efficacy of the condom or cap is acceptable to many couples. The condom is totally free of any need for medical supervision, and the choice of caps has not changed for many years. In choosing an OC, the best course seems to choose a pill on the basis of its clinical benefits rather than to be preoccupied with subtle metabolic differences. Data from several studies emphasize the importance of considering both smoking habits and age as risk factors. The problem of absent withdrawal bleeds is relatively common with low dose OCs and is frequently associated with breakthrough bleeding. Unless the woman has missed taking her OC and is fairly sure she is pregnant, it is wise for her to continue taking the OCs. The progestogen only pill is used by a slowly increasing minority of women. It is extremely safe because of the minimal metabolic changes associated with its use. Its disadvantages are that it must be taken on a precise schedule and that menstrual disturbance is common. There are 5 IUDs to choose from, now that the Saf-T-Coil has been discontinued. These are the Lippes loop, the copper-7 and mini copper-7, copper T 200, Multiload Cu250, and the Nova-T. Injectable contraception is an effective and safe method chosen by a minority of women in the UK. 2 preparations are used: medroxyprogesterone acetate (Depo-Provera) and norethisterone enanthate. Natural family planning is not usually advocated as a method due to its notoriously low efficacy, yet some highly motivated couples have achieved failure rates as low as 1.1 pregnancies/100 woman years. An estrogen progestogen combination administered up to 72 hours or insertion of an IUD up to 120 hours after intercourse are both effective in preventing implantation of a fertilized egg. Menstrual regulation is a procedure used to terminate a suspected pregnancy within 14 days of a missed period. The procedure appears to have little place in the future due to improvements in pregnancy testing technology.

MeSH terms

  • Contraception*
  • Contraceptives, Oral
  • Female
  • Humans
  • Intrauterine Devices

Substances

  • Contraceptives, Oral