Hello! Sorry for the long break. Anyways, I’m back today with a quick post on contraception. This will be the first in a series of a few posts about contraception.
I’m lucky to see a fair number of young females in my practice, but I am often shocked at their disregard for their fertility. Of course, I see some women who want to become pregnant, but the vast majority of my patients in this category aren’t ready for that – at least not yet. As part of every new patient visit, I always ask about how many sexual partners a patient has had in the last 12 months, what they’re using for contraception/protection, and whether or not they have any current concerns regarding sexually transmitted infections. Depending on what their answers are, I will address their knowledge, concerns, and preferences regarding their contraceptive options.
I see part of my responsibility as providing education to these women, so if they are dissatisfied with their current contraceptive option or are acting recklessly (“uh, I don’t know… condoms…sometimes?”), I take a few minutes to go through the CDC’s contraceptive efficacy chart with them and discuss the options that may work for them. Of course, I always preface this with the need for condoms and limiting the number of partners in order to reduce the risk of sexually transmitted infections.
Here is the document/image I discuss with patients, taken from the CDC (link to PDF below). Many patients are SHOCKED at the effectiveness – or lack thereof – of some methods they may have relied on in the past to prevent pregnancy. Note that this document outlines typical use, not perfect use of each method discussed.
Two things to ask your patients before narrowing in on a few methods that may work for them during your discussion: 1) what is their timeline for pregnancy, if at all?, and 2) how “reliable” are they at taking medications daily/on a regular basis? Most people are able to be honest about each of those questions. I also require a negative urine pregnancy test before starting ANY prescribed contraceptive; that might be the old ER nurse in me that trusts no one’s last menstrual period, but I feel better knowing that I’ve done my due diligence before prescribing!
Here is link to a PDF of the document above. I recommend keeping copies of it in your patient handout files for easy discussion with patients. We’ll go through the pros and cons of the methods above coming up in future posts, but this is at least a place to start the discussion with patients!