By Guillebaud, John
Common practitioners are frequently good put to supply solid contraceptive recommendation simply because they already recognize the patient's health and wellbeing and conditions. a few practices are very good; others offer little past oral birth control and dedicate inadequate time and ability to counselling. This top promoting pocketbook summarizes the tools to be had and the criteria to be thought of in utilizing them
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Additional info for Contraception today : a pocketbook for general practitioners
Particularly useful choices are the POP, depot medroxyprogesterone acetate (DMPA) and the LNG IUS 44 Migraine Studies have shown an increased risk of ischaemic stroke in migraine sufferers and in COC users. There is good evidence of exacerbation by arterial risk factors, including increasing age above 35, and some evidence that certain features of the headaches themselves tend to focus the risk of this rare catastrophe in a pill-user. See Figure 8 and the Boxes for details. Migraines are here defined as episodic headaches with nausea and photophobia, usually onesided, lasting 4–72 hours.
Hannaford P, Webb A. Evidence-guided prescribing of combined oral contraceptives: consensus statement. ] Therefore: 1. Prescribers should always take a comprehensive personal and family history to exclude absolute and relative contraindications to the use of COCs (see Boxes on pp. 33–36). A personal history of definite VTE remains an absolute contraindication to any COC containing EE combined with any progestogen. 2. The risk factors for VTE and arterial wall disease must be assessed, separately and most carefully (see Tables 5 and 6).
4. Lovemaking during the 7 days after any packet is only safe if you do go on to the next one: otherwise (if you are going to take a break from the pill) start using condoms after the last pill in the pack 5. Even if your ‘period’ has not stopped yet, or for any other reason, never start your next packet late. This is because the pill-free time is obviously a time when your ovaries are not getting the contraceptive, so might anyway be beginning to escape from its actions. (This simple explanation should always be given, it greatly improves compliance) 6.
Contraception today : a pocketbook for general practitioners by Guillebaud, John