Most Appropriate Contraceptive Methods For Each Situation
Women who use contraception are often young and without serious health problems. Therefore, most of them do not care much about adverse effects or complications when choosing your birth control. Many even start using a contraceptive with no prior medical advice.
The problem is that not every young woman is necessarily a healthy individual flatly. On the contrary, it is very common to find examples of young women who are smokers or have obesity, hypertension, diabetes, migraines, fibroids or other health problems, often still unknown by themselves.
There are currently on the market contraception for everyone. No provisional or definitive methods; There hormonal and non-hormonal methods; there are oral drugs, injections, patches or for use in the genitals; there are methods of daily use, weekly, monthly or lasting up to five years; there are methods that can prevent some diseases or even treat them; and there are methods, which if not properly prescribed, can cause significant side effects or aggravate medical conditions already pre-existing.
Therefore, choosing the most appropriate contraceptive method for your case should not be trivialized, for when choosing a wrong method, you can not only fail to achieve clinical advantages, but also have health problems resulting from this bad choice.
Among the different types of contraception, those based on the administration of hormones progesterone and estrogen, either orally, injection, transcutaneous, subcutaneous or vaginal administration are that often have a higher frequency of side effects or warnings for certain clinical conditions. But they are not the only ones.
In this article we summarize the recommendations of the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC) and the British National Health Department about the indications and contraindications of the main contraceptive methods.
Contraceptive methods most suitable for certain health problems
Let us quote some common diseases and show what are the acceptable contraception or not for every situation.
Contraceptive methods described in the text will be classified into 4 categories:
1. There is no limitation due to the use of the method in this situation.
2. There is a low risk, but the benefits outweigh the risks in this situation.
3. There is significant risk that overlaps the potential benefits in this situation.
4. There is a risk very high and the method is contraindicated in this situation.
When the method is classified in categories 1 and 2 it may be indicated for patients with that particular disease. When the method is classified in Category 3, it should only be used if there is no other option available. When the method is classified as category 4, it should not be used under any circumstances.
1. There is no limitation due to the use of contraceptives following method: minipill (progesterone pill), hormone injectable contraceptive (Depo-Provera), contraceptive implant, copper IUD, Mirena IUD (hormonal IUD) or male condom.
2. It is not completely without risk, but the benefits of these methods outweigh the risks in this situation: contraceptive Pill estrogen and progesterone contraceptive patch or vaginal ring with estrogen and progesterone.
Note: the hormonal injectable contraceptive (3 months) is regarded as category 2 after 45 years old.
1. There is no limitation due to the use of the following contraceptive method: Contraceptive Pill estrogen and progesterone contraceptive patch, vaginal ring with estrogen and progesterone contraceptive implant or male condom.
2. It is not completely without risk, but the benefits of these methods outweigh the risks in this situation: copper IUD, Mirena IUD (hormonal IUD), mini pill (progesterone pill) or hormonal injectable contraceptive (Depo-Provera).
1. There is no limitation due to the use of contraceptives following method: minipill (progesterone pill), hormone injectable contraceptive (Depo-Provera), contraceptive implant, copper IUD, Mirena IUD (hormonal IUD) or male condom.
2. It is not completely without risk, but the benefits of these methods outweigh the risks in this situation: contraceptive Pill estrogen and progesterone contraceptive patch or vaginal ring with estrogen and progesterone.
b) over 35 years and up to 14 cigarettes on average per day
1. There is no limitation due to the use of contraceptives following method: minipill (progesterone pill), hormone injectable contraceptive (Depo-Provera), contraceptive implant, copper IUD, Mirena IUD (hormonal IUD) or male condom.
3. There is significant risk that overlaps the potential benefits in this situation: contraceptive Pill estrogen and progesterone contraceptive patch or vaginal ring with estrogen and progesterone.
c) more than 35 years and more than 15 cigarettes on average per day
1. There is no limitation due to the use of contraceptives following method: minipill (progesterone pill), hormone injectable contraceptive (Depo-Provera), contraceptive implant, copper IUD, Mirena IUD (hormonal IUD) or male condom.
4. There is a very high risk and the following methods are contraindicated in this situation: contraceptive Pill estrogen and progesterone contraceptive patch or vaginal ring with estrogen and progesterone.
1. There is no limitation due to the use of contraceptives following method: minipill (progesterone pill), hormone injectable contraceptive (Depo-Provera), contraceptive implant, copper IUD, Mirena IUD (hormonal IUD) or male condom.
2. It is not completely without risk, but the benefits of these methods outweigh the risks in this situation: contraceptive Pill estrogen and progesterone contraceptive patch and vaginal ring with estrogen or progesterone.
b) BMI between 35 and 39.9 kg / m²
1. There is no limitation due to the use of contraceptives following method: minipill (progesterone pill), hormone injectable contraceptive (Depo-Provera), contraceptive implant, copper IUD, Mirena IUD (hormonal IUD) or male condom.
3. There is significant risk that overlaps the potential benefits in this situation: contraceptive Pill estrogen and progesterone contraceptive patch or vaginal ring with estrogen and progesterone.
c) BMI greater than 40 kg / m²
1. There is no limitation due to the use of contraceptives following method: minipill (progesterone pill), hormone injectable contraceptive (Depo-Provera), contraceptive implant, copper IUD, Mirena IUD (hormonal IUD) or male condom.
4. There is a very high risk and the following methods are contraindicated in this situation: contraceptive Pill estrogen and progesterone contraceptive patch or vaginal ring with estrogen and progesterone.
a) women with hypertensive blood pressure levels below 159/99 mmHg
1. There is no limitation due to the use of contraceptives following method: minipill (progesterone pill), contraceptive implant, copper IUD, Mirena IUD (hormonal IUD) or male condom.
2. It is not completely without risk, but the benefits of these methods outweigh the risks in this situation: Hormonal Contraceptive injection (Depo-Provera).
3. There is significant risk that overlaps the potential benefits in this situation: contraceptive Pill estrogen and progesterone contraceptive patch or vaginal ring with estrogen and progesterone.
b) hypertensive women with blood pressure levels higher than 160/100 mmHg
1. There is no limitation due to the use of contraceptives following method: copper IUD or male condom.
2. It is not completely without risk, but the benefits of these methods outweigh the risks in this situation: minipill (progesterone pill), the contraceptive implant or IUD Mirena (hormonal IUD).
4. There is a very high risk and the following methods are contraindicated in this situation: contraceptive Pill estrogen and progesterone contraceptive patch or vaginal ring with estrogen and progesterone.
F. Methods contraceptives for women who have had a stroke
1. There is no limitation due to the use of contraceptives following method: copper IUD or male condom.
2. It is not completely without risk, but the benefits of these methods outweigh the risks in this situation: minipill (progesterone pill), the contraceptive implant or IUD Mirena (hormonal IUD).
Note: If the patient has had a stroke while wearing an implant or the mini pill, the risk of these methods is regarded as Category 3 and its maintenance is discouraged.
3. There is significant risk that overlaps the potential benefits in this situation: Hormonal Contraceptive injection (Depo-Provera).
4. There is a very high risk and the following methods are contraindicated in this situation: contraceptive Pill estrogen and progesterone contraceptive patch or vaginal ring with estrogen and progesterone.
G. Birth control methods for women who have a history of ischemic heart disease
1. There is no limitation due to the use of contraceptives following method: copper IUD or male condom.
2. It is not completely without risk, but the benefits of these methods outweigh the risks in this situation: minipill (progesterone pill), the contraceptive implant or IUD Mirena (hormonal IUD).
Note: If the patient had a cardiac ischemia while wearing implant, IUD Mirena or mini pill, the risk of these methods is regarded as Category 3 and its maintenance is discouraged.
3. There is significant risk that overlaps the potential benefits in this situation: Hormonal Contraceptive injection (Depo-Provera).
4. There is a very high risk and the following methods are contraindicated in this situation: contraceptive Pill estrogen and progesterone contraceptive patch or vaginal ring with estrogen and progesterone.
H. Birth control methods for women who have frequent headache
a) women with common headache (which is not classified as migraine)
1. There is no limitation due to the use of contraceptives following method: All contraceptive methods are considered Category 1. However, if the patient has frequent headache and already use birth control pill of estrogen and progesterone contraceptive patch or vaginal ring with estrogen and progesterone, these are now considered category 2. In such cases, substitute another method is not mandatory, but can help.
b) Women under 35 years and migraine without aura
1. There is no limitation due to the use of contraceptives following method: minipill (progesterone pill), copper IUD or male condom.
Note: If the patient already uses the mini pill, this method is regarded as Category 2. The exchange by a method considered Category 1 is not mandatory, but it can help.
2. It is not completely without risk, but the benefits of these methods outweigh the risks in this situation: contraceptive Pill estrogen and progesterone contraceptive patch, vaginal ring with estrogen and progesterone hormonal contraceptive injection (Depo-Provera), implants contraceptive or IUD Mirena (hormonal IUD)
Note: If the patient already uses contraceptive pill of estrogen and progesterone contraceptive patch, vaginal ring with estrogen and progesterone, these methods are now considered as Category 3 and its maintenance is discouraged.
c) Women over 35 years and migraine without aura
1. There is no limitation due to the use of contraceptives following method: minipill (progesterone pill), copper IUD or male condom.
Note: If the patient already uses the mini pill, this method is regarded as Category 2. The exchange by a method considered Category 1 is not mandatory, but it can help.
2. It is not completely without risk, but the benefits of these methods outweigh the risks in this situation: Hormonal Contraceptive injection (Depo-Provera), contraceptive implant or IUD Mirena (hormonal IUD).
3. There is significant risk that overlaps the potential benefits in this situation: contraceptive Pill estrogen and progesterone contraceptive patch or vaginal ring with estrogen and progesterone.
Note: If the patient already uses contraceptive pill of estrogen and progesterone contraceptive patch, vaginal ring with estrogen and progesterone, these methods are now considered as Category 4 and its maintenance is contraindicated.
d) women of any age with migraine with aura
1. There is no limitation due to the use of contraceptives following method: copper IUD or male condom.
2. It is not completely without risk, but the benefits of these methods outweigh the risks in this situation: Hormonal Contraceptive injection (Depo-Provera), contraceptive implant, mini pill (progesterone pill) or Mirena IUD (hormonal IUD).
Note: If the patient already uses any of the above methods, they are now considered as Category 3 and its maintenance is discouraged.
4. There is a very high risk and the following methods are contraindicated in this situation: contraceptive Pill estrogen and progesterone contraceptive patch or vaginal ring with estrogen and progesterone.
a) Diabetes under 20 years of duration and without vascular complications
1. There is no limitation due to the use of contraceptives following method: copper IUD or male condom.
2. It is not completely without risk, but the benefits of these methods outweigh the risks in this situation: contraceptive Pill estrogen and progesterone contraceptive patch, vaginal ring with estrogen and progesterone hormonal contraceptive injection (Depo-Provera), minipill (progesterone pill), the contraceptive implant or IUD Mirena (hormonal IUD).
b) Diabetes more than 20 years duration or vascular complications (including nephropathy, retinopathy or neuropathy)
1. There is no limitation due to the use of contraceptives following method: copper IUD or male condom.
2. It is not completely without risk, but the benefits of these methods outweigh the risks in this situation: minipill (progesterone pill), the contraceptive implant or IUD Mirena (hormonal IUD).
3. There is significant risk that overlaps the potential benefits in this situation: contraceptive Pill estrogen and progesterone contraceptive patch, vaginal ring with estrogen and progesterone or hormonal injectable contraceptive (Depo-Provera).
Note: if the vascular complications were severe, the above methods are listed as Category 3 may be considered as category 4.
J. Birth control methods for women with thyroid problems
1. There is no limitation due to the use of contraceptives following method: All contraceptive methods are considered category 1, for none of them demonstrably affects the thyroid.
K. Methods contraceptives for women with endometriosis
1. There is no limitation due to the use of the following contraceptive method: Contraceptive Pill estrogen and progesterone contraceptive patch, vaginal ring with estrogen and progesterone hormonal contraceptive injection (Depo-Provera), mini pill (progesterone pill), contraceptive implant, IUD Mirena (hormone IUD) or male condom.
2. It is not completely without risk, but the benefits of these methods outweigh the risks in this situation: copper IUD.
K. Birth control methods for women with benign ovarian tumors
1. There is no limitation due to the use of contraceptives following method: All contraceptive methods are considered category 1, for none of them proven to have influence on ovarian benign tumors.
L. Contraceptive methods for women with uterine fibroids
a) fibroids that do not cause deformation of the uterine cavity
1. There is no limitation due to the use of the following contraceptive method: Contraceptive Pill estrogen and progesterone contraceptive patch, vaginal ring with estrogen and progesterone hormonal contraceptive injection (Depo-Provera), mini pill (progesterone pill), the contraceptive implant or condom male.
2. It is not completely without risk, but the benefits of these methods outweigh the risks in this situation: copper IUD or Mirena IUD (hormonal IUD).
b) fibroids that cause deformation of the uterine cavity
1. There is no limitation due to the use of the following contraceptive method: Contraceptive Pill estrogen and progesterone contraceptive patch, vaginal ring with estrogen and progesterone hormonal contraceptive injection (Depo-Provera), mini pill (progesterone pill), the contraceptive implant or condom male.
4. There is a very high risk and the following methods are contraindicated in this situation: copper IUD or Mirena IUD (hormonal IUD).