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Contraception

Contraception

Contraception

Leslie A. Shimp, Pharm.D., M.S.
Leslie A. Shimp, Pharm.D., M.S.
on behalf of University of Texas at Austin College of Pharmacy

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Review:

Launch date: 09 Mar 2017
Expiry Date:

Last updated: 13 Mar 2017

Reference: 170998

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Description

Virtually all reproductive-age women in the US who have ever had sexual intercourse have used contraception. Among the 62 million US women in their childbearing years, about 70% are at risk of pregnancy (sexually active and do not want to become pregnant); of these, about 11% are not currently using contraception. When surveyed, a large percentage of women agree that contraceptive use has positive effects on their lives, including that they are able to take better care of themselves or their families (63%), able to financially support themselves (56%), able to complete their education (51%), and able to be employed (50%). Women report a number of reasons for using contraception, including being unable to afford a baby, not being ready for children, feeling a baby would interrupt goals, and wanting to maintain control in their lives. Using contraception to allow planning for pregnancy and spacing of pregnancies also contributes to healthier pregnancies and better maternal and child health. Since 1982, oral contraceptives and female sterilization have been the two most commonly used contraceptive methods in the US.1 About 64% of women using contraceptives use reversible methods, while 27% and 10% rely on female and male sterilization, respectively. Four of every 5 sexually experienced women have used oral contraceptives. Women have many contraceptive options, including hormonal methods (eg, pills, patches, implants, vaginal rings, levonorgestrel intrauterine devices [IUDs]) and nonhormonal methods (eg, copper IUDs, condoms, diaphragms). Even among the oral contraceptives, there are many options – combined estrogen/pro-gestin pills, progestin-only pills, monophasic or multiphasic pills, shortened hormone-free intervals, and extended cycle regimens. In recent years, there has been a trend towards greater use of long-acting reversible contraceptives (LARCs), mainly the IUD. Several options are also available for emergency contraception, including nonprescription products. An understanding of the differences among contraceptives is essential when helping a woman select the method(s) best suited to her needs. This issue will focus on the reversible contraceptive methods most often used by women (oral contraceptives, IUDs), and emergency contraception. Factors to consider when choosing a contraceptive – including ease of use, efficacy, side effects, drug interactions, and contraindications – will be discussed. Further information on less frequently used contraceptives, and more detailed information on oral contraceptives, is in a special Provider Connection available in the online edition at www.rxconsultant.com. See the inset on page 4 for useful Resources for Providers. Format This CE activity is a monograph (PDF file).

Objectives

Objectives
List commonly-used methods of contraception and discuss their relative effectiveness. Counsel women about their choice of methods. List the estrogen and progestin ingredients of oral contraceptives (OCs). Discuss OC indications, noncontraceptive benefits, contraindications, adverse effects, and drug interactions. Counsel patients about what to do if they forget to take their OCs. Discuss the types of intrauterine devices (IUDs), including indications and potential adverse effects. Counsel patients about the available methods of emergency contraception, including their relative effectiveness, instructions for use, and adverse effects.
Leslie A. Shimp, Pharm.D., M.S.

Author Information Play Video Bio

Leslie A. Shimp, Pharm.D., M.S.
on behalf of University of Texas at Austin College of Pharmacy

Leslie A. Shimp, Pharm.D., M.S. is a Professor of Pharmacy at the University of Michigan College of Pharmacy; and a Clinical Pharmacist for the U-M Health System in Ann Arbor, MI. Dr. Shimp would like to acknowledge the contribution of Aimrie Ream, Pharm.D. candidate, 2015 in the preparation of this issue.

Current Accreditations

This course has been certified by or provided by the following Certified Organization/s:

  • Accreditation Council for Pharmacy Education (ACPE)
  • 1.50 Hours -
    Exam Pass Rate: 75
    -
    Reference: 0428-0000-14-013-H01-P

Faculty and Disclosures

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