Contraceptive Management

With proper contraceptive management, women can control the timing of pregnancy and start a family on their own terms. Unintended pregnancy is sometimes welcome, but it often brings a host of difficulties and uncertainties. For those women, the priority is to avoid those difficulties. The most effective way of doing that is with proper contraceptive, and with so many varieties available to women and men, there is a regimen for everyone. But as simple as contraceptive might seem, it is still something that should be chosen carefully, with the assistance of a knowledgeable healthcare provider. A general practitioner is capable of assessing contraceptive options for their patients and help them come to an informed decision.

What does contraceptive management look like?

Because some forms of contraception are available over the counter, there is a pervading belief that all forms are equally effective and equally benign enough to handle. That is, unfortunately, not the case, which means that both men and women need to know all of their options. For men, the choices really are limited and simple enough to understand. There are condoms and there is a vasectomy. The picture is much more complicated for women who have more options, and some of those options can produce some adverse effects. Unsurprisingly, women usually require contraceptive management services more often. This is what a healthcare provider will discuss with their female patients on the topic of contraception:

1. Efficacy – There are multiple approaches to contraception, but they aren’t all equal in effectiveness. The most effective contraception methods are sterilization and long acting methods like intrauterine and implant options. Clearly, these options are reserved for women who either never want to become pregnant or are not intending on becoming pregnant in the following year. For this reason, the most important question a healthcare provider asks regarding contraception is “Do you intend on becoming pregnant over the next year?”

If used consistently and properly, oral contraceptives, patches, injectable contraceptives and vaginal rings are highly effective. Realistically, though, they fail more often than they should because women forget to use them or do not follow dosing instructions. These contraceptives can produce adverse effects and require close monitoring by a healthcare provider.

Other forms of contraception include female condoms, cervical caps and diaphragms. These contraception methods are less effective than the options listed above, but still have a 90+ percent success rate if applied correctly. Barrier contraceptives usually produce minimal side effects and protect against some STDs. They should not be relied on to protect against STDs that spread through skin to skin contact.

2. Adverse and positive noncontraceptive effects – Although many women experience no adverse effects from contraception, some do, and for a small portion of women, the effects are debilitating. Side effects resulting from oral, patch or injectable contraception include headaches, nausea, breast pain, mood swings and emotional issues, bloating and reduced sex drive. These effects often disappear after the patient adjusts to them, but not always. Fortunately, with so many contraception options available, a healthcare provider can help their patients find an approach that is most comfortable.

Some women, though, are unable to use some forms of contraception due to medical contraindications. This mostly refers to women at risk of hormone-dependent cancers or women who currently have hormone-dependent cancer.

And there are positive effects associated with these contraceptives as well. They may reduce cramping, clear up skin, improve mood and even reduce the risk of some cancers. Estrogen-containing contraception is also believed to help women suffering from osteoporosis, as it improves bone mineral density. Weighing the good and the bad is something healthcare providers are equipped to do for their patients.

3. Contraception and preference – Efficacy and secondary effects are not the only factors that women consider when choosing a contraceptive. Women also have to consider their desired fertility timeline, as some contraceptives temporarily suppress fertility even after they are discontinued. Other factors include tolerance for applying the contraception, the protection, if any, it offers against STDs, how convenient it is to use and replace, its financial cost, its effect on uterine bleeding and the patient’s sexual patterns, which refer to number of partners and frequency of sex. A healthcare provider will help patients answer these questions and develop a contraception plan that satisfies them as thoroughly as possible.

4. Proper use of the contraception – Rates of reliable contraception use drop quickly over time and this is a major cause of unintended pregnancy. Forgetfulness or complacency may emerge after using the contraception for an extended period, resulting in undisciplined use of birth control. This is important to avoid, so healthcare providers can offer strategies to patients to help them remember when to use the contraceptive. As most forms of contraception function by slowly dosing the patient with hormones, it is essential to follow a strict dosing schedule to ensure there is enough hormone in the blood to prevent pregnancy.

Also, patients using barrier and IUD forms of contraception may find them difficult or uncomfortable to use at first. As part of contraception management, a healthcare provider will show the patient the proper way to apply the contraceptive to ensure it works correctly and feels comfortable.

5. Altering contraceptive use as the patient’s needs change – Many women have no desire to become pregnant ever, and that’s perfectly fine. However, most women prefer a wait and see approach, changing their contraception regimen when they do desire to have a child. As the patient’s needs and preferences change, the healthcare provider can help them develop a new contraception regimen. This can be done to change a patient’s window of fertility or just provide a flexible form of contraception that won’t produce long term birth control effects. The healthcare provider’s goal is to ensure the patient is able to control pregnancy timing while remaining comfortable.

With so many factors to consider, contraception management is an involved topic that should not be taken lightly. Fortunately, it’s a process that men and women don’t have to go through alone, as general practitioners are thoroughly versed on the subject.