The Handbook of Contraception: A Guide for Practical Management (Current Clinical Practice)

The Handbook of Contraception: A Guide for Practical Management provides a comprehensive review of contraception methods for all reproductive-aged women, including those who are young and healthy, postpartum, perimenopausal, adolescent, or who have a medical disease. Because of the vast and diverse list of various contraceptive methods available, this text updates the health care provider with information on safety, practical counseling tools, advantages, and disadvantages of each contraception method. This superb reference offers inclusive information on oral, injectable, emergency, and various cervical barrier contraceptives, as well as behavioral methods of contraception and sterilization methods. An extensive review of currently available laparoscopic and hysterscopic tubal sterilization techniques is also included as well as a chapter introducing the new surgical contraceptive implant, Implanon®. The Handbook of Contraception: A Guide for Practical Management is designed to give the modern health care provider up-to-date information on safety, side effects, advantages, and practical counseling tools. Cover 1 Series Editor Introduction 8 Preface 10 Contents 12 Contributors 14 1. Contraceptive Overview 16 INTRODUCTION 16 GOALS OF THE HEALTH CARE PROVIDER 17 TRENDS OF CONTRACEPTIVE USE AND STERILIZATION 20 EFFECTIVENESS OF METHODS COMPARED 22 BETTER EFFICACY AFTER EXTENDED USE 25 COSTS OF DIFFERENT METHODS 25 ADVANCES IN REPRODUCTIVE HEALTH 26 REFERENCES 27 2. Oral Contraceptives: History, Pharmacology, Metabolic Effects, Side Effects, and Health Benefits 28 INTRODUCTION 28 LEGAL HISTORY 29 MECHANISM OF ACTION 33 CLINICAL EFFECTIVENESS 34 ADVANTAGES OF LOW-DOSE OCS 35 DISADVANTAGES OF LOW-DOSE OCS 35 PHARMACOLOGY 36 METABOLIC EFFECTS AND SIDE EFFECTS: ESTROGEN AND PROGESTIN 38 REPRODUCTIVE EFFECTS OF LOW-DOSE OCS 47 NEOPLASTIC EFFECTS OF LOW-DOSE OCS 47 DRUG INTERACTIONS 49 CONTRACEPTIVE HEALTH BENEFITS 50 NON-CONTRACEPTIVE HEALTH BENEFITS 50 REFERENCES 52 INTRODUCTION 60 PATIENT EDUCATIONAL POINTS 61 PATIENT SELECTION AND SCREENING 63 CONTRAINDICATIONS TO USE 66 COUNSELING TIPS 69 TIMING OF INITIATION 70 WARNING SIGNS 71 OPTIONS 71 CHOOSING AN OC FORMULATION 71 MANAGING PROBLEMS 77 REFERENCES 79 3. Oral Contraceptives: Patient Screening and Counseling, Pill Selection, and Managing Side Effects 60 INTRODUCTION 60 PATIENT EDUCATIONAL POINTS 61 PATIENT SELECTION AND SCREENING 63 CONTRAINDICATIONS TO USE 66 COUNSELING TIPS 69 TIMING OF INITIATION 70 WARNING SIGNS 71 OPTIONS 71 CHOOSING AN OC FORMULATION 71 MANAGING PROBLEMS 77 REFERENCES 79 4. Progestin-Only Oral Contraceptives 82 INTRODUCTION 82 MECHANISM OF ACTION 82 CLINICAL EFFECTIVENESS 83 ADVANTAGES OF POPs 83 DISADVANTAGES OF POPs 84 CONTRAINDICATIONS TO USE 84 EVALUATIONS, PATIENT SELECTION, AND COUNSELING 85 COUNSELING TIPS 86 WARNING SIGNS 87 OPTIONS AVAILABLE 87 REFERENCES 88 5. Contraceptive Patch 90 INTRODUCTION 90 PHARMACODYNAMICS 91 METABOLISM 91 MECHANISM OF ACTION 92 CLINICAL EFFECTIVENESS 92 ADVANTAGES OF THE PATCH 92 DISADVANTAGES OF THE PATCH 93 SIDE EFFECTS 93 CONTRAINDICATIONS 94 DRUG INTERACTIONS 95 COUNSELING AND PATIENT SELECTION 95 INSTRUCTIONS TO USE 96 POOR CANDIDATES FOR THE PATCH 99 COUNSELING TIPS 99 PRODUCT 100 REFERENCES 100 6. Contraceptive Ring 102 INTRODUCTION 102 PRODUCT DESCRIPTION 102 METABOLISM 104 MECHANISM OF ACTION 104 CLINICAL EFFECTIVENESS 105 ADVANTAGES OF THE CONTRACEPTIVE RING 105 DISADVANTAGES OF THE CONTRACEPTIVE RING 106 SIDE EFFECTS 106 DRUG INTERACTIONS 109 COUNSELING AND PATIENT SELECTION 109 SUMMARY 112 REFERENCES 112 7. Long-Acting Progestin Injectables 116 INTRODUCTION 116 HISTORY 117 PHARMACODYNAMICS 117 MECHANISM OF ACTION 118 CLINICAL EFFECTIVENESS 119 ADVANTAGES OF LONG-ACTING PROGESTIN INJECTABLES 119 DISADVANTAGES OF LONG-ACTING PROGESTIN INJECTABLES 120 SIDE EFFECTS 121 CONTRAINDICATIONS 123 DRUG INTERACTIONS 124 GOOD CANDIDATES FOR LONG-ACTING PROGESTIN INJECTABLES 124 COUNSELING AND PATIENT SELECTION 124 INSTRUCTIONS TO USE 125 COUNSELING TIPS 127 OPTIONS AVAILABLE 127 REFERENCES 128 8. Contraceptive Implants 132 INTRODUCTION 132 BENEFITS OF IMPLANTABLE CONTRACEPTIVES 132 ADVANTAGES OF PROGESTIN-ONLY CONTRACEPTION 133 MECHANISM OF ACTION 134 IMPLANON: THE SINGLE-ROD ENG IMPLANT 135 SUMMARY 142 REFERENCES 142 9. Intrauterine Devices 144 INTRODUCTION 144 HISTORICAL PERSPECTIVE 145 MECHANISM OF ACTION 146 EFFICACY OF IUC 146 BARRIERS TO IUC 147 SIDE EFFECTS AND CONCERNS 148 IUD AS EMERGENCY CONTRACEPTION 149 THERAPEUTIC USES OF THE LNG-IUS 150 GOOD CANDIDATES FOR IUC USE 152 GOOD CANDIDATES FOR LNG-IUS 153 CONTRAINDICATIONS TO IUC USE 153 COUNSELING GUIDELINES 154 INSERTION INSTRUCTIONS 154 COUNSELING TIPS 155 MANAGING PROBLEMS 156 REMOVAL 156 CURRENTLY AVAILABLE IUCS 157 REFERENCES 157 10. Barrier Contraceptives 162 MALE CONDOMS 162 VAGINAL SPERMICIDES 167 CERVICAL BARRIER METHODS: COMPARISON OF THE DIAPHRAGM, FEMALE CONDOM, CERVICAL CAP AND SHIELD, AND VAGINAL SPONGE 170 REFERENCES 189 11. Behavioral Methods of Contraception 194 INTRODUCTION 194 CANDIDATES FOR NFP OR FAMS 194 EFFICACY AND CONTINUATION RATES 195 TRAINING 195 OPTIONS: BEHAVIORAL METHODS OF CONTRACEPTION 195 SUMMARY 207 REFERENCES 208 12. Emergency Contraceptives 210 INTRODUCTION 210 MECHANISM OF ACTION 212 EFFECTIVENESS 212 ADVANTAGES 213 DISADVANTAGES 213 INDICATIONS AND USAGE 214 SIDE EFFECTS 214 METABOLIC EFFECTS 215 CONTRAINDICATIONS 216 FETAL EFFECTS 216 COUNSELING TIPS BEFORE TREATMENT 216 COUNSELING AFTER TREATMENT 217 OPTIONS 217 REFERENCES 218 13. Female Tubal Sterilization 220 INTRODUCTION 220 POPULARITY 221 HEALTH BENEFITS OF STERILIZATION 222 TRADITIONAL STERILIZATION METHODS 222 TRANSCERVICAL APPROACH 233 AVOIDING AND MANAGING REGRET 235 RESEARCH METHODS 238 CONCLUSION 245 REFERENCES 246 14. Contraceptives for Special Populations 250 ADOLESCENTS 250 PERIMENOPAUSAL WOMEN 256 FOLLOWING PREGNANCY AND DURING LACTATION 262 REFERENCES 266 15. Choosing the Optimal Contraceptive Method in Women With Medical Disease 270 INTRODUCTION 270 GENERAL COUNSELING AND ASSESSING RISK 271 STEP-WISE QUESTIONS TO CONSIDER IN CHOOSING A BIRTH CONTROL METHOD FOR A WOMAN WITH A MEDICAL DISEASE 281 REFERENCES 294 Index 298 Cover......Page 1 Series Editor Introduction......Page 8 Preface......Page 10 Contents......Page 12 Contributors......Page 14 INTRODUCTION......Page 16 GOALS OF THE HEALTH CARE PROVIDER......Page 17 TRENDS OF CONTRACEPTIVE USE AND STERILIZATION......Page 20 EFFECTIVENESS OF METHODS COMPARED......Page 22 COSTS OF DIFFERENT METHODS......Page 25 ADVANCES IN REPRODUCTIVE HEALTH......Page 26 REFERENCES......Page 27 INTRODUCTION......Page 28 LEGAL HISTORY......Page 29 MECHANISM OF ACTION......Page 33 CLINICAL EFFECTIVENESS......Page 34 DISADVANTAGES OF LOW-DOSE OCS......Page 35 PHARMACOLOGY......Page 36 METABOLIC EFFECTS AND SIDE EFFECTS: ESTROGEN AND PROGESTIN......Page 38 NEOPLASTIC EFFECTS OF LOW-DOSE OCS......Page 47 DRUG INTERACTIONS......Page 49 NON-CONTRACEPTIVE HEALTH BENEFITS......Page 50 REFERENCES......Page 52 INTRODUCTION......Page 60 PATIENT EDUCATIONAL POINTS......Page 61 PATIENT SELECTION AND SCREENING......Page 63 CONTRAINDICATIONS TO USE......Page 66 COUNSELING TIPS......Page 69 TIMING OF INITIATION......Page 70 CHOOSING AN OC FORMULATION......Page 71 MANAGING PROBLEMS......Page 77 REFERENCES......Page 79 MECHANISM OF ACTION......Page 82 ADVANTAGES OF POPs......Page 83 CONTRAINDICATIONS TO USE......Page 84 EVALUATIONS, PATIENT SELECTION, AND COUNSELING......Page 85 COUNSELING TIPS......Page 86 OPTIONS AVAILABLE......Page 87 REFERENCES......Page 88 INTRODUCTION......Page 90 METABOLISM......Page 91 ADVANTAGES OF THE PATCH......Page 92 SIDE EFFECTS......Page 93 CONTRAINDICATIONS......Page 94 COUNSELING AND PATIENT SELECTION......Page 95 INSTRUCTIONS TO USE......Page 96 COUNSELING TIPS......Page 99 REFERENCES......Page 100 PRODUCT DESCRIPTION......Page 102 MECHANISM OF ACTION......Page 104 ADVANTAGES OF THE CONTRACEPTIVE RING......Page 105 SIDE EFFECTS......Page 106 COUNSELING AND PATIENT SELECTION......Page 109 REFERENCES......Page 112 INTRODUCTION......Page 116 PHARMACODYNAMICS......Page 117 MECHANISM OF ACTION......Page 118 ADVANTAGES OF LONG-ACTING PROGESTIN INJECTABLES......Page 119 DISADVANTAGES OF LONG-ACTING PROGESTIN INJECTABLES......Page 120 SIDE EFFECTS......Page 121 CONTRAINDICATIONS......Page 123 COUNSELING AND PATIENT SELECTION......Page 124 INSTRUCTIONS TO USE......Page 125 OPTIONS AVAILABLE......Page 127 REFERENCES......Page 128 BENEFITS OF IMPLANTABLE CONTRACEPTIVES......Page 132 ADVANTAGES OF PROGESTIN-ONLY CONTRACEPTION......Page 133 MECHANISM OF ACTION......Page 134 IMPLANON: THE SINGLE-ROD ENG IMPLANT......Page 135 REFERENCES......Page 142 INTRODUCTION......Page 144 HISTORICAL PERSPECTIVE......Page 145 EFFICACY OF IUC......Page 146 BARRIERS TO IUC......Page 147 SIDE EFFECTS AND CONCERNS......Page 148 IUD AS EMERGENCY CONTRACEPTION......Page 149 THERAPEUTIC USES OF THE LNG-IUS......Page 150 GOOD CANDIDATES FOR IUC USE......Page 152 CONTRAINDICATIONS TO IUC USE......Page 153 INSERTION INSTRUCTIONS......Page 154 COUNSELING TIPS......Page 155 REMOVAL......Page 156 REFERENCES......Page 157 MALE CONDOMS......Page 162 VAGINAL SPERMICIDES......Page 167 CERVICAL BARRIER METHODS: COMPARISON OF THE DIAPHRAGM, FEMALE CONDOM, CERVICAL CAP AND SHIELD, AND VAGINAL SPONGE......Page 170 REFERENCES......Page 189 CANDIDATES FOR NFP OR FAMS......Page 194 OPTIONS: BEHAVIORAL METHODS OF CONTRACEPTION......Page 195 SUMMARY......Page 207 REFERENCES......Page 208 INTRODUCTION......Page 210 EFFECTIVENESS......Page 212 DISADVANTAGES......Page 213 SIDE EFFECTS......Page 214 METABOLIC EFFECTS......Page 215 COUNSELING TIPS BEFORE TREATMENT......Page 216 OPTIONS......Page 217 REFERENCES......Page 218 INTRODUCTION......Page 220 POPULARITY......Page 221 TRADITIONAL STERILIZATION METHODS......Page 222 TRANSCERVICAL APPROACH......Page 233 AVOIDING AND MANAGING REGRET......Page 235 RESEARCH METHODS......Page 238 CONCLUSION......Page 245 REFERENCES......Page 246 ADOLESCENTS......Page 250 PERIMENOPAUSAL WOMEN......Page 256 FOLLOWING PREGNANCY AND DURING LACTATION......Page 262 REFERENCES......Page 266 INTRODUCTION......Page 270 GENERAL COUNSELING AND ASSESSING RISK......Page 271 STEP-WISE QUESTIONS TO CONSIDER IN CHOOSING A BIRTH CONTROL METHOD FOR A WOMAN WITH A MEDICAL DISEASE......Page 281 REFERENCES......Page 294 Index......Page 298 I opened my series editor manuscript of The Handbook of Contraception: A Guide for Practical Management, edited by Drs. Donna Shoupe and Siri Kjos, on a tiny plane on the way to giving a lecture in Albany, NY. I expected to peruse the ma- script, and found that I could not put it down. The Handbook of Contraception: A Guide for Practical Management is an incredibly informative and enjoyable read. In keeping with the objective of this series for primary care clinicians, there is a quality in this title that is uncommon among medical textbooks. The chapters of this book are written with extraordinary intelligence and und- standing, and with attention to practical considerations in the selection and mana- ment of contraceptive options. The authors have reviewed the science behind contraception, including the chemical structure and effects of hormonal contraception, physiology of contraception, efficacy rates, and side effects, as well as the practical considerations that are relevant in helping patients choose between different cont- ceptive options. They do this with a clarity of language and intent that lets the book cover with sufficient detail the full range of questions that any primary care clinician will have regarding any of the traditional or new contraceptive options. Also included in each chapter is a section on “counseling tips,” which explicitly answers many of the questions that clinicians and their patients often have when discussing contraceptive options. For a book so useful and well done, the editors and authors deserve our thanks. Contraceptive Overview / Donna Shoupe -- Oral Contraceptives: History, Pharmacology, Metabolic Effects, Side Effects, And Health Benefits / Donna Shoupe And Daniel R. Mishell, Jr. -- Oral Contraceptives: Patient Screening And Counseling, Pill Selection, And Managing Side Effects / Donna Shoupe -- Progestin-only Oral Contraceptives / Donna Shoupe -- Contraceptive Patch / Donna Shoupe -- Contraceptive Ring / Susan A. Ballagh -- Long-acting Progestin Injectables: Comparison Of Depo-provera With Depo-subq Provera 104 / Ronna Jurow And Donna Shoupe -- Contraceptive Implants: Introducing Implanon / Philip D. Darney. Intrauterine Devices: Comparison Of The Copper T Intrauterine Device With The Levonorgestrel Ius / Angela Y. Chen And Susie Baldwin -- Barrier Contraceptives: Male Condoms, Vaginal Spermicides, And Cervical Barrier Methods / Donna Shoupe -- Behavioral Methods Of Contraception / Jennefer A. Russo And Anita L. Nelson -- Emergency Contraceptives / Donna Shoupe -- Female Tubal Sterilization: Traditional And Research Methods / Charles M. March -- Contraception For Special Populations: Adolescents And Perimenopausal Women Following Pregnancy And During Lactation / Donna Shoupe. Choosing The Optimal Contraceptive Method In Women With Medical Disease / Siri L. Kjos. Edited By Donna Shoupe, Siri L. Kjos. Includes Bibliographical References And Index. Contraceptive overview / Donna Shoupe Oral contraceptives: history, pharmacology, metabolic effects, side effects, and health benefits / Donna Shoupe and Daniel R. Mishell, Jr. Oral contraceptives: patient screening and counseling, pill selection, and managing side effects / Donna Shoupe Progestin-only oral contraceptives / Donna Shoupe Contraceptive patch / Donna Shoupe Contraceptive ring / Susan A. Ballagh Long-acting progestin injectables: comparison of Depo-Provera with Depo-SubQ Provera 104 / Ronna Jurow and Donna Shoupe Contraceptive implants: introducing Implanon / Philip D. Darney Intrauterine devices: comparison of the Copper T intrauterine device with the Levonorgestrel Intrauterine system / Angela Y. Chen and Susie Baldwin Barrier contraceptives: male condoms, vaginal spermicides, and cervical barrier methods / Donna Shoupe Behavioral methods of contraception / Jennefer A. Russo and Anita L. Nelson Emergency contraceptives / Donna Shoupe Female tubal sterilization: traditionaland research methods / Charles M. March Contraception for special populations: adolescents and perimenopausal women following pregnancy and during lactation / Donna Shoupe Choosing the optimal contraceptive method in women with medical disease / Siri L. Kjos. Reviews the various forms of contraception, including delivery systems, such as the patch and vaginal ring, formulation oral contraceptive pills, and the extended cycle regimen, as well as the more established methods. This text discusses the practical aspects of each method as related to administration issues, failure rates, and side effects