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__NOTOC__
__NOTOC__
 
{| class="infobox" style="margin: 0 0 0 0; border: 0; float: right; width: 100px; background: #A8A8A8; position: fixed; top: 250px; right: 21px; border-radius: 0 0 10px 10px;" cellpadding="0" cellspacing="0" ;
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! style="padding: 0 5px; font-size: 85%; background: #A8A8A8" align="center" |{{fontcolor|#2B3B44|Birth control Resident Survival Guide Microchapters}}
|-
! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align="left" |[[Birth control resident survival guide#Overview|Overview]]
|-
! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align="left" |[[Birth control resident survival guide#Birth Control Options|Birth Control Options]]
|-
! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align="left" |[[Birth control resident survival guide#Female birth control options|Female Options]]
|-
! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align="left" |[[Birth control resident survival guide#Male birth control options|Male Options]]
|-
! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align="left" |[[Birth control resident survival guide#Indications|Indications]]
|-
! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align="left" |[[Birth control resident survival guide#Contraindications|Contraindications]]
|-
! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align="left" |[[Birth control resident survival guide#Emergency Contraception|Emergency Contraception]]
|-
! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align="left" |[[Birth control resident survival guide#Side Effects|Side Effects]]
|-
! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align="left" |[[Birth control resident survival guide#U.S. Medical Eligibility Criteria for Contraceptive Use (MEC), 2016|Eligibility Criteria]]
|-
! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align="left" |[[ Birth control resident survival guide#Dos|Dos]]
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! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align="left" |[[ Birth control resident survival guide#Don'ts|Don'ts]]
|}
{{WikiDoc CMG}}; {{AE}} {{hudakarman}}
{{WikiDoc CMG}}; {{AE}} {{hudakarman}}


{{SK}} Contraception options, Birth control options, Planned parenthood, Birth prevention, Family planning, Conception prevention
==Overview==
==Overview==
[[Contraception]] or [[birth control]] is the prevention of unwanted [[pregnancy]] intentionally by using one of many different methods including  devices, [[Sexual practice|sexual practices,]] [[chemicals]], drugs or [[surgical]] procedures. [[Contraception]] methods can also be used for other purposes such as prevention of [[sexual transmitted infection]], treatment of different conditions as [[acne]], [[polycystic ovary syndrome]], [[endometriosis]], [[amenorrhea]], [[dysmenorrhea]], [[premenstrual syndrome]], [[primary ovarian insufficiency]], and heavy [[menstrual periods]].
[[Contraception]] or [[birth control]] is mainly used for the prevention of unwanted [[pregnancy]] intentionally by using one of many different methods including  devices, [[Sexual practice|sexual practices,]] [[chemicals]], drugs or [[surgical]] procedures. [[Contraception]] methods can also be used for other purposes such as prevention of [[Sexually transmitted disease|sexual transmitted infection]], treatment of different conditions such as [[acne]], [[polycystic ovary syndrome]], [[endometriosis]], [[amenorrhea]], [[dysmenorrhea]], [[premenstrual syndrome]], [[Ovarian insufficiency|primary ovarian insufficiency]], and heavy [[menstrual periods]]. Health care providers should consider the important elements when choosing the most appropriate contraceptive method for women, men, or couples such as safety, effectiveness, availability (including accessibility and affordability), and acceptability. CDC has created recommendations and categories for the use of birth control based on the element of safety. 
 
 
==Birth Control Options==
==Birth Control Options==


===Female birth control options===
===Female birth control options===


Long acting reversible contraception (LARC): are 99% effective, high rate of satisfaction, long-term use, quick return to [[fertility]] when discontinued and include the following:<ref name="pmid21668037">{{cite journal| author=Stoddard A, McNicholas C, Peipert JF| title=Efficacy and safety of long-acting reversible contraception. | journal=Drugs | year= 2011 | volume= 71 | issue= 8 | pages= 969-80 | pmid=21668037 | doi=10.2165/11591290-000000000-00000 | pmc=3662967 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21668037  }}</ref>
Long-acting reversible contraception (LARC): is 99% effective, has a high rate of satisfaction, long-term use, quick return to [[fertility]] when discontinued and includes the following:<ref name="pmid21668037">{{cite journal| author=Stoddard A, McNicholas C, Peipert JF| title=Efficacy and safety of long-acting reversible contraception. | journal=Drugs | year= 2011 | volume= 71 | issue= 8 | pages= 969-80 | pmid=21668037 | doi=10.2165/11591290-000000000-00000 | pmc=3662967 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21668037  }}</ref>


*[[Intrauterine device]] ([[IUD|IUDs]])  (> 99% effective)<ref name="pmid20634208">{{cite journal| author=Blumenthal PD, Voedisch A, Gemzell-Danielsson K| title=Strategies to prevent unintended pregnancy: increasing use of long-acting reversible contraception. | journal=Hum Reprod Update | year= 2011 | volume= 17 | issue= 1 | pages= 121-37 | pmid=20634208 | doi=10.1093/humupd/dmq026 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20634208  }}</ref>
*[[Intrauterine device]] ([[IUD|IUDs]])  (> 99% effective)<ref name="pmid20634208">{{cite journal| author=Blumenthal PD, Voedisch A, Gemzell-Danielsson K| title=Strategies to prevent unintended pregnancy: increasing use of long-acting reversible contraception. | journal=Hum Reprod Update | year= 2011 | volume= 17 | issue= 1 | pages= 121-37 | pmid=20634208 | doi=10.1093/humupd/dmq026 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20634208  }}</ref>
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*Vaginal Ring  (91% effective)
*Vaginal Ring  (91% effective)


[[Barrier contraception|Barrier]] and chemical Methods<ref name="pmid11091990">{{cite journal| author=Gilliam ML, Derman RJ| title=Barrier methods of contraception. | journal=Obstet Gynecol Clin North Am | year= 2000 | volume= 27 | issue= 4 | pages= 841-58 | pmid=11091990 | doi=10.1016/s0889-8545(05)70174-1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11091990  }}</ref><ref name="pmid6759027">{{cite journal| author=Craig S, Hepburn S| title=The effectiveness of barrier methods of contraception with and without spermicide. | journal=Contraception | year= 1982 | volume= 26 | issue= 4 | pages= 347-59 | pmid=6759027 | doi=10.1016/0010-7824(82)90102-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6759027  }}</ref>
[[Barrier contraception|Barrier]] and chemical methods<ref name="pmid11091990">{{cite journal| author=Gilliam ML, Derman RJ| title=Barrier methods of contraception. | journal=Obstet Gynecol Clin North Am | year= 2000 | volume= 27 | issue= 4 | pages= 841-58 | pmid=11091990 | doi=10.1016/s0889-8545(05)70174-1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11091990  }}</ref><ref name="pmid6759027">{{cite journal| author=Craig S, Hepburn S| title=The effectiveness of barrier methods of contraception with and without spermicide. | journal=Contraception | year= 1982 | volume= 26 | issue= 4 | pages= 347-59 | pmid=6759027 | doi=10.1016/0010-7824(82)90102-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6759027  }}</ref>


*[[Female condom|Female Condom]]
*[[Female condom|Female Condom]]
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*[[Copper]] [[IUD]]
*[[Copper]] [[IUD]]
*[[Emergency contraceptive pill|Emergency contraceptive pills]]<ref name="pmid10846441">{{cite journal| author=Schiavon R, Jiménez-Villanueva CH, Ellertson C, Langer A| title=[Emergency contraception: a simple, safe, effective and economical method for preventing undesired pregnancy]. | journal=Rev Invest Clin | year= 2000 | volume= 52 | issue= 2 | pages= 168-76 | pmid=10846441 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10846441  }}</ref>
*[[Emergency contraceptive pill|Emergency contraceptive pills]]<ref name="pmid10846441">{{cite journal| author=Schiavon R, Jiménez-Villanueva CH, Ellertson C, Langer A| title=[Emergency contraception: a simple, safe, effective and economical method for preventing undesired pregnancy]. | journal=Rev Invest Clin | year= 2000 | volume= 52 | issue= 2 | pages= 168-76 | pmid=10846441 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10846441  }}</ref>
Note:
*You can use [[IUD]] in a nulliparous female
*[[Progestin]] [[subdermal implant]] is more effective that [[IUD]] (failure rate .2-.8%) and female fertilization (.5% failure rate)
<br />


===Male birth control options===
===Male birth control options===
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==Indications==
==Indications==


*[[Prevention]] of [[unwanted pregnancy]]
*Contraceptive use: [[Prevention]] of [[unwanted pregnancy]]
*[[Treatment]] of different conditions (non-[[contraceptive]] use) such as:<ref name="pmid20933112">{{cite journal| author=Fraser IS| title=Non-contraceptive health benefits of intrauterine hormonal systems. | journal=Contraception | year= 2010 | volume= 82 | issue= 5 | pages= 396-403 | pmid=20933112 | doi=10.1016/j.contraception.2010.05.005 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20933112  }}</ref>
*Non-contraceptive use: [[Treatment]] of different conditions such as:<ref name="pmid20933112">{{cite journal| author=Fraser IS| title=Non-contraceptive health benefits of intrauterine hormonal systems. | journal=Contraception | year= 2010 | volume= 82 | issue= 5 | pages= 396-403 | pmid=20933112 | doi=10.1016/j.contraception.2010.05.005 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20933112  }}</ref>
**[[Acne]]
**[[Acne]]
**[[Amenorrhea]]
**[[Amenorrhea]]
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==Contraindications==
==Contraindications==
===Combined hormonal contraceptives===
===Combined hormonal contraceptives===
[[Absolute contraindication|Absolute contraindications]]<ref name="pmid16183538" />
 
======Absolute contraindications<ref name="pmid16183538" />======


*[[Pregnancy]]
*[[Pregnancy]]
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*
*


[[Relative contraindication]]
======Relative contraindication<ref name="pmid16183538" />======


*[[Age]] ≥ 35 and [[smoking]] < 15 [[cigarettes]] per day
*[[Age]] ≥ 35 and [[smoking]] < 15 [[cigarettes]] per day
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*[[Progesterone receptor]]-positive [[breast cancer]]
*[[Progesterone receptor]]-positive [[breast cancer]]


==Emergency contraception==
==Emergency Contraception==
<ref name="pmid20020019">{{cite journal| author=| title=Emergency contraception. | journal=Paediatr Child Health | year= 2003 | volume= 8 | issue= 3 | pages= 181-92 | pmid=20020019 | doi=10.1093/pch/8.3.181 | pmc=2792670 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20020019  }}</ref>
<ref name="pmid20020019">{{cite journal| author=| title=Emergency contraception. | journal=Paediatr Child Health | year= 2003 | volume= 8 | issue= 3 | pages= 181-92 | pmid=20020019 | doi=10.1093/pch/8.3.181 | pmc=2792670 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20020019  }}</ref>
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
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|}
|}


==Side effects==
==Side Effects==




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<br />
<br />


==U.S. Medical Eligibility Criteria for Contraceptive Use (MEC), 2016 <ref name="urlwww.cdc.gov">{{cite web |url=https://www.cdc.gov/mmwr/volumes/65/rr/pdfs/rr6503.pdf |title=www.cdc.gov |format= |work= |accessdate=}}</ref>==
==U.S. Medical Eligibility Criteria for Contraceptive Use (MEC), 2016==
 
<ref name="urlwww.cdc.gov">{{cite web |url=https://www.cdc.gov/mmwr/volumes/65/rr/pdfs/rr6503.pdf |title=www.cdc.gov |format= |work= |accessdate=}}</ref>


<span style="font-size:85%">'''Abbreviations:''' '''BMI:''' [[body mass index]]; '''CHC:''' [[combined hormonal contraceptive]]; '''COC:''' [[combined oral contraceptive]]; '''Cu-IUD:''' [[copper-containing intrauterine device]]; '''ECP:''' [[emergency contraceptive pill]]; '''IUD:''' [[intrauterine device]]; '''LNG:''' [[levonorgestrel]]; '''POC:''' [[progestin-only contraceptive]];  '''STD:''' [[sexually transmitted disease]];  '''UPA:''' [[ulipristal acetate]]  </span>  
<span style="font-size:85%">'''Abbreviations:''' '''BMI:''' [[body mass index]]; '''CHC:''' [[combined hormonal contraceptive]]; '''COC:''' [[combined oral contraceptive]]; '''Cu-IUD:''' [[copper-containing intrauterine device]]; '''ECP:''' [[emergency contraceptive pill]]; '''IUD:''' [[intrauterine device]]; '''LNG:''' [[levonorgestrel]]; '''POC:''' [[progestin-only contraceptive]];  '''STD:''' [[sexually transmitted disease]];  '''UPA:''' [[ulipristal acetate]]  </span>  
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{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
! rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Catgory}}
! rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Category}}
! rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Characterestics}}
! rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Characteristics}}
|-
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |1
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |1
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The following table focuses on the safety of the use of contraceptive method for a person with a particular characteristic based on CDC guidance and recommendations:<br />
The following table focuses on the safety of the use of the contraceptive method for a person with a particular characteristic based on CDC guidelines and recommendations:<br />


{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
|-
! rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Condition}}
! rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Condition}}
! rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Best option}}
! colspan="11" align="center" style="background:#4479BA; color: #FFFFFF;" + |Category
! rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Contraindication}}
|-
! rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|1}}
! align="center" style="background:#4479BA; color: #FFFFFF;" + |
! rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|2}}
! rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|+ |1}}
! rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|3}}
! rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|+ |2}}
! rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|4}}
! rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|+ |3}}
! rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|+ |4}}


|-
|-
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''<21 days postpartum''
''<21 days postpartum''
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |CHCs
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |Implants
| style="padding: 5px 5px; background: #F5F5F5;" |Implants
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''With other risk factors for VTE  ''
''With other risk factors for VTE  ''
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |Implants
| style="padding: 5px 5px; background: #F5F5F5;" |Implants
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''Without other risk factors for VTE''
''Without other risk factors for VTE''
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |Implants
| style="padding: 5px 5px; background: #F5F5F5;" |Implants
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| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''30–42 days postpartum''  
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''30–42 days postpartum''  


''With other risk factors for VTE''  
''With other risk factors for VTE''
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |Implants
| style="padding: 5px 5px; background: #F5F5F5;" |Implants


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| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''30–42 days postpartum''  
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''30–42 days postpartum''  


''Without other risk factors for VTE''  
''Without other risk factors for VTE''
| style="padding: 5px 5px; background: #F5F5F5;" |Implants
 
DMPA
 
POP
| style="padding: 5px 5px; background: #F5F5F5;" |CHCs
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''>42 days postpartum''
| style="padding: 5px 5px; background: #F5F5F5;" |Implants
| style="padding: 5px 5px; background: #F5F5F5;" |Implants


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| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''>42 days postpartum''  
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Postpartum (non-breastfeeding women)''
 
''<21 days postpartum''
| style="padding: 5px 5px; background: #F5F5F5;" |Implants
 
DMPA
 
POP
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |CHCs
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Postpartum (non-breastfeeding women)''
 
''21–42 days postpartum''  
 
''With other risk factors for VTE''
| style="padding: 5px 5px; background: #F5F5F5;" |Implants
 
DMPA
 
POP
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |CHCs
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Postpartum (non-breastfeeding women)''
''21–42 days postpartum''
''Without other risk factors for VTE''
| style="padding: 5px 5px; background: #F5F5F5;" |Implants
| style="padding: 5px 5px; background: #F5F5F5;" |Implants


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| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Postpartum (non-breastfeeding women)''
 
''>42 days postpartum''
| style="padding: 5px 5px; background: #F5F5F5;" |CHCs
 
Implants
 
DMPA
 
POP
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Postpartum (including cesarean delivery)
 
<10 minutes after delivery of the placenta
 
''Breastfeeding''
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD
 
| style="padding: 5px 5px; background: #F5F5F5;" |LNG-IUD
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Postpartum (including cesarean delivery)
 
a. <10 minutes after delivery of the placenta
 
''Non-breastfeeding''
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD
 
LNG-IUD 
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |10 minutes after delivery of the placenta to <4 weeks
(breastfeeding or non-breastfeeding)
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD
LNG-IUD 
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |≥4 weeks (breastfeeding or non-breastfeeding)
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD
 
LNG-IUD 
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Postpartum sepsis''
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD
LNG-IUD 
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Multiple risk factors''
''for atherosclerotic cardiovascular disease  ''
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD
| style="padding: 5px 5px; background: #F5F5F5;" |LNG-IUD
Implants
POP
| style="padding: 5px 5px; background: #F5F5F5;" |CHCs
DMPA
<br />
| style="padding: 5px 5px; background: #F5F5F5;" |CHCs
|-
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Superficial venous disorders''
 
Varicose veins
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD
 
LNG-IUD
 
Implants
 
DMPA
 
POP
 
CHCs
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |CHCs
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Superficial venous disorders''
''Superficial venous thrombosis (acute or history)''
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD
LNG-IUD
Implants
DMPA
POP
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |CHCs
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Headaches
Non-migraine (mild or severe)
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD
LNG-IUD
Implants
DMPA
POP
CHCs
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Migraine
 
''Without aura (includes menstrual migraine)''
<br />
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD
 
LNG-IUD
 
Implants
 
DMPA
 
POP
 
<br />
| style="padding: 5px 5px; background: #F5F5F5;" |CHCs
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Migraine with aura''
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD
LNG-IUD
Implants
DMPA
POP
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |CHCs
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Multiple sclerosis''
''With prolonged immobility''
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD
LNG-IUD
Implants
POP
| style="padding: 5px 5px; background: #F5F5F5;" |DMPA
| style="padding: 5px 5px; background: #F5F5F5;" |CHCs
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Multiple sclerosis''
''Without prolonged''
''immobility''
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD
LNG-IUD
Implants
POP
| style="padding: 5px 5px; background: #F5F5F5;" |DMPA
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Suspected''  Gestational trophoblastic disease
 
''(immediate post-evacuation)''
 
''Uterine size first trimester''
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD
 
LNG-IUD
 
Implants
 
DMPA
 
POP
 
CHCs
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Suspected  Gestational trophoblastic disease''
''(immediate post-evacuation)''
''Uterine size second trimester''
| style="padding: 5px 5px; background: #F5F5F5;" |Implants
DMPA
POP
CHCs
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD
LNG-IUD
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Confirmed gestational trophoblastic disease''
''(after the initial evacuation and during monitoring)''
''Undetectable/nonpregnant β-hCG levels''
<br />
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD
LNG-IUD
Implants
DMPA
POP
CHCs
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Decreasing β-hCG levels''
<br />
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (continuation)
 
LNG-IUD (continuation)
 
Implants
 
DMPA
 
POP
 
CHCs
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation)
 
LNG-IUD (initiation)
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Persistently elevated β-hCG levels or malignant disease,''
''with no evidence or suspicion of intrauterine disease''
<br />
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (continuation)
LNG-IUD (continuation)
Implants
DMPA
POP
CHCs
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation)
LNG-IUD (initiation)
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Persistently elevated β-hCG levels or malignant disease,''
''with evidence or suspicion of intrauterine disease''
| style="padding: 5px 5px; background: #F5F5F5;" |Implants
DMPA
POP
CHCs
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (continuation)
LNG-IUD (continuation)
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation)
LNG-IUD (initiation)
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Sexually transmitted diseases
Current purulent cervicitis
or chlamydial infection or gonococcal infection
<br />
| style="padding: 5px 5px; background: #F5F5F5;" |Implants
DMPA
POP
CHCs
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (continuation)
LNG-IUD (continuation)
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation)
LNG-IUD (initiation)
|-
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Vaginitis
 
(including ''Trichomonas vaginalis'' and bacterial vaginosis)
| style="padding: 5px 5px; background: #F5F5F5;" |Implants
 
DMPA
 
POP
 
CHCs
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation)
 
LNG-IUD (initiation)
 
 
Cu-IUD (continuation)
 
LNG-IUD (continuation)
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |High risk for HIV
| style="padding: 5px 5px; background: #F5F5F5;" |Implants
DMPA
POP
CHCs
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation)
LNG-IUD (initiation)
Cu-IUD (continuation)
LNG-IUD (continuation)
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''HIV infection''
| style="padding: 5px 5px; background: #F5F5F5;" |Implants
DMPA
POP
CHCs
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
Line 423: Line 798:
|-
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |
''HIV infection'' 
''Clinically well receiving ARV therapy''
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation)
LNG-IUD (initiation)
Cu-IUD (continuation)
LNG-IUD (continuation)
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''HIV infection''
''Not clinically well or not receiving ARV therapy''
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (continuation)
LNG-IUD (continuation)
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation)
LNG-IUD (initiation)
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Cystic fibrosis''
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD
LNG-IUD
Implants
POP
CHCs
| style="padding: 5px 5px; background: #F5F5F5;" |DMPA
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Antiretroviral therapy''
''Nucleoside reverse transcriptase inhibitors (NRTIs)''
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation)
Cu-IUD (continuation)
LNG-IUD (initiation)
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation)
LNG-IUD (initiation)
LNG-IUD (continuation)
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Nonnucleoside reverse transcriptase inhibitors (NNRTIs)''
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation)
Cu-IUD (continuation)
LNG-IUD (initiation)
DMPA
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation)
LNG-IUD (initiation)
LNG-IUD (continuation)
Implants
POP
CHCs
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Ritonavir-boosted protease inhibitors''
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation)
 
Cu-IUD (continuation)
 
LNG-IUD (initiation)
 
DMPA
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation)
 
LNG-IUD (initiation)
 
LNG-IUD (continuation)
 
Implants
 
POP
 
CHCs
 
<br />
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Protease inhibitors without ritonavir''
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation)
Cu-IUD (continuation)
LNG-IUD (initiation)
LNG-IUD (continuation)
DMPA
Implants
POP
CHCs
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation)
LNG-IUD (initiation)
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''CCR5 co-receptor antagonists''
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation)
Cu-IUD (continuation)
LNG-IUD (initiation)
LNG-IUD (continuation)
DMPA
Implants
POP
CHCs
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation)
LNG-IUD (initiation)
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''HIV integrase strand transfer inhibitors''
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation)
 
Cu-IUD (continuation)
 
LNG-IUD (initiation)
 
LNG-IUD (continuation)
 
DMPA
 
Implants
 
POP
 
CHCs
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation)
 
LNG-IUD (initiation)
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Fusion inhibitors''
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation)
Cu-IUD (continuation)
LNG-IUD (initiation)
LNG-IUD (continuation)
DMPA
Implants
POP
CHCs
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD (initiation)
LNG-IUD (initiation)
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''Psychotropic medications a. SSRIs''
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD
LNG-IUD
DMPA
Implants
POP
CHCs
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |''St. John’s wort''
| style="padding: 5px 5px; background: #F5F5F5;" |Cu-IUD
 
LNG-IUD
 
DMPA
| style="padding: 5px 5px; background: #F5F5F5;" |Implants
 
POP
 
CHCs
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
Line 456: Line 1,031:
|}
|}


==Do's==
==Dos==


*Increase the [[levothyroxine]] dose in [[patients]] with [[hypothyroidism]] who started taking [[Oral contraceptive|OCPs]]. [[Oral contraceptive|OCPs]] (estrogen) increases the [[liver]] synthesis of thyroxin-binding globulin ([[TBG]]) and hence decreases the effect of [[levothyroxine]]. [[Oral contraceptives]] ([[estrogen]]) alter the transport and tissue delivery of [[thyroid hormone]] by increasing the synthesis of  throxine-binding globulin relative [[hypothyroid]] state in [[patients]] with [[hypothyroidism]]. Increase the dose of [[levothyroxine]] when starting [[Oral contraceptives|OCPs]].
*Increase the [[levothyroxine]] dose in [[patients]] with [[hypothyroidism]] who started taking [[Oral contraceptive|OCPs]]. [[Oral contraceptives]] ([[estrogen]]) alter the transport and tissue delivery of [[thyroid hormone]] by increasing the synthesis of  throxine-binding globulin which can lead to a relative [[hypothyroid]] state in [[patients]] with [[hypothyroidism]].
*Consider increasing the dose of [[warfarin]] when the [[patient]] use [[Oral contraceptives|OCPs]]
*Consider increasing the dose of [[warfarin]] when the [[patient]] uses [[Oral contraceptives|OCPs]]
*Give two forms of [[contraceptives]] and take monthly [[Pregnancy test|pregnancy tests]] for sexually active women who use [[Isotretinoin]] for [[acne]]
*Give two forms of [[contraceptives]] and take monthly [[Pregnancy test|pregnancy tests]] for sexually active women who use [[Isotretinoin]] for [[acne]]
*Give non-oral form of [[contraception]] ([[IUD]], [[implant]]) for one year to [[patients]] who underwent [[bariatric surgery]] to achieve [[weight loss]] goals and stabilize [[nutritional]] status
*Give non-oral form of [[contraception]] ([[IUD]], [[implant]]) for one year to [[patients]] who underwent [[bariatric surgery]] to achieve [[weight loss]] goals and stabilize [[nutritional]] status
*You can use [[IUD]] in a nulliparous female who has no contraindications


==Don'ts==
==Don'ts==


*Don't give CHC for a patient of  age ≥ 35 who smokes ≥15 cigarettes per day
*Don't give CHC to a patient of  age ≥ 35 who smokes ≥15 cigarettes per day
*Don't give CHC for a patient  with history of [[Migraine headache]] with [[aura]] or [[Focal neurologic signs|focal neurological symptoms]]<br />
*Don't give CHC for a patient  with history of [[Migraine headache]] with [[aura]] or [[Focal neurologic signs|focal neurological symptoms]]<br />


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Latest revision as of 19:11, 19 February 2021

Birth control Resident Survival Guide Microchapters
Overview
Birth Control Options
Female Options
Male Options
Indications
Contraindications
Emergency Contraception
Side Effects
Eligibility Criteria
Dos
Don'ts

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Huda A. Karman, M.D.

Synonyms and keywords: Contraception options, Birth control options, Planned parenthood, Birth prevention, Family planning, Conception prevention

Overview

Contraception or birth control is mainly used for the prevention of unwanted pregnancy intentionally by using one of many different methods including devices, sexual practices, chemicals, drugs or surgical procedures. Contraception methods can also be used for other purposes such as prevention of sexual transmitted infection, treatment of different conditions such as acne, polycystic ovary syndrome, endometriosis, amenorrhea, dysmenorrhea, premenstrual syndrome, primary ovarian insufficiency, and heavy menstrual periods. Health care providers should consider the important elements when choosing the most appropriate contraceptive method for women, men, or couples such as safety, effectiveness, availability (including accessibility and affordability), and acceptability. CDC has created recommendations and categories for the use of birth control based on the element of safety.

Birth Control Options

Female birth control options

Long-acting reversible contraception (LARC): is 99% effective, has a high rate of satisfaction, long-term use, quick return to fertility when discontinued and includes the following:[1]

Injectable contraception[4]

Combined hormonal contraceptives[5]

Barrier and chemical methods[6][7]

  • Female Condom
  • Diaphragm
  • Cervical Cap
  • Sponge
  • Spermicide (80% failure rate if used alone). Should be used with cervical cap or diaphragm, may damage the genital epithelium and increase risk of acquiring SDIs[8]

Traditional options/Natural contraception[9]

Surgical options

Emergency contraception

Male birth control options

Male contraception includes the following:[15]

Barrier contraception

Male Sterilization

Coitus Interruptus or Withdrawal (75% effective)[19]

Hormonal Contraception[20]

Hormonal contraceptive injectable regimes using testosterone combined with other molecules


Indications


Contraindications

Combined hormonal contraceptives

Absolute contraindications[5]
Relative contraindication[5]

IUDs

Subdermal implant

Emergency Contraception

[30]

Contracetion option Hours after intercourse Efficacy
Copper containing IUD 0 to 120 hour/5 days >99%
Ulipristal 0 to 120 hour/5 days 98-99%
Levonorgestril 0 to 72 hour/3 days 59-94%
Oral contraceptive pills 0 to 72 hour/3 days 47-89%

Side Effects

[31][32]

Contraceptive method Side effects
Combined hormonal contraceptives

(OCPs, patch, ring)

Breakthrough menstrual bleeding

Breast Tenderness

Nausea

Weight gain

Rare side effects: Cardiovascular events (heavy smoker, over age 35 years)

  • Deep venous thrombosis
  • Ischemic stroke
  • Myocardial infarction
  • Hypertension (patients with a history of hypertension in pregnancy or with a family history of hypertension)
Subdermal implant Unscheduled bleeding,

Weight gain

Headache

Ovulation and fertility occur within one month after removal

DMPA Amenorrheah

Initial irregular bleeding

Reversible bone loss, delayed return to fertility, +/- weight gain

Progestin IUD Amenorrhea

Irregular bleeding

Copper IUD Heavy menses

Menestrual and intermenestrual pain Dysmenorrhea

Spermicide May damage the genital epithelium and increase risk of acquiring SDIs



U.S. Medical Eligibility Criteria for Contraceptive Use (MEC), 2016

[33]

Abbreviations: BMI: body mass index; CHC: combined hormonal contraceptive; COC: combined oral contraceptive; Cu-IUD: copper-containing intrauterine device; ECP: emergency contraceptive pill; IUD: intrauterine device; LNG: levonorgestrel; POC: progestin-only contraceptive; STD: sexually transmitted disease; UPA: ulipristal acetate


Women, men, or couples should consider the following elements when choosing the most appropriate contraceptive method:

  • Safety
  • Effectiveness
  • Availability (including accessibility and affordability)
  • Acceptability
  • Categories of medical eligibility criteria for contraceptive use


Category Characteristics
1 A condition for which there is no restriction for the use of the contraceptive method
2 A condition for which the advantages of using the method generally outweigh the theoretical or proven risks
3 A condition for which the theoretical or proven risks usually outweigh the advantages of using the method
4 A condition that represents an unacceptable health risk if the contraceptive method is used


The following table focuses on the safety of the use of the contraceptive method for a person with a particular characteristic based on CDC guidelines and recommendations:

Condition Category
1 2 3 4
Breastfeeding

<21 days postpartum

Implants

DMPA

POP

CHCs
21 to <30 days postpartum

With other risk factors for VTE  

Implants

DMPA

POP

CHCs
21 to <30 days postpartum

Without other risk factors for VTE

Implants

DMPA

POP

CHCs
30–42 days postpartum

With other risk factors for VTE

Implants

DMPA

POP

CHCs
30–42 days postpartum

Without other risk factors for VTE

Implants

DMPA

POP

CHCs
>42 days postpartum Implants

DMPA

POP

CHCs
Postpartum (non-breastfeeding women)

<21 days postpartum

Implants

DMPA

POP

CHCs
Postpartum (non-breastfeeding women)

21–42 days postpartum

With other risk factors for VTE

Implants

DMPA

POP

CHCs
Postpartum (non-breastfeeding women)

21–42 days postpartum

Without other risk factors for VTE

Implants

DMPA

POP

CHCs
Postpartum (non-breastfeeding women)

>42 days postpartum

CHCs

Implants

DMPA

POP

Postpartum (including cesarean delivery)

<10 minutes after delivery of the placenta

Breastfeeding

Cu-IUD LNG-IUD
Postpartum (including cesarean delivery)

a. <10 minutes after delivery of the placenta

Non-breastfeeding

Cu-IUD

LNG-IUD

10 minutes after delivery of the placenta to <4 weeks

(breastfeeding or non-breastfeeding)

Cu-IUD

LNG-IUD

≥4 weeks (breastfeeding or non-breastfeeding) Cu-IUD

LNG-IUD

Postpartum sepsis Cu-IUD

LNG-IUD

Multiple risk factors

for atherosclerotic cardiovascular disease  

Cu-IUD LNG-IUD

Implants

POP

CHCs

DMPA

CHCs
Superficial venous disorders

Varicose veins

Cu-IUD

LNG-IUD

Implants

DMPA

POP

CHCs

CHCs
Superficial venous disorders

Superficial venous thrombosis (acute or history)

Cu-IUD

LNG-IUD

Implants

DMPA

POP

CHCs
Headaches

Non-migraine (mild or severe)

Cu-IUD

LNG-IUD

Implants

DMPA

POP

CHCs

Migraine

Without aura (includes menstrual migraine)

Cu-IUD

LNG-IUD

Implants

DMPA

POP


CHCs
Migraine with aura Cu-IUD

LNG-IUD

Implants

DMPA

POP

CHCs
Multiple sclerosis

With prolonged immobility

Cu-IUD

LNG-IUD

Implants

POP

DMPA CHCs
Multiple sclerosis

Without prolonged

immobility

Cu-IUD

LNG-IUD

Implants

POP

DMPA
Suspected Gestational trophoblastic disease

(immediate post-evacuation)

Uterine size first trimester

Cu-IUD

LNG-IUD

Implants

DMPA

POP

CHCs

Suspected Gestational trophoblastic disease

(immediate post-evacuation)

Uterine size second trimester

Implants

DMPA

POP

CHCs

Cu-IUD

LNG-IUD

Confirmed gestational trophoblastic disease

(after the initial evacuation and during monitoring)

Undetectable/nonpregnant β-hCG levels

Cu-IUD

LNG-IUD

Implants

DMPA

POP

CHCs

Decreasing β-hCG levels


Cu-IUD (continuation)

LNG-IUD (continuation)

Implants

DMPA

POP

CHCs

Cu-IUD (initiation)

LNG-IUD (initiation)

Persistently elevated β-hCG levels or malignant disease,

with no evidence or suspicion of intrauterine disease

Cu-IUD (continuation)

LNG-IUD (continuation)

Implants

DMPA

POP

CHCs

Cu-IUD (initiation)

LNG-IUD (initiation)

Persistently elevated β-hCG levels or malignant disease,

with evidence or suspicion of intrauterine disease

Implants

DMPA

POP

CHCs

Cu-IUD (continuation)

LNG-IUD (continuation)

Cu-IUD (initiation)

LNG-IUD (initiation)

Sexually transmitted diseases


Current purulent cervicitis

or chlamydial infection or gonococcal infection

Implants

DMPA

POP

CHCs

Cu-IUD (continuation)

LNG-IUD (continuation)

Cu-IUD (initiation)

LNG-IUD (initiation)

Vaginitis

(including Trichomonas vaginalis and bacterial vaginosis)

Implants

DMPA

POP

CHCs

Cu-IUD (initiation)

LNG-IUD (initiation)


Cu-IUD (continuation)

LNG-IUD (continuation)

High risk for HIV Implants

DMPA

POP

CHCs

Cu-IUD (initiation)

LNG-IUD (initiation)


Cu-IUD (continuation)

LNG-IUD (continuation)

HIV infection Implants

DMPA

POP

CHCs


HIV infection

Clinically well receiving ARV therapy

Cu-IUD (initiation)

LNG-IUD (initiation)


Cu-IUD (continuation)

LNG-IUD (continuation)

HIV infection

Not clinically well or not receiving ARV therapy

Cu-IUD (continuation)

LNG-IUD (continuation)

Cu-IUD (initiation)

LNG-IUD (initiation)

Cystic fibrosis Cu-IUD

LNG-IUD

Implants

POP

CHCs

DMPA
Antiretroviral therapy

Nucleoside reverse transcriptase inhibitors (NRTIs)

Cu-IUD (initiation)

Cu-IUD (continuation)

LNG-IUD (initiation)

Cu-IUD (initiation)

LNG-IUD (initiation)

LNG-IUD (continuation)

Nonnucleoside reverse transcriptase inhibitors (NNRTIs) Cu-IUD (initiation)

Cu-IUD (continuation)

LNG-IUD (initiation)

DMPA

Cu-IUD (initiation)

LNG-IUD (initiation)

LNG-IUD (continuation)

Implants

POP

CHCs

Ritonavir-boosted protease inhibitors Cu-IUD (initiation)

Cu-IUD (continuation)

LNG-IUD (initiation)

DMPA

Cu-IUD (initiation)

LNG-IUD (initiation)

LNG-IUD (continuation)

Implants

POP

CHCs


Protease inhibitors without ritonavir Cu-IUD (initiation)

Cu-IUD (continuation)

LNG-IUD (initiation)

LNG-IUD (continuation)

DMPA

Implants

POP

CHCs

Cu-IUD (initiation)

LNG-IUD (initiation)

CCR5 co-receptor antagonists Cu-IUD (initiation)

Cu-IUD (continuation)

LNG-IUD (initiation)

LNG-IUD (continuation)

DMPA

Implants

POP

CHCs

Cu-IUD (initiation)

LNG-IUD (initiation)

HIV integrase strand transfer inhibitors Cu-IUD (initiation)

Cu-IUD (continuation)

LNG-IUD (initiation)

LNG-IUD (continuation)

DMPA

Implants

POP

CHCs

Cu-IUD (initiation)

LNG-IUD (initiation)

Fusion inhibitors Cu-IUD (initiation)

Cu-IUD (continuation)

LNG-IUD (initiation)

LNG-IUD (continuation)

DMPA

Implants

POP

CHCs

Cu-IUD (initiation)

LNG-IUD (initiation)

Psychotropic medications a. SSRIs Cu-IUD

LNG-IUD

DMPA

Implants

POP

CHCs

St. John’s wort Cu-IUD

LNG-IUD

DMPA

Implants

POP

CHCs

Dos

Don'ts

References

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