Category Archives: Contraception

Intrauterine contraception (copper or progestagenic)

When to insert, and when precautions are needed Note the following general principles: IUC should not be inserted where there is a possibility of existing pregnancy (previous sex without a reliable method of contraception being used correctly for every episode … Continue reading

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Progestagen-only pill

Remember that enzyme inducers exert an effect on other medications for 28 days after their cessation. This means, among other things, that when starting an oral contraceptive within 28 days after finishing an EI it’s necessary to use other precautions … Continue reading

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Combined hormonal contraceptives

COC, patch, or vaginal ring. Random notes If a woman with a history of UPSIĀ  within the past three weeks needs contraception and her pregnancy test is negative, she can go ahead and start; however, she should check another pregnancy … Continue reading

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Shortening PFIs

Remember that some of the newer pills are designed to have shorter PFIs (known a little more accurately as HFIs; hormone-free intervals) by having more actual pills per packet – that way, it’s possible to shorten the PFI without also … Continue reading

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Diagnosing aura

When are migraine-associated visual symptoms an aura, and when are they not? Most of the time it doesn’t matter, but it becomes of vital importance when assessing a woman’s suitability for oestrogen-containing contraception. Fortunately, the JFPRHC has just published an … Continue reading

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Problematic bleeding in women on hormonal contraception

Things to look for include: Pregnancy STIs Cervical cancer Possibly polyps/fibroids/ovarian cysts – debatable whether these could cause irregular bleeding. History Duration of use of the hormonal method – irregular bleeding normal initially Compliance with the method if not LARC … Continue reading

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Management of irregular bleeding with Implanon/Nexplanon

This month’s JFPRHC had a short but useful article on the management of irregular bleeding with etonorgestrel implants. The authors sensibly pointed out that it’s wise to be fairly proactive in management – a ‘wait and see’ attitude can have … Continue reading

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