Contraception Your Questions Answered

Publisher: Elsevier Health Sciences
Publication Date: 2017
ISBN 10: 0702070009
ISBN 13: 9780702070006
eISBN: 9780702069987
Edition: 7th


This seventh edition has been completely revised and updated, incorporating relevant WHO and national guidance documents: therefore imparting best evidence-based practice for all methods. Combined oral contraceptives (COCs) Based on the long-established evidence that 7 days of routinely not-taking pills in each cycle is too long for maintained ovarian suppression - and this necessarily leads to too little margin for errors in pill-taking - the authors recommend that providers switch to a new norm for all users of either: Tricycling, the 84/4 regimen, or totally continuous use (365/365), OR, for women who remain keen to see monthly pill-bleeds (which are completely unnecessary for health), one of the regimens (24/4 or 21/4) that shorten the contraception-non-taking time to 4 days

Table of Contents

Front Matter

  • Notices
  • About the Authors
  • Preface to the 7th Edition
  • Preface to the 6th Edition
  • Preface to the 5th Edition
  • List of Abbreviations
  • Notes
  • How to Use This Book
  • preface

CHAPTER 1: Introduction

  • Population and Sustainability
  • Sexual and Contraceptive History-Taking and Counselling – The Importance of Fertility Control

CHAPTER 2: Aspects Of Human Fertility and Fertility Awareness: Natural Birth Control

  • Background Considerations
  • Fertility Awareness: Background and Mechanisms
  • Effectiveness
  • Advantages and Indications
  • Problems and Disadvantages
  • Breastfeeding as Natural Birth Control
  • The (Near) Future

CHAPTER 3: Male Methods of Contraception

  • Coitus Interruptus
  • The Condom: Background and Mechanism
  • The Condom: Effectiveness
  • The Condom: Advantages and Indications
  • The Condom: Problems and Disadvantages
  • The Condom: Present Designs

CHAPTER 4: Vaginal Methods of Contraception

  • Occlusive Caps
  • Occlusive Caps: Effectiveness
  • Occlusive Caps: Advantages and Beneficial Effects
  • Occlusive Caps: Main Problems and Disadvantages
  • Occlusive Caps: Selection of Users and Devices
  • Occlusive Caps: Initial Fitting, Training and Follow-Up Arrangements
  • Occlusive Caps: Management of Side-Effects and Complications
  • Female Condoms
  • Spermicides
  • Vaginal Contraception: Unresolved Safety Issues
  • The (Near) Future in Vaginal Contraception

CHAPTER 5: The Combined Oral Contraceptive – Selection and Eligibility

  • Background: Efficacy and Mechanisms
  • Effectiveness of the Coc – Circumstances in Which it Can be Reduced
  • Drug Interactions Affecting the COC
  • Starting Routines with the COC
  • Major Systemic Efects of the COC
  • Advantages and Beneficial Effects
  • Reversibility of the COC
  • Main Disadvantages and Problems
  • The COC and Neoplasia (Benign and Malignant)
  • The COC and Breast Cancer
  • The COC and Circulatory Diseases
  • The 1995 Controversy About Venous Thromboembolism (VTE) – where are we Now?
  • Selection of Users and Formulations: Choosing the ‘Safer Women’ and the ‘Safer Pills’
  • More about THE Available Pill Formulations
  • Indications and Contraindications for the COC Method, IN More Depth
  • Migraine with and without Aura
  • Individual Variation in Blood Levels of Sex Steroids: The Implications for Treatment of the Symptom of Breakthrough Bleeding (BTB)
  • Initial Choice of Preparation, and Early Follow-Up
  • The Pros and Cons of Phasic Pills

CHAPTER 6: The Combined Oral Contraceptive – Follow-UP Arrangements and New Routes of Administration

  • Follow-Up Arrangements: The Monitoring of those Side-Effects and Complications Particularly Relevant to COC Safety
  • Implication of Surgery
  • Dealing with Other Side-Effects and Events During Pill Use
  • Central Nervous System
  • Gastrointestinal System
  • Inborn Errors of Metabolism
  • Respiratory System
  • Urinary System
  • Reproductive System – Obstetrics
  • Reproductive System – Gynaecology
  • The Breasts
  • Musculoskeletal System
  • Cutaneous System
  • Allergies and Inflammations
  • Special Considerations: When to Come off The Pill?
  • Some Revision Questions
  • Non-Oral Routes of Administration of Combined Hormonal Contraceptives (CHCS)

CHAPTER 7: The Progestogen-Only Pill

  • Background and Mechanisms
  • Effectiveness
  • Advantages and Beneficial Side-Effects
  • Main Problems and Disadvantages
  • Selection of Users and of Formulations
  • Use of the Pop in Lactation
  • Initial Management and Follow-Up Arrangements
  • Management of Side-Effects or Complications

CHAPTER 8: Injectables and Implants

  • Injectables
  • Effectiveness
  • Subdermal Implants

CHAPTER 9: Intrauterine Devices and Systems

  • Background and Mechanisms
  • Effectiveness
  • Advantages and Benefits
  • Main Problems and Disadvantages
  • Intrauterine Pregnancy (IUC IN SITU)
  • Extrauterine Pregnancy
  • ‘Lost Threads’
  • Expulsion
  • Perforation
  • Pelvic Infection
  • Pain and Bleeding
  • Selection of Users and of Devices
  • Choice of Device
  • Insertion Timing and Procedure
  • Patient Information and Follow-Up Arrangements
  • Duration of Use – and Reversibility
  • GyneFix VIZ
  • The Levonorgestrel-Releasing Intrauterine Systems (LNG-IUSs)
  • The Future
  • Conclusions

CHAPTER 10: Emergency (Postcoital) Contraception

  • Background Mechanisms
  • Effectiveness
  • Indications and Advantages of Postcoital Contraception
  • Disadvantages of Postcoital Contraception
  • Patient Selection and Choice of Method
  • Counselling and Management at the First Visit
  • Follow-Up

CHAPTER 11: Contraception for the Young, the Not Quite so Young – and in Future

  • Compliance with Contraceptive Methods
  • Iatrogenic Causes of Unplanned Pregnancies
  • Contraception/Sterilization after Pregnancy
  • Contraception for the Older Woman – Above Age 40
  • The Future

Further Reading


Appendix A: Use of Licensed Products in an Unlicensed Way

Appendix B: ‘Quick Starting’ and ‘Bridging’

Appendix C: UKMEC Summary Sheets: Common Reversible Methods