How to prescribe?

How to prescribe?

I. Lete

Department of Gynaecology, Hospital Santiago Apóstol,

Vitoria, Spain

Prior to prescribing any contraceptive method we must consider

some important issues related with the contraception.

First we should consider the contraceptive needs of women and

men, but also the individual needs of the woman asking us for contraceptive

counseling. Also we should consider the non contraceptive benefits of

contraceptive methods and finally we must analyze all the information regarding

the criteria of evidence based medicine.

The data of a US survey demonstrate that the first request for a

contraceptive method is to be easy to use and then to be reliable. In the other

hand the most important request to Spanish women is the reliability of the

method. Matching the two surveys we can conclude that the needs of women are:

efficacy, no side effects, comfortability and confidence.

At the moment of the contraceptive counseling, it is necessary

to obtain a complete clinical history and to discuss the efficacy, explaining

the different Pearl Index, the possibility of side effects and the need, to some

methods, of a good compliance. This information can help the woman to clarify

her first option.

It is very important to analyze the non contraceptive benefits

of contraception with the aim of extend the possibilities of the contraception

(i.e. to treat the acne, to treat the menorrhagia, to prevent STD or to prevent

genital neoplasm) . To give further and veritable information, we have some

tools and the most important of them are the medical eligibility criteria of the

World Health Organization.

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