Table of Contents
First ask a few questions
‘First, I need to ask a few questions about your health and relationships to decide which methods are most appropriate for you…’
- Relationship (regular partner/multiple partners)
- Menstrual history
- Previous contraception and chance of pregnancy
- Are they post-partum or breast feeding?
- PMHx: current conditions, past history, STIs, past obstetric history/previous ectopic pregnancies
- Contraindications to COCP
- Smoking (+ age >35)
- Hx/FHx of
- Venous thromboembolism
- Breast/cervical cancer
- Migraine with aura
What they like and what they know
- Ask them what they are hoping to get out of the consultation and what they know so far (let the patient lead the consultation)
- Try to determine which type of method will be most appropriate
- Any preferences
- Preferred administration method
- Ability to remember to take pills
- Tolerance of injections
Describe a method in more detail
- How it works
- Treatment course
- Side effects/risks (and effects on menstrual cycles)
- Positives vs. negatives
Briefly discuss other options
- Mention alternatives
- Let the patient think about it and advise them they can return again if they wish to discuss other options
- Give leaflets and recommend websites
Learn about contraception here!
Test yourself with some questions!
Which contraceptive methods are suitable for breastfeeding mothers?
You have seen a patient with menorrhagia who would like contraception. Which methods would you discuss with her?
A patient who travels frequently and who does not like taking pills asks for some contraceptive options. What would you suggest?
A woman who’s partner has HIV with an undetectable viral load asks about contraception. She is HIV-negative. What would you discuss?