Contraception choices in women with underlying medical conditions

Rachel A. Bonnema, Megan C. McNamara, Abby L. Spencer

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Primary care physicians often prescribe contraceptives to women of reproductive age with comorbidities. Novel delivery systems (e.g., contraceptive patch, contraceptive ring, single-rod implantable device) may change traditional risk and benefit profiles in women with comorbidities. Effective contraceptive counseling requires an understanding of a woman's preferences and medical history, as well as the risks, benefits, adverse effects, and contraindications of each method. Noncontraceptive benefits of combined hormonal contraceptives, such as oral contraceptive pills, include regulated menses, decreased dysmenorrhea, and diminished premenstrual dysphoric disorder. Oral contraceptive pills may be used safely in women with a range of medical conditions, including well-controlled hypertension, uncomplicated diabetes mellitus, depression, and uncomplicated valvular heart disease. However, women older than 35 years who smoke should avoid oral contraceptive pills. Contraceptives containing estrogen, which can increase thrombotic risk, should be avoided in women with a history of venous thromboembolism, stroke, cardiovascular disease, or peripheral vascular disease. Progestin-only contraceptives are recommended for women with contraindications to estrogen. Depo-Provera, a long-acting injectable contraceptive, may be preferred in women with sickle cell disease because it reduces the frequency of painful crises. Because of the interaction between antiepileptics and oral contraceptive pills, Depo-Provera may also be considered in women with epilepsy. Implanon, the single-rod implantable contraceptive device, may reduce symptoms of dysmenorrhea. Mirena, the levonorgestrel-containing intrauterine contraceptive system, is an option for women with menorrhagia, endometriosis, or chronic pelvic pain.

Original languageEnglish (US)
Pages (from-to)621-628
Number of pages8
JournalAmerican Family Physician
Volume82
Issue number6
StatePublished - Sep 15 2010

Fingerprint

Contraception
Contraceptive Agents
Oral Contraceptives
Levonorgestrel
Dysmenorrhea
Medroxyprogesterone Acetate
Comorbidity
Estrogens
Contraceptive Devices
Menorrhagia
Heart Valve Diseases
Pelvic Pain
Menstruation
Peripheral Vascular Diseases
Venous Thromboembolism
Sickle Cell Anemia
Primary Care Physicians
Progestins
Endometriosis
Smoke

ASJC Scopus subject areas

  • Family Practice

Cite this

Bonnema, R. A., McNamara, M. C., & Spencer, A. L. (2010). Contraception choices in women with underlying medical conditions. American Family Physician, 82(6), 621-628.

Contraception choices in women with underlying medical conditions. / Bonnema, Rachel A.; McNamara, Megan C.; Spencer, Abby L.

In: American Family Physician, Vol. 82, No. 6, 15.09.2010, p. 621-628.

Research output: Contribution to journalArticle

Bonnema, RA, McNamara, MC & Spencer, AL 2010, 'Contraception choices in women with underlying medical conditions', American Family Physician, vol. 82, no. 6, pp. 621-628.
Bonnema RA, McNamara MC, Spencer AL. Contraception choices in women with underlying medical conditions. American Family Physician. 2010 Sep 15;82(6):621-628.
Bonnema, Rachel A. ; McNamara, Megan C. ; Spencer, Abby L. / Contraception choices in women with underlying medical conditions. In: American Family Physician. 2010 ; Vol. 82, No. 6. pp. 621-628.
@article{21e457c0dbb9410ba85008898ce58cbb,
title = "Contraception choices in women with underlying medical conditions",
abstract = "Primary care physicians often prescribe contraceptives to women of reproductive age with comorbidities. Novel delivery systems (e.g., contraceptive patch, contraceptive ring, single-rod implantable device) may change traditional risk and benefit profiles in women with comorbidities. Effective contraceptive counseling requires an understanding of a woman's preferences and medical history, as well as the risks, benefits, adverse effects, and contraindications of each method. Noncontraceptive benefits of combined hormonal contraceptives, such as oral contraceptive pills, include regulated menses, decreased dysmenorrhea, and diminished premenstrual dysphoric disorder. Oral contraceptive pills may be used safely in women with a range of medical conditions, including well-controlled hypertension, uncomplicated diabetes mellitus, depression, and uncomplicated valvular heart disease. However, women older than 35 years who smoke should avoid oral contraceptive pills. Contraceptives containing estrogen, which can increase thrombotic risk, should be avoided in women with a history of venous thromboembolism, stroke, cardiovascular disease, or peripheral vascular disease. Progestin-only contraceptives are recommended for women with contraindications to estrogen. Depo-Provera, a long-acting injectable contraceptive, may be preferred in women with sickle cell disease because it reduces the frequency of painful crises. Because of the interaction between antiepileptics and oral contraceptive pills, Depo-Provera may also be considered in women with epilepsy. Implanon, the single-rod implantable contraceptive device, may reduce symptoms of dysmenorrhea. Mirena, the levonorgestrel-containing intrauterine contraceptive system, is an option for women with menorrhagia, endometriosis, or chronic pelvic pain.",
author = "Bonnema, {Rachel A.} and McNamara, {Megan C.} and Spencer, {Abby L.}",
year = "2010",
month = "9",
day = "15",
language = "English (US)",
volume = "82",
pages = "621--628",
journal = "American Family Physician",
issn = "0002-838X",
publisher = "American Academy of Family Physicians",
number = "6",

}

TY - JOUR

T1 - Contraception choices in women with underlying medical conditions

AU - Bonnema, Rachel A.

AU - McNamara, Megan C.

AU - Spencer, Abby L.

PY - 2010/9/15

Y1 - 2010/9/15

N2 - Primary care physicians often prescribe contraceptives to women of reproductive age with comorbidities. Novel delivery systems (e.g., contraceptive patch, contraceptive ring, single-rod implantable device) may change traditional risk and benefit profiles in women with comorbidities. Effective contraceptive counseling requires an understanding of a woman's preferences and medical history, as well as the risks, benefits, adverse effects, and contraindications of each method. Noncontraceptive benefits of combined hormonal contraceptives, such as oral contraceptive pills, include regulated menses, decreased dysmenorrhea, and diminished premenstrual dysphoric disorder. Oral contraceptive pills may be used safely in women with a range of medical conditions, including well-controlled hypertension, uncomplicated diabetes mellitus, depression, and uncomplicated valvular heart disease. However, women older than 35 years who smoke should avoid oral contraceptive pills. Contraceptives containing estrogen, which can increase thrombotic risk, should be avoided in women with a history of venous thromboembolism, stroke, cardiovascular disease, or peripheral vascular disease. Progestin-only contraceptives are recommended for women with contraindications to estrogen. Depo-Provera, a long-acting injectable contraceptive, may be preferred in women with sickle cell disease because it reduces the frequency of painful crises. Because of the interaction between antiepileptics and oral contraceptive pills, Depo-Provera may also be considered in women with epilepsy. Implanon, the single-rod implantable contraceptive device, may reduce symptoms of dysmenorrhea. Mirena, the levonorgestrel-containing intrauterine contraceptive system, is an option for women with menorrhagia, endometriosis, or chronic pelvic pain.

AB - Primary care physicians often prescribe contraceptives to women of reproductive age with comorbidities. Novel delivery systems (e.g., contraceptive patch, contraceptive ring, single-rod implantable device) may change traditional risk and benefit profiles in women with comorbidities. Effective contraceptive counseling requires an understanding of a woman's preferences and medical history, as well as the risks, benefits, adverse effects, and contraindications of each method. Noncontraceptive benefits of combined hormonal contraceptives, such as oral contraceptive pills, include regulated menses, decreased dysmenorrhea, and diminished premenstrual dysphoric disorder. Oral contraceptive pills may be used safely in women with a range of medical conditions, including well-controlled hypertension, uncomplicated diabetes mellitus, depression, and uncomplicated valvular heart disease. However, women older than 35 years who smoke should avoid oral contraceptive pills. Contraceptives containing estrogen, which can increase thrombotic risk, should be avoided in women with a history of venous thromboembolism, stroke, cardiovascular disease, or peripheral vascular disease. Progestin-only contraceptives are recommended for women with contraindications to estrogen. Depo-Provera, a long-acting injectable contraceptive, may be preferred in women with sickle cell disease because it reduces the frequency of painful crises. Because of the interaction between antiepileptics and oral contraceptive pills, Depo-Provera may also be considered in women with epilepsy. Implanon, the single-rod implantable contraceptive device, may reduce symptoms of dysmenorrhea. Mirena, the levonorgestrel-containing intrauterine contraceptive system, is an option for women with menorrhagia, endometriosis, or chronic pelvic pain.

UR - http://www.scopus.com/inward/record.url?scp=78049366591&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78049366591&partnerID=8YFLogxK

M3 - Article

C2 - 20842989

AN - SCOPUS:78049366591

VL - 82

SP - 621

EP - 628

JO - American Family Physician

JF - American Family Physician

SN - 0002-838X

IS - 6

ER -