Contraception

1. Big picture

Contraception means prevention of unintended pregnancy by interfering with ovulation, fertilization, sperm transport, implantation, or gamete access.

For the final exam, contraception is not only “which method prevents pregnancy.” You must be able to choose the safest method for the individual woman:

Woman requests contraception
        ↓
Exclude pregnancy
        ↓
Ask: age, smoking, breastfeeding, thromboembolism risk, migraine, hypertension, liver disease, cancer, drugs, STI risk
        ↓
Choose method:
- most effective if long-term contraception wanted
- estrogen-free if estrogen contraindicated
- condom if STI protection needed
- emergency contraception if recent unprotected intercourse

The examiner especially tests:

• combined hormonal contraception mechanisms and contraindications;
• intrauterine device complications and contraindications;
• lactation contraception;
• emergency contraception;
• difference between estrogen-containing and progestin-only methods.

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