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Contraceptive options for women with medical conditions

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Women with a need for contraception should be given information about and offered a choice of all methods, according to NICE. Contraceptive counselling should be individualised to the woman and her needs.

This involves understanding a woman's preferences and medical history as well as taking into account the risks, benefits, and contraindications of each available method.1 Furthermore, efficacy and how to start and stop contraception should be discussed. Specific medical conditions, such as epilepsy, diabetes, obesity, and inflammatory bowel disease are considered in this article.

Women should be counselled about long-acting reversible contraception (LARC) methods.2 It is worth considering that LARC is more cost effective than the combined oral contraceptive pill, even at one year of use. It is recommended that verbal and written information is provided.

NICE advises that increasing the number of women who choose a LARC method may reduce the number of unintended pregnancies.2 Moreover, risk of sexually transmitted infection may be assessed.

Epilepsy

Highly effective contraception in women with epilepsy is particularly important owing to the risk of congenital malformation with anti-epileptic drugs (AEDs). Careful counselling about appropriate contraceptive choices is required to avoid unplanned pregnancy.3


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