Week 13 Discussion: Contraception
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Ingrid Suazo
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Ingrid Suazo
Week 13 Discussion: Contraception
1. Before prescribing an OCP regimen, what tests or examinations would you like to perform?
J.L is qualified for the contraceptives. The pregnancy test is essential because J.L has been dating for five months. J.L may be looking for contraceptives, yet she is pregnant. Then, I would test for blood pressure if she tests negative for pregnancy. Oral contraceptives containing estrogen may increase blood pressure (Podfigurnaet al., 2020). Thus, women who have high blood pressure may be at risk of heart attack and stroke if they use oral contraceptives that increase blood pressure. I must also carry out a clinical breast examination to exclude pre-existing conditions which contraindicate its use.
2. Identify three different contraceptive regimens that could be chosen for J.L. Note their differences and why you chose them.
J.L suggests that she may be at risk of cardiovascular disease. Her father had an MI and died at sixty-three. The medical history suggests that J.L should use contraceptives that have less risk on individuals at risk of cardiovascular disease. I would recommend a subdermal implant, intrauterine device, and condoms. An intrauterine device(IUD) is a T-shaped device that fits inside the uterus to prevent sperm from reaching the fertilized egg (Sahooet al., 2020). Liletta, Mirena, Skyla, and Kyleena are among the UDI types that release small amounts of progestin. The four types will be a good option for J.L because of his medical history of heavy periods. On the other hand, a subdermal implant involves the placement of polymer capsules or rods under the skin to deliver steroid progestin (Nash, 2019). The hormones diffuse at a stable rate and are effective for one to five years. A condom is the other contraceptive that J.L can use. A thin pouch prevents sperm from reaching the vagina (Bucciero & Parda-Chlebowicz, 2018).Condom prevents pregnancy and also protects humans from STIs and HIV when used correctly and consistently
3. Identify the potential side effects that need to be relayed to J.L. Note especially those side effects for which J.L. should seek immediate medical care.
She may expect to feel lightheaded immediately after the insertion of the IUD, but the feeling should not take long (Sahoo et al., 2020). The method prevents pregnancy, but if she gets pregnant, there is a risk for infection, early labor, miscarriage, and delivery. Besides, it slightly raises the risk of pelvic inflammatory disease. The subdermal implant may have multiple side effects, including stomach cramping, nausea, breast tenderness, and dizziness (Nash, 2019). Condoms can lead to latex allergy, including rush.References
Bucciero, M., & Parda-Chlebowicz, M. (2018). Contraception: overview. In Ambulatory Gynecology (pp. 33-57). Springer, New York, NY.
Nash, H. A. (2019). Controlled release systems for contraception. In Medical applications of controlled release (pp. 35-64). CRC Press.
Podfigurna, A., Meczekalski, B., Petraglia, F., & Luisi, S. (2020). Clinical, hormonal and metabolic parameters in women with PCOS with different combined oral contraceptives (containing chlormadinone acetate versus drospirenone). Journal of endocrinological investigation, 43(4), 483-492.
Sahoo, C. K., Mishra, A., Ramana, D. V., & Bhaskar, J. (2020). Intrauterine Devices: A Review. Research Journal of Pharmaceutical Dosage Forms and Technology, 12(3), 162-168.ROXANA
Test before OCP Regimens Prescription
The basic requirements prior to prescription of Oral Contraceptive Pills are the females health history and blood pressure test. Most OCPs contain estrogen, which could increase the patient’s blood pressure resulting in further risk factors such as stroke and myocardial infarction (Guillebaud, 2019). According to the J.Ls case, her health history is already known, a blood pressure test is therefore, necessary before OCPs prescription. A pregnancy test is also necessary to ascertain that she is not pregnant.
Alternative Contraception Regimens
Majority of contraception methods have associated risks either from their chemical compositions, method of use or depending on the female’s body compatibility to the method. Considering myocardial infarction is significant in J.Ls family health history, it is safer to opt for a non-hormonal method that will not attract the risk of a heart attack in the future. Therefore, she could opt to use an IUD, especially a hormone-free copper. She could also choose OCPs that do not contain estrogen, such as the minipill, to lower the risk of high blood pressure. The minipill is a safer choice as it only contains progestin (Glisic et. al., 2018). Additionally, barrier methods such as insertion devices like a diaphragm, sponge, or cervical cap used alongside a spermicide could be viable options for J.L.
Potential Side Effects
Certain side effects are associated with the three birth control options. The side effects associated with IUD insertions are bleeding in between periods, severe period pain, heavy flows, and high chances of ectopic pregnancy if the IUD fails by any chance (NallN, 2018). Minipill is also associated with irregular menstruation, acne, and reduced sex drive. In using barrier methods, diaphragms, sponges, and vaginal caps could bring about vaginal burning and irritation resulting from the use of spermicides. Diaphragms and vaginal caps may also result in allergic reactions causing strong vaginal odors. Using these barrier methods may also increase the chances of contracting UTIs.
References
Glisic, M., Shahzad, S., Tsoli, S., Chadni, M., Asllanaj, E., Rojas, L. Z., … & Franco, O. H. (2018). Association between progestin-only contraceptive use and cardiometabolic outcomes: a systematic review and meta-analysis. European journal of preventive cardiology, 25(10), 1042-1052.
Guillebaud, J. (2019). Contraception today. CRC Press.
NallN, R. (2018). IUD side effects: What they are and how to manage them. Retrieved from https://www.medicalnewstoday.com/articles/322655
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