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SBA Questions
Published in Justin C. Konje, Complete Revision Guide for MRCOG Part 2, 2019
A 30-year-old woman attends for counselling having delayed applying her contraceptive patch for 3 days (i.e. she forgot to take the patch off on time and applied the next patch after 72 h) – 1 week into the cycle. What would be your recommendation for this woman?Apply new patch and offer emergency contraception (EC) in the form of the levonorgestrel emergency contraception (LNG-EC) and continue with patch cycleApply new patch and consider as Day 1 of patch cycle and use barrier method for 7 daysApply new patch and consider as Day 1 of patch cycle and offer LNG-EC and barrier method for 7 daysApply new patch and consider as Day 1 of patch cycle – no additional contraception neededOffer a barrier method for 7 days and restart the new patch cycle
Adolescent contraception
Published in Joseph S. Sanfilippo, Eduardo Lara-Torre, Veronica Gomez-Lobo, Sanfilippo's Textbook of Pediatric and Adolescent GynecologySecond Edition, 2019
Hanna Goldberg, Jasmine Multani, Sari Kives
Contraindications, side effects profile, and noncontraceptive benefits are similar to those of the COC; there are noted increased rates of breast discomfort and local skin irritation but less breakthrough bleeding with the patch.130 There is no clinically significant effect on patient weight gain.124,131,132 However, women over 90 kg were shown to have increased pregnancy rates compared with thinner women and thus are thought to be poorer candidates for this method of contraception.7,132 In 2005 and 2006, the FDA issued warnings with regard to the contraceptive patch, indicating 60% increased estrogen exposure and a possible twofold increase in VTE in users of this product as compared with the COC. Subsequently, studies investigating the association between the patch and VTE demonstrated conflicting results. Three studies found no significant increased risk of thromboembolic events among contraceptive patch users.133–135 A more recent case-control study, which was an extension of an earlier study, continued to demonstrate a twofold increased risk of VTE.136 The estimated frequency of VTE in women who use the contraceptive patch is 5.3 per 10,000 women, which is similar to COC users.130
Combined oral contraceptive methods
Published in Sarah Bekaert, Alison White, Integrated Contraceptive and Sexual Healthcare, 2018
Sarah Bekaert, Alison White, Kathy French, Kevin Miles
The contraceptive patch works by: inhibiting ovulationaltering cerivcal mucus so that it is impenetrable to spermmaking the endometrium unfavourable to implantation.
Understanding Contraceptive Failure: An Analysis of Qualitative Narratives
Published in Women's Reproductive Health, 2023
Lori Frohwirth, Jennifer Mueller, Ragnar Anderson, Patrice Williams, Shivani Kochhar, S. Kate Castle, Megan L. Kavanaugh
Our respondents described using a wide range of contraceptive methods, though all could be categorized as “moderately effective” or “least effective” methods (Centers for Disease Control and Prevention, 2014). Condoms and pills were among the most common methods used, and nearly half of respondents used withdrawal; many of these methods were used in combination. Less frequently mentioned methods were injectables, the contraceptive ring, FABMs, emergency contraception, abstinence, sterilization, suppositories, foam, and diaphragms. No one who described using FABMs in our sample was using any formal method, and none had received any training or instruction; they relied on tracking apps and their own understanding of fertility within their menstrual cycles. No respondent described using the contraceptive patch, an intrauterine device (IUD), or a contraceptive implant.
The influence of hormonal contraception on depression and female sexuality: a narrative review of the literature
Published in Gynecological Endocrinology, 2022
Laura Buggio, Giussy Barbara, Federica Facchin, Laura Ghezzi, Dhouha Dridi, Paolo Vercellini
COCs are the most used type of hormonal contraception. Other birth-control formulations releasing estrogen-progestogens, such as the transdermal patch and the vaginal ring, have become available in the last years. Both vaginal ring and contraceptive patch showed mixed and variable effects regarding sexual function, and no firm conclusions on their sexual effects can be drawn [111]. Some authors reported a decrease in sexual function in women using vaginal rings compared with women using COCs [112,113]. On the other hand, other researchers have shown an improvement in several domains of female sexuality, such as libido, satisfaction with sex, frequency and intensity of orgasm, and sexual fantasies in women using vaginal rings vs. non-users [114]. Regarding the transdermal patch, Gracia et al. [112] reported a slight increase in sexual function scores compared to women using COCs.
The effect of different contraceptive methods on the vaginal microbiome
Published in Expert Review of Clinical Pharmacology, 2021
Carlo Bastianelli, Manuela Farris, Paola Bianchi, Giuseppe Benagiano
Finally, Madden et al [37], as part of the ‘Contraceptive CHOICE Project’ (a prospective cohort study designed to promote the use of long-acting reversible methods of contraception) [38], compared the incidence of BV in women using a Cu-IUD, with that in women using a hormonal method [the NuvaRing©, a generically mentioned COC, or an unspecified contraceptive patch]. A total of 153 subjects negative for BV at baseline, were recruited; 90 (59%) chose the IUD and 63 (41%) chose a COC, the contraceptive vaginal ring (CVR), or a patch. The incidence of BV was 37.0% among IUD users and 19.3% in COC, ring and patch users (P = 0.03). However, in a model adjusted for statistical variables, IUD users were no more likely to acquire BV (aOR: 1.28, 95%CI: 0.53–3.06) than COC, ring, and patch users. The associations between intermediate flora and BV remained significant (aOR: 3.30, 95%CI: 1.51–7.21, and aOR: 2.54, 95%CI: 1.03–6.24, respectively).