Contraception
Periodic Abstinence
Barrier (Condom/ Diaphragm)
Hormonal/ Postcoital contraception
COCP
POP (mini-pill)
Continuous progesterone (Implanon)
Depot progesterone
Morning-after pill
Emergency IUD
IUD
Vasectomy
0.04/HWY failure
+: effective
-: irreversible (no guarantee of fertility upon reversal)
Tubal Ligation
0.04/HWY failure
+: effective
-: irreversible (no guarantee of fertility upon reversal)
NOTE: Only Sterilisation, COCP, continuous progesterone are most effective (<1% failure)
Source
Llewellyn-Jones. 9th Ed 2010
- Up to 30/HWY failure (Highly motivated, 5/HWY)
Barrier (Condom/ Diaphragm)
- 7/HWY failure rate
- +: Easily available, some protection against STI, reversible
- -: inc failure with poor usage
Hormonal/ Postcoital contraception
COCP
- 0.3/HWY failure
- Monophasic/ Triphasic (lesser progesterone as it reduces HDL-c
- +: dec ovarian+endometrial ca, reversible
- -: STI, inc cervical ca,
- C/I
- Heart conditions (VTE, IHD, HTN)
- Stroke sx (severe migraine)
- Familial hyperlipidaemia
- Liver disorders
- Oestrogen-dependent cancer
- Undiagnosed vaginal bleeding
POP (mini-pill)
- +: for breastfeeding or C/I
- -: BTB, same time each day,
Continuous progesterone (Implanon)
- 0.07/HWY failure
- +: lasts 3y, ovulation 1/12 after removal
Depot progesterone
- 2.3/HWY failure
Morning-after pill
- High dose progesterone: prevents ovulation
- Works if taken within 72h
- -: n+v,
Emergency IUD
- For late presenters. Can be inserted 120h postcoital/ ovulation
- Give with azithromycin
IUD
- 3.5/HWY failure
- +: lasts 3-8y,
- C/I:
- PID (current/past/risks)
- Hx of ectopic pregnancy
- Valvular heart disease
- Undiagnosed vaginal bleeding
- Congenital uterine shape
- Wilson's disease (Copper IUD)
Vasectomy
0.04/HWY failure
+: effective
-: irreversible (no guarantee of fertility upon reversal)
Tubal Ligation
0.04/HWY failure
+: effective
-: irreversible (no guarantee of fertility upon reversal)
NOTE: Only Sterilisation, COCP, continuous progesterone are most effective (<1% failure)
Source
Llewellyn-Jones. 9th Ed 2010