Many elements need to be considered individually by a woman, man, or couple when choosing the most appropriate contraceptive method. Some of these elements include safety, effectiveness, availability (including accessibility and affordability), and acceptability. Although most contraceptive methods are safe for use by most women, U.S. MEC provides recommendations on the safety of specific contraceptive methods for women with certain characteristics and medical conditions.
Question 1 Use two reference on each
Compare and contrast two forms of contraception including indications, contraindications, side effects, US Medical Eligibility Criteria (USMRC), US Selected Practice Recommendations for Contraceptive Use (USSPR), affordability, and mechanisms of action.
Contraceptive counseling provides education, dispels misinformation, facilitates selection of a method that will be successful for the individual, and encourages patient involvement in healthcare decisions and life goals. Discussing contraception brings the nurse practitioner and patient together to create a tailored plan that meets the individual’s reproductive needs over a lifetime.
Question 2 use two reference on each.
Discuss any clinical encounters that you may have had relating to contraception. How did you counsel patients on their choices and possible risks? Describe how you would explain the differences to your patients in the long acting reversible contraceptive devices.
Expert Solution Preview
Introduction:
When it comes to the selection and use of contraceptive methods, it is crucial to consider various factors such as safety, effectiveness, availability, and acceptability. In this response, I will compare and contrast two forms of contraception, considering their indications, contraindications, side effects, US Medical Eligibility Criteria (USMRC), US Selected Practice Recommendations for Contraceptive Use (USSPR), affordability, and mechanisms of action. Additionally, I will discuss clinical encounters relating to contraception and explain how I would counsel patients on their choices and possible risks, with a focus on long-acting reversible contraceptive devices.
Answer to Question 1:
One form of contraception that can be compared to another is the oral contraceptive pill (OCP) and the contraceptive implant.
Indications: The OCP is indicated for women who desire an effective and reversible method of contraception. It is also beneficial for those with menstrual irregularities, dysmenorrhea, and acne. On the other hand, the contraceptive implant is indicated for women seeking long-term contraception with high efficacy, as it provides continuous release of progestin over a period of three years.
Contraindications: The OCP is contraindicated in women with a history of blood clots, certain types of cancer, liver disease, or uncontrolled hypertension. In contrast, the contraceptive implant is contraindicated in women with a history of thromboembolic events, liver tumors, or unexplained vaginal bleeding.
Side effects: Common side effects of the OCP include breakthrough bleeding, breast tenderness, and nausea. In contrast, the most common side effect of the contraceptive implant is irregular bleeding.
US Medical Eligibility Criteria (USMRC) and US Selected Practice Recommendations for Contraceptive Use (USSPR): Both the OCP and the contraceptive implant are categorized as Category 1 (no restrictions for use) by the USMRC. The USSPR also supports their use as safe and effective contraceptive options.
Affordability: The OCP is generally more affordable, as it is widely available in generic forms. However, the contraceptive implant may have higher upfront costs but can be cost-effective in the long term due to its duration of use without the need for monthly refills.
Mechanism of action: The OCP primarily works through the inhibition of ovulation and changes in cervical mucus, making it difficult for sperm to reach the egg. The contraceptive implant releases progestin, which thickens cervical mucus, inhibits ovulation, and alters the endometrium to prevent implantation.
Answer to Question 2:
In my clinical encounters relating to contraception, I have counseled patients on various contraceptive methods, including long-acting reversible contraceptive (LARC) devices. When discussing LARC options, such as the intrauterine device (IUD) and contraceptive implant, I would explain the differences to the patients as follows:
1. Intrauterine Device (IUD): I would explain that an IUD is a small T-shaped device inserted into the uterus, providing long-term contraception. It can be either hormonal (progestin-releasing) or non-hormonal (copper). I would emphasize that hormonal IUDs are highly effective, lasting for 3 to 7 years depending on the specific type, and work by thickening cervical mucus, inhibiting sperm motility, and altering the endometrium to prevent implantation. Non-hormonal IUDs, on the other hand, rely on the copper’s spermicidal effect. I would discuss the potential side effects and benefits of each type, ensuring the patient understands the appropriate choice based on their individual preferences and medical history.
2. Contraceptive Implant: I would explain that a contraceptive implant is a small, flexible rod placed under the skin of the upper arm. It releases a progestin hormone continuously over a period of three years. I would highlight that the implant is an effective form of contraception, providing a reversible and long-term option. Its mechanism of action involves thickening cervical mucus, inhibiting ovulation, and altering the endometrium. I would discuss potential side effects such as irregular bleeding and the importance of regular follow-up visits for monitoring and evaluation.
During these counseling sessions, I would ensure that patients understand the benefits, risks, and expected outcomes of each contraceptive method. I would discuss their individual preferences, medical history, and any concerns they may have to guide them towards making an informed decision regarding their reproductive health.
