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Contraception

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Overview

Virtually all reproductive-age women in the US who have ever had sexual intercourse have used contraception. Among the 62 million US women in their childbearing years, about 70% are at risk of pregnancy (sexually active and do not want to become pregnant); of these, about 11% are not currently using contraception.

When surveyed, a large percentage of women agree that contraceptive use has positive effects on their lives, including that they are able to take better care of themselves or their families (63%), able to financially support themselves (56%), able to complete their education (51%), and able to be employed (50%).

Women report a number of reasons for using contraception, including being unable to afford a baby, not being ready for children, feeling a baby would interrupt goals, and wanting to maintain control in their lives. Using contraception to allow planning for pregnancy and spacing of pregnancies also contributes to healthier pregnancies and better maternal and child health.

Since 1982, oral contraceptives and female sterilization have been the two most commonly used contraceptive methods in the US.1 About 64% of women using contraceptives use reversible methods, while 27% and 10% rely on female and male sterilization, respectively. Four of every 5 sexually experienced women have used oral contraceptives.

Women have many contraceptive options, including hormonal methods (eg, pills, patches, implants, vaginal rings, levonorgestrel intrauterine devices [IUDs]) and nonhormonal methods (eg, copper IUDs, condoms, diaphragms). Even among the oral contraceptives, there are many options – combined estrogen/pro-gestin pills, progestin-only pills, monophasic or multiphasic pills, shortened hormone-free intervals, and extended cycle regimens. In recent years, there has been a trend towards greater use of long-acting reversible contraceptives (LARCs), mainly the IUD. Several options are also available for emergency contraception, including nonprescription products. An understanding of the differences among contraceptives is essential when helping a woman select the method(s) best suited to her needs.

This issue will focus on the reversible contraceptive methods most often used by women (oral contraceptives, IUDs), and emergency contraception. Factors to consider when choosing a contraceptive – including ease of use, efficacy, side effects, drug interactions, and contraindications – will be discussed. Further information on less frequently used contraceptives, and more detailed information on oral contraceptives, is in a special Provider Connection available in the online edition at www.rxconsultant.com. See the inset on page 4 for useful Resources for Providers.

Details

Publication Date: 09/25/2014
Expiration Date: 09/25/2017
CE Credit: 1.5 (0.15 CEU)
Type of Activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.

Authors

Leslie A. Shimp, Pharm.D., M.S. is a Professor of Pharmacy at the University of Michigan College of Pharmacy; and a Clinical Pharmacist for the U-M Health System in Ann Arbor, MI. Dr. Shimp would like to acknowledge the contribution of Aimrie Ream, Pharm.D. candidate, 2015 in the preparation of this issue.

Disclosure Statement

Dr. Shimp reports no financial or personal relationship with any commercial interest producing, marketing, reselling, or distributing a product or service that appears in this issue.

Target Audience

This accredited program is targeted to pharmacists and nurses.

Goals & Objectives

At the conclusion of this program, participants will be able to:

    1. List commonly-used methods of contraception and discuss their relative effectiveness. Counsel women about their choice of methods.
    2. List the estrogen and progestin ingredients of oral contraceptives (OCs). Discuss OC indications, noncontraceptive benefits, contraindications, adverse effects, and drug interactions. Counsel patients about what to do if they forget to take their OCs.
    3. Discuss the types of intrauterine devices (IUDs), including indications and potential adverse effects.
    4. Counsel patients about the available methods of emergency contraception, including their relative effectiveness, instructions for use, and adverse effects.

Accreditation Statements

The Rx Consultant is a publication of Continuing Education Network, Inc.

Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education as a provider of continuing pharmacy education.

Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.

ACPE Universal Activity Number: 0428-0000-14-013-H01-P


Exam & Credit Statement Procedures

Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Editorial and Review Board

Chief Editor and CE Administrator


Terry M. Baker, PharmD

Managing Editor


Tracy Farnen, PharmD

Associate Editors


James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Kaiser Permanente
Oakland, CA

Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA

Richard Ron Finley, B.S. Pharm.,R.Ph.
Clinical Pharmacist (volunteer faculty)
University of California, San Francisco (UCSF) Memory and Aging Center
Lecturer (Emeritus) UCSF, Department of Clinical Pharmacy
Health Sciences Clinical Professor, UCSF School of Pharmacy
San Francisco, CA

Consultant Pharmacist
Ray Dolby Brain Health Center, Sutter Health/CPMC
San Francisco, CA

Consult Pharmacist Aging and Adult Health Services
San Francisco Health Department
San Francisco, CA

Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System

Adjunct Clinical Professor
College of Pharmacy
Touro University
Vallejo, CA

Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Stockton, CA

Visiting Associate Professor and Lecturer
Nursing School
Samuel Merritt University
Oakland, CA

Pamela Mausner, MD

Helen Berlie, Pharm.D. CDE, BCACP
Clinical Assistant Professor, Pharmacy Practice
Wayne State University
Detroit, MI

Ambulatory Care Specialist - Diabetes
Health Centers Detroit Medical Group
Detroit, MI

Senior Editorial Advisor


Gerard Hatheway, PharmD, PhD

Editorial Advisors


Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Angie S. Graham, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD

Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners


Emily K.
Meuleman, RN, C, MS

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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