Contraception options in primary care: how to choose and consider contraindicati

Contraception Options in Primary Care

• Primary care offers a comprehensive range of contraceptive methods, including long-acting reversible contraception (LARC), combined hormonal contraception (pill, patch, vaginal ring), progestogen-only contraception, and barrier methods ¹,².
• Information on all methods, including their efficacy, mechanism of action, adverse effects, drug interactions, and health risks/benefits, should be provided to facilitate informed choice ¹.
• When selecting a method, it is crucial to exclude pregnancy and assess the individual's suitability based on their medical history, comorbidities, lifestyle, reproductive history, and current drug treatments ¹,².
• The UK Medical Eligibility Criteria for Contraceptive Use (UKMEC) should be consulted for combined hormonal, progestogen-only, and intrauterine contraception to ensure safe use based on medical conditions and personal characteristics ¹.
• For barrier methods, sterilization, and natural family planning, the World Health Organization Medical Eligibility Criteria for Contraceptive Use (WHOMEC) should be referenced ¹.
• Specific considerations apply to different age groups:
• For women aged 35 and over who smoke, combined hormonal contraception may be contraindicated due to cardiovascular risk factors ¹.
• In girls younger than 18, all methods can be considered if not contraindicated, but regular hormonal contraception should be avoided in those not yet menstruating. The progestogen-only injectable (DMPA) should only be considered if other methods are unsuitable or unacceptable, and its use should be carefully considered in those with risk factors for osteoporosis ¹.
• When a woman is unable to exclude pregnancy, an interim method should be supplied if required ².
• In England and Wales, contraceptive advice and treatment can be provided to young people under 16 without parental consent if they meet the Fraser criteria for competence ¹.