How can I effectively counsel patients on contraceptive options and their associated risks?

Effective counselling on contraceptive options and their associated risks requires a personalised, comprehensive approach that respects the patient's individual needs, preferences, and circumstances. Healthcare professionals should provide detailed verbal and written information about the full range of contraceptive methods, including long-acting reversible contraception (LARC), highlighting their efficacy, duration, risks, side effects, non-contraceptive benefits, and procedures for initiation and discontinuation. This enables patients to make informed choices and use their chosen method effectively ¹.

Before initiating contraception, a thorough medical, menstrual, sexual, and contraceptive history should be taken to exclude pregnancy and assess medical eligibility, including any contraindications or special considerations such as current venous thromboembolism or breastfeeding status ¹.

Counselling should be sensitive to cultural, religious, and individual differences, and healthcare professionals should have access to trained interpreters or advocates when needed to ensure clear communication and informed consent ¹. For young people under 16, the Fraser guidelines and safeguarding considerations must be applied, ensuring they understand the advice and that provision is in their best interest ¹,².

Healthcare professionals should promote safer sex practices and assess the risk of sexually transmitted infections (STIs), advising testing and providing information about local STI services as appropriate ¹.

When discussing risks, it is important to balance the benefits and potential side effects of each method, managing common side effects proactively and referring to specialist contraceptive care when complex medical conditions exist ¹.

For young women, especially those under 25, counselling should focus on helping them choose the most effective and appropriate method for their lifestyle, with emphasis on dispelling myths (e.g., fertility immediately after abortion) and ensuring access to contraception promptly after pregnancy or abortion ².

Recent literature supports these principles, emphasizing the importance of shared decision-making, personalised risk-benefit discussions, and addressing patient concerns to improve contraceptive uptake and adherence (Black et al., 2015). It also highlights the need for healthcare providers to be competent in managing side effects and providing ongoing support to optimise contraceptive use (Black et al., 2015).