Your Options for Contraception

Below is a great video outlining the various options for contraception.

There are three categories of reversible methods:
Intrauterine (hormonal IUD, copper IUD)
Hormonal (pills, patch, depot injection; nuvaring, we do not offer the implant in Canada)

Irreversible methods – vasectomy, tubal ligation.

Of note the IUD is just as effective, and reversible.

HEADSS history – identifying risk factors.
Provide counselling and advice around the most appropriate method for the adolescent, with regard to the specific indications and contraindications. Adolescent should provide input.

prevention of teratogenicity when starting medication such as accutaine

Side effects:
weight gain
may experience irregular bleeding particularly in the first three to six months, and ultimately may have minimal to no bleeding.

Caution with CYP inducers, rendering OCP ineffective

Absolute contraindications to combined oral contraceptives

(estrogen component, hypercoagulability):
Acute or recent (within last three months) history of DVT/PE
Liver disease/hepatocellular carcinoma/cirrhosis
Hypertension with BP >160/100
Migraine with aura
Diabetes mellitus with complications (ie.nephropathy, neuropathy, retinopathy)

Provide counselling and advice on safe sexual practices – including utilizing barrier methods, such as condoms to help prevent against STIs.

Cervical cancer screening to start at 21years of age, or after onset of sexual activity, whichever is first.

Legal age for consent is 16 years and older, non-exploitative in nature.
If 14-15 years of age, </= 5 years older, non exploitative
if 12-13 years of age, </=2 years older, non exploitative

Emergency contraception:

Yuzpe method (depending on the type of contraceptive pills the patient is on)

Levonogestrel emergency (ideally within 72h, but up to 120h), if within 60 minutes of taking the tablet, vomiting occurs (as this is a side effect), the dose needs to be repeated.

The IUD method can also be utilized as emergency contraception within 5 days/120h.

The adolescent:
Here are some options, speak to your doctor about your options.


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