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How to prescribe ?. Dr. Iñaki Lete Jefe de Servicio de Ginecología Hospital Santiago. Vitoria. What to consider. Contraceptive needs. Non contraceptive benefits. EBM. Prescription. 1 .- Contraceptive needs. Contraceptive needs of U.S. women. Easy to use, 91% Sure, 90%
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How to prescribe ? Dr. Iñaki Lete Jefe de Servicio de Ginecología Hospital Santiago. Vitoria
What to consider Contraceptive needs Non contraceptive benefits EBM Prescription Servicio de Ginecología
1.- Contraceptive needs Servicio de Ginecología
Contraceptive needs of U.S. women • Easy to use, 91% • Sure, 90% • Reliable, 89% • Without side effects, 85% • Non hormonal, 63% • Monthly administration, 62% www.drkop.com/news/special-reports/birthcontrol Servicio de Ginecología
Contraceptive needs of Spanish women • Reliable, 72,2% • Sure, 18% • Good bleeding pattern, 8,5% • Comfortable, 0,8% • Cheep, 0,4% Haya J y cols. Preferencias anticonceptivas en la mujer que solicita anticoncepción. Toko-Gin Pract 2003;62:279-84. Servicio de Ginecología
Needs of women • Efficacy • No side effects • Easy to use. Comfortable • Confidence with the method Servicio de Ginecología
Efficacy Method Pearl Index < 1 2 - 10 > 10 Hormonal Combined Minipill Implant Injectable IUD Condom Sterilization Withdrawal + + + + + + + + Servicio de Ginecología
Side effects Method Bleeding disorders Weight gain Pain Hormonal Combined Minipill Implant Injectable IUD Condom Sterilization Withdrawal + + + + + + Servicio de Ginecología
Easy to use Method Needs compliance Yes Hormonal Combined Minipill Implant Injectable IUD Condom Sterilization Withdrawal + + + + Servicio de Ginecología
Effectiveness Method Pearl Index < 1 2 - 10 > 10 Hormonal Combined Minipill Implant Injectable IUD Condom Sterilization Withdrawal + + + + + + + + Servicio de Ginecología
Confidence with the contraceptive methodHave you ever been relieved when period started? The TNS Nippo Study. European survey about the confidence on contraception and the emotional consequences of forgetting the pill. N=8531 women & men. Servicio de Ginecología
2.- Non contraceptive benefits Servicio de Ginecología
Adolescence • Can we prevent STD and to preserve the fertility ? Servicio de Ginecología
Perimenopause • Can We: • To prevent osteoporosis • To treat the menorrhagia • To prevent some genital cancers Servicio de Ginecología
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3.- EBM Servicio de Ginecología
Medical eligibilitycriteria • Category 1: any restriction • Category 2: benefits > risks • Category 3: risks > benefits • Category 4: only under further evaluation Servicio de Ginecología
Conclusions • The prescription of any contraceptive method is a two way process • The most important fact is to listen the women and men and to discuss the advantages and risks of the contraceptive methods • Any medical analysis, exploration, smear…. can supply the adequate information Servicio de Ginecología
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