How to prescribe?
I. Lete
Department of Gynaecology, Hospital Santiago Apóstol,
Vitoria, Spain
Prior to prescribing any contraceptive method we must consider
some important issues related with the contraception.
First we should consider the contraceptive needs of women and
men, but also the individual needs of the woman asking us for contraceptive
counseling. Also we should consider the non contraceptive benefits of
contraceptive methods and finally we must analyze all the information regarding
the criteria of evidence based medicine.
The data of a US survey demonstrate that the first request for a
contraceptive method is to be easy to use and then to be reliable. In the other
hand the most important request to Spanish women is the reliability of the
method. Matching the two surveys we can conclude that the needs of women are:
efficacy, no side effects, comfortability and confidence.
At the moment of the contraceptive counseling, it is necessary
to obtain a complete clinical history and to discuss the efficacy, explaining
the different Pearl Index, the possibility of side effects and the need, to some
methods, of a good compliance. This information can help the woman to clarify
her first option.
It is very important to analyze the non contraceptive benefits
of contraception with the aim of extend the possibilities of the contraception
(i.e. to treat the acne, to treat the menorrhagia, to prevent STD or to prevent
genital neoplasm) . To give further and veritable information, we have some
tools and the most important of them are the medical eligibility criteria of the
World Health Organization.