Women Of Child-bearing Age And Access To Contraceptive Methods

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October 26, 2019
Women of child-bearing age hold a right to information and access to contraceptive methods which will help prevent unintended and unwanted pregnancies.
One form of contraception is the use of medications such as Progestin-only contraceptives and combined hormonal contraceptives. Progestin-only contraceptives (POCs) is indicated for lactating mothers since estrogen inhibits breast milk production and for women who cannot tolerate combined oral contraceptives since these have estrogen while combined oral contraceptives (COCs) are indicated for the following: reduced risk of ovarian and endometrial cancers, ectopic pregnancy, ovarian cysts, benign breast disease; medication for acne; dysmenorrhea; low androgen; weak-flow menstrual bleeding secondary to fibroids; pain relief from pre-menstrual syndrome (PMS); controls monthly cycle and reduces the frequency of hot flashes in menopausal women.
Both POPs and COCs are contraindicated for patients who have liver disease, breast cancer, and an unexplained vaginal bleeding (Lopez et al, 2016).
The USMEC criteria for POCs include the following: 1) It has no restriction for use for menarche at less than 18 y/o, anemia, benign ovarian tumor, family history of breast cancer, breastfeeding (> or equal to 1 month postpartum), cervical, endometrial cancer, mild compensated cirrhosis, history of gestational diabetes mellitus (DM), depressive disorders, and gestational trophoblastic disease; 2) The use is relatively contraindicated when the advantages generally outweigh the risks in undiagnosed mass, high or low-risk deep venous thrombosis, DM, nephropathy, and hyperlipidemia CITATION Kur16 \l 1033 (Kurtis, et al., 2016). For CHCs, the criteria include: 1) No restriction of use for most type of anemias (except, sickle cell disease), cervical ectropion, mild liver cirrhosis, endometriosis, endometrial hyperplasia and cancer, epilepsy, gestational trophoblastic disease, non-migrainous headache, and history of pelvic surgery; 2) The use is used with precaution in major surgery without prolonged immobilization, previous cholecystectomy, migraine with aura, history of high blood pressure, and ulcerative colitis (Curtis KM, Tepper NK, Jatlaoui TC, et al., 2016).
According to US Selected Practice Recommendations for Contraceptive Use (USSPR), the use of POPs can be started as soon as these are needed. However, there are special considerations for amenorrhea, postpartum breastfeeding or non-breastfeeding mother, post-abortio...