Dr. Iñaki Lete Jefe de Servicio de Ginecología Hospital Santiago. Vitoria
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Transcript of Dr. Iñaki Lete Jefe de Servicio de Ginecología Hospital Santiago. Vitoria
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Dr. Iñaki LeteDr. Iñaki LeteJefe de Servicio de GinecologíaJefe de Servicio de GinecologíaHospital Santiago. VitoriaHospital Santiago. Vitoria
How to prescribe ?
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Servicio de Ginecología
What to consider
Non contraceptive benefits EBM
Contraceptive needs
Prescription
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Servicio de Ginecología
1.- Contraceptive needs
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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
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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.
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Servicio de Ginecología
Needs of women
• Efficacy• No side effects• Easy to use. Comfortable• Confidence with the method
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Servicio de Ginecología
Method Pearl Index
< 1 2 - 10 > 10
Hormonal Combined Minipill Implant InjectableIUDCondomSterilizationWithdrawal
+++++
+
+
+
Efficacy
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Servicio de Ginecología
Method
Bleeding
disorders Weight gain Pain
Hormonal Combined Minipill Implant InjectableIUDCondomSterilizationWithdrawal
++++ +
Side effects
+
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Servicio de Ginecología
Method Needs compliance
Hormonal Combined Minipill Implant InjectableIUDCondomSterilizationWithdrawal
++
+
+
Easy to use
Yes
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Servicio de Ginecología
Method Pearl Index
< 1 2 - 10 > 10
Hormonal Combined Minipill Implant InjectableIUDCondomSterilizationWithdrawal
+++
+
+
+
Effectiveness
++
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Servicio de Ginecología
28
29
39
53
57
81
83
72
71
61
46
42
19
16
1
1
0 20 40 60 80 100
Cooper IUD
Ring
Patch
Pill (current)
Condom
Rythm
Withdrawal
Yes No NS/NC
Confidence with the contraceptive method
Have 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.
The TNS Nippo Study. European survey about the confidence on contraception and the emotional consequences of forgetting the pill. N=8531 women & men.
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Servicio de Ginecología
2.- Non contraceptive benefits
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Servicio de Ginecología
Adolescence
• Can we prevent STD and to preserve the fertility ?
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Servicio de Ginecología
Perimenopause
• Can We:– To prevent osteoporosis– To treat the menorrhagia– To prevent some genital cancers
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Servicio de Ginecología
Conditions Naturals Barrier Cu IUD LNG IUD CHC Gestagens Sterilization
High efficacy - + ++ +++ +++ +++ +++
Simptoms treat - - - + +++ + - Osteoporosis prevention - - - - ++ - -
Treat menorrhagia - - - +++ ++ +++ -
+
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Servicio de Ginecología
3.- EBM
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Servicio de Ginecología
Medical eligibility criteria
• Category 1: any restriction• Category 2: benefits > risks• Category 3: risks > benefits• Category 4: only under further
evaluation
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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
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Servicio de Ginecología
How to prescribe ?
Prescription
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Servicio de Ginecología
How to prescribe ?
Contraception
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Servicio de Ginecología
How to prescribe ?
Family Planning
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Servicio de Ginecología
How to prescribe ?
Reproductive Health Care
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Servicio de Ginecología
How to prescribe ?
Human Rights