Abstract:
BACKGROUND:Most women of child-bearing age want a safe method of contraception. Numerous methods are available, with different modes of application. In situations involving particular risks, the selection of the right method poses a special challenge. METHODS:Contraceptive methods for use in various situations with increased risk are presented in the light of a selective review of the literature, including the relevant current guidelines. RESULTS:The current recommendations of the World Health Organization (WHO) can be used to determine whether any particular contraceptive method is applicable. In particular, the use of combined hormonal contraceptives may be contraindicated in the presence of certain risk factors, especially when there is an elevated risk of thromboembolism. Situations of increased risk include a genetic predisposition to thrombophilia, diabetes mellitus, age over 35, and nicotine abuse. Careful attention to the choice of an appropriate contraceptive agent is also necessary for women with hypertension, hepatic tumors, headache (including migraine), and epilepsy. For such patients, good alternatives include the use of a gestagen (=progesterone) single-agent preparation, an intrauterine device, or a pessary. CONCLUSION:Meticulous history-taking and clinical examination are important components of contraceptive counseling that enable the identification of all potential risk factors. In situations of increased risk, decisions must be taken individually. Depending on the nature of the patient's underlying illness, interdisciplinary collaboration may be advisable. Even in situations of increased risk, an appropriated risk-benefit analysis should make it possible to find a suitable contraceptive method for any woman who needs one.
journal_name
Dtsch Arztebl Intjournal_title
Deutsches Arzteblatt internationalauthors
Römer Tdoi
10.3238/arztebl.2019.0764subject
Has Abstractpub_date
2019-11-08 00:00:00pages
764-774issue
45issn
1866-0452pii
arztebl.2019.0764journal_volume
116pub_type
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abstract::[This corrects the article DOI: 10.3238/arztebl.2017.0661.]. ...
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pub_type: 已发布勘误
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