Abstract

PIP: This article addresses contraceptive issues for teenagers; women in the perimenopausal, postpartum, and postabortion periods; women with hematological disorders (e.g., acquired hemolytic anemia); women suffering from migraine; women with diabetes; and women with epilepsy. Specifically, it discusses how women's contraceptive needs change as they age. For example, the ideal method for perimenopausal women, who generally do not want to risk pregnancy, is male or female sterilization. The article also informs the reader what methods are most appropriate at the different periods of one's life and for various conditions. For example, since teens tend to be sexually active, the double Dutch method--condom plus combined oral contraceptive (COC) is a good practice for them. The low-dose lipid-friendly COC provides good cycle control for teens. Women with transient cerebral ischemia-related focal membrane, crescendo migraine, and focal migraine occurring for the first time after using COCs and currently use ergotamine therapy should absolutely not use COCs. The article also has tables which are helpful for practitioners. Table 1 lists the criteria for prescribing a medical contraceptive to teens without parental knowledge and consent. Table 2 explains either what contraceptives are or are not safe and effective for women with hemolytic disorders. For example, the IUD is contraindicated for women with immune thrombocytopenia purpura and thrombocythemia. A sidebar provides the reader a clinical focus.