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Perspectives

Current choices of hormonal contraception: what are the factors to consider?

Mary Stewart, Caroline Harvey, Kathleen McNamee

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Abstract

This article provides a broad overview of the available hormonal contraceptive choices and the factors to consider when prescribing these methods. Contraceptive adherence will be increased if people are aware of and can access safe, effective and suitable methods of contraception.

Key Points

  • There is now a wide array of hormonal contraceptive options for women to choose from. GPs and other primary health providers are well placed to provide evidence-based and balanced guidance to assist in appropriate individualised choice.
  • Long-acting reversible contraception, particularly ‘fit and forget’ implants and intrauterine devices, provide very high efficacy, immediate reversibility and are safe for use by most women. They are, however, underused in the Australian setting.
  • The international Medical Eligibility Criteria (MEC) system provides an essential framework for understanding any absolute or relative contraindications when prescribing hormonal contraception.
  • Although most women can safely use combined hormonal contraceptives, history taking with reference to the MEC framework is extremely important so that women at higher risk of venous thromboembolism, stroke and ischaemic heart disease can be offered alternative methods.

    Picture credit: © SPL/John Bavosi.

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