Contraception Methods Counselling: Pros and Cons

Progestogen-only pill - Traditional Norgeston - Desogestrel - Drospirenone

- Easy to use, controlled by user - Very few contraindications - May help with: PMS, dysmenorrhoea, HMB

- Remember to take daily - Unpredictable bleeding pattern

Progestogen Implant (Nexplanon LARC)

- Very effective - Lasts 3 years - No action needed by user post fitting

- HCP has to insert and remove - Unpredictable bleeding

Progestogen-only injection (DMPA) Medroxyprogesterone acetate Must assess osteoporosis RFs before starting injection and after 2 years

- Stops periods (could be a con) - No need to remember daily

- Requires 3 monthly repeat - Delays return to fertility (for up to 1 year) after stopping - Common initial erratic bleeding - Weight gain - 4% reduction in bone density, no increase in osteoporosis or fracture risk

- Very effective - Lasts for 3–8 years - Once fitted, no action needed by users - Fewer/no periods

• Minor medical procedure to insert, can be painful • Very small risk of perforation • Small risk of expulsion • Small risk of infection for 3/52 after insertion Periods LNG-IUD: Risk of light vaginal bleeding for up to 3–6 months after insertion Cu-IUD: RIsk of heavier/longer/more painful periods

- Very effective - Lasts for 5-10 years - Once fitted, no action needed by users - No hormonal SEs - Effective as soon as inserted

Combined Hormonal Contraception Pill, patch, ring

- Easy to use, controlled by user - Very few contraindications - May help with: PMS, dysmenorrhoea, HMB - Regular withdrawal bleed – improves irregular bleeding - Used to treat acne, endometriosis, polycystic ovary syndrome - Associated with a reduction in ovarian and endometrial cancer risk

• Need to remember to take/change it regularly • Many medical contraindications e.g. VTE, CVD, migraine with aura • Small increase in risk of VTE • Small increased risk of breast cancer