Week 13 Discussion: Contraception

Fernando Wong

Florida National University

Advanced Pharmacology

Week 13 Discussion: Contraception

Oral contraceptive pills increase the risk of developing cardiovascular diseases. For J.L., she has a positive family history of cardiovascular disease. Necessary tests include blood pressure and pregnancy screening. World health organization recommends that it is desirable before initiation OCP regimen to take blood pressure measurements.

For J.L, due to her history of heavy menses, the appropriate contraception would be combined oral contraceptive pills, the combined contraceptive patch, or combined injectable contraceptives (Lethaby et al., 2019). These contraception types contain two hormones: estrogen and progesterone. Combined oral contraceptive pills are a type of contraception taken orally. The regimen is a 21-day or 24-day whereby pills are taken for days, then a seven-day break during which menstruation occurs. The contraceptive patch is placed on the skin on the upper arm, lower abdomen, buttocks, or back and slowly releases hormones estrogen and progesterone to the body. The patch is used once a week and replaced with a new one. The duration of placing patches is three weeks, then a one-week break to allow for menstruation. Combined injectable contraceptives are a monthly injectable form of hormonal contraception. The shot is given intramuscularly every 28 days to 30 days. According to the World Health Organization (2016), the injection should be administered on the same day every month.

Combined hormonal contraception has multiple side effects. Side effects that warrant immediate medical care include increased blood pressure, blood clots, especially on the legs, and migraines. Pain and swelling of the legs with red or darkened skin indicate a possible blood clot formation in the vessels. This warrants urgent medical care. Increasing blood pressure causes problems for the heart and organs. High blood pressure is not a good sign for an individual with a risk of developing cardiovascular diseases (Cooper & Mahdy, 2020).

References

Cooper, D. B., & Mahdy, H. (2020). Oral Contraceptive Pills. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430882/

Lethaby, A., Wise, M. R., Weterings, M. A., Bofill Rodriguez, M., & Brown, J. (2019). Combined hormonal contraceptives for heavy menstrual bleeding. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd000154.pub3

World Health Organization. (2016). Selected practice recommendations for contraceptive use (3rd ed.). WHO Document Production Services.

Week 13 Discussion

Liliana Acosta

Advanced Pharmacology

Contraceptive counseling helps improve the quality of life by preventing unwanted pregnancies. Through the counseling process, a nurse is able to identify different relational tasks and communication aspects that help them meet the client’s needs. There are different approaches that are adopted in contraceptive counseling which include using a shared decision making process, and adopting a close and trusting approach to the process (Petitti & Sidney, 2015). Also, there is the provision of counseling on side effects as well as adoption of strategies that enhance contraceptive continuation.

There are various contraceptives to choose from. Fertility awareness–based methods (FAB), combined oral contraceptives (COCs), the patch, and the vaginal ring, Depot medroxyprogesterone acetate (DMPA) injection (Depo-Provera), IUDs and subdermal implants, Subdermal progestin implant, levonorgestrel ECP. Progestin-only methods like the implant, mini-pill, the shot, and Skyla and Mirena IUDs don’t increase risk of developing blood clots (Petitti & Sidney, 2015). Therefore, I would suggest the most beneficial method for Karen to be Subdermal progestin implant among most effective methods. Long-acting reversible contraceptive, with single-rod implant releasing etonogestrel slowly over 3 years (Farley, 2018).

Using a method of birth control with estrogen increases a young woman’s risk of forming a blood clot by several times. I would not recommend any combined contraceptive methods including combined oral contraceptives (COCs), the patch, and the vaginal ring.

References

Farley, N. R. (2018). Combined oral contraceptives, smoking, and cardiovascular risk. Journal of Epidemiology and Community Health, 52(12), 775–785.

Petitti, D. B., & Sidney, S. (2015). Four Decades of Research on Hormonal Contraception. The Permanente Journal, 9(1), 29–34.