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26 year old attends to ask about contraception. She was taking the COC until 2 years ago. She was then very unwell with abdominal problems and was discovered to have a liver tumour. She has had surgical treatment for this and been told her prognosis is good. She is still under f/u.

She is in a long term relationship but would not want to be pregnant now nor in the next 2 years.

UKMEC and how we can make use of it.

Section B: Contraceptive Methods

Introduction - Key Points

Implanon NXT

Three sections

Contraceptive methods for contraceptive purposes.

Each category should be considered independently.

Oral contraception

Depo provera

A: INTRODUCTION

explanation of medical eligibility criteria, references, abbreviations, changes from previous, development, consensus group

B: CONTRACEPTIVE METHODS

each method has a section and for each method a classification is given for its use in patients with certain medical conditions

C: SUMMARY

summary pages of the full text version

Cases

Mirena

Copper IUD

"The UKMEC should be used as a guide to safe use of contraception however, this should not replace clinical judgement and evaluation in individual situations."

Case 2

26

G1P0T1

Liver disease

36 year old who has had 3 children and wants to find a long term contraceptive. She has epilepsy for which she takes lamotrigine. She also has a bicornuate uterus.

The Future...

Case 3

36

G3P3

Epilepsy

Bicornuate uterus

UKMEC

Case 1

18 y.o.

G0

COC

Migraine

* IUD fitting - update

* auditing our practice

* emergency contraception

* the changing face of medical education

* Jaydess

* STIs and their impact on contraceptive choice

* contraceptive myths and how we re-educate

18 year old female attends requesting repeat prescription of the combined oral contraceptive pill. Previous prescriptions were done by another doctor. On direct questioning you discover she has migraines with visual loss. Her last migraine occurred 5 years ago. She is very reluctant to change to another method.

Released in 2006 and updated 2009.

Based on the World Health Organisation medical eligibility criteria which was produced to be used by countries internationally to adapt to their own needs.

Evidence Based Medicine

Data for safe contraceptive use in special circumstances relating to family history, personal history, drug use.

Developed using evidence based medicine and expert consensus at the Clinical Effectiveness Unit, Faculty of Sexual and Reproductive Health UK.

Case 4

45

G2P2

Endometriosis

DVT

45 year old attends due to heavy bleeding which she is aware is because of endometriosis. She tells you she can't have any hormones as she had a DVT age 30 prior to the 2 pregnancies she has had. Due to the DVT she had clexane in pregnancy. She is keen to avoid further surgery for endometriosis because of her past DVT.

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