This interactive tool can be used to review relevant research and practice tips with residents and other learners who will be counseling patients on contraceptive options. PDF versions also available for download in English and Spanish. For a detailed comparison of Long-Acting Contraceptive options, see Which Long-Acting Contraceptive Is Right for Me?
contraceptive if I’ve never
had a baby?
For patients who are more sensitive to pain, one consideration is to schedule IUD insertion during menstrual bleeding, when the cervix is slightly more open. Consider asking patients about their past experiences with pelvic exams and pap smears to elicit any history of intense cervical or pelvic pain.
For more, see:
Lohr, P et al. Use of intrauterine devices in nulliparous women. Contraception, Volume 95, Issue 6, 529-537.
For more, see:
Amico J et al. “She just told me to leave it”: Women’s experiences discussing early elective IUD removal. Contraception. 2016 Oct; 94(4): 357–361. doi: 10.1016/j.contraception.2016.04.012
Gold RB. Guarding against coercion while ensuring access: a delicate balance. Guttmacher Policy Review, 2014, 17(3): 8–14.
RHEDI Contraceptive Counseling: Patient Provider Perspectives.
against HIV and other
Williams, RL et al. Dual Use of Long-Acting Reversible Contraceptives and Condoms Among Adolescents. Journal of Adolescent Health, Volume 52, Issue 4, S29-S34.
Peipert, J et al. Adherence to dual-method contraceptive use.Contraception,Volume 84, Issue 3, 2011, 252-258.
However it is always important to identify and support the patient’s priorities (i.e., pregnancy prevention) even when that may conflict with public health concerns (i.e., STI prevention). The following article provides an ethical framework for such scenarios and concludes that the medical community should never restrict access to contraception:
Haddad LB et al. Contraception and prevention of HIV transmission: a potential conflict of public health principles. J Fam Plann Reprod Health Care 2015;41:20-23.. You should use a condom every time you have sex, even with an IUD or implant, to prevent HIV and other sexually transmitted infections.
Local resources may also provide reduced cost contraceptives or sliding-scale plans. Some clincs may allow payment plans., it may cost several hundred dollars.
Ortiz, ME and Croxatto, H. Copper-T intrauterine device and levonorgestrel intrauterine system: biological bases of their mechanism of action. Contraception, vol. 75, 6, S16-S30.
Nelson AL, Massoudi N. New developments in intrauterine device use: focus on the US. Open Access J Contracept. 2016;7:127-141. Published 2016 Sep 13. doi:10.2147/OAJC.S85755
to get pregnant?
Greene D et al. Interest in and experience with IUD self-removal. Contraception, Volume 90, Issue 1, 54–59. You can get pregnant right after the IUD or implant is removed.