By John Guillebaud MA FRCSEd FRCOG(Hon) FFSRH(Hon) FCOG(SA), Anne MacGregor MBBS MD MRSRH MICR DIPM
Birth control: Your Questions responded is the confirmed fundamental resource of knowledge approximately reversible tools of birth control. offered in a casual - and but hugely informative - question-and-answer kind, it represents a discussion among health care professional (asking the questions) and reproductive wellbeing and fitness expert (providing the answers). the most target of the ebook is to provide useful assistance to busy clinicians after they are confronted with sufferers who wish support with deciding upon the easiest technique of controlling fertility. such a lot chapters finish with questions commonly asked by means of sufferers - the solutions to which might be very tricky for the unprepared and busy clinician to improvise 'on the spot' within the surgical procedure.
Written by means of birth control professional Professor John Guillebaud, this ebook is a useful source for GPs, relatives making plans medical professionals and nurses, trainee and advisor gynaecologists, clinical scholars and the common reader.
- Popular query and solution format.
- Practical focus.
- Detailed attention of reversible contraception technology.
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Additional resources for Contraception : your questions answered
The life-table method of analysis is an attempt to overcome these problems. This takes into account all the reasons for contraceptive discontinuation, and permits the calculation of failure rates (or the rates for other events such as expulsion of an IUD) for speciﬁed intervals of use. The Pearl rate on the other hand pools the data and can give only one common measurement, not compensating for dropouts for varying reasons nor for different durations of use in different studies. 2—cont’d USA data used by WHO (Trussell): % of women having an unintended pregnancy within the ﬁrst year of use Typical use* Coitus interruptus Spermicides alone Fertility awareness: Calendar Ovulation (mucus) method Sympto-thermal Postovulation Persona No method, young women No method at age 40 No method at age 45 No method at age 50 (if still having menses) Perfect use† 27 29 – – – – 6–?
Continuing research into birth planning by methods of fertility awareness has shown that women can be taught to detect the changes occurring in the size of the external cervical os, and also in its position relative to the introitus. The cervix starts low and feels ﬁrm, then rises appreciably during the follicular phase, until around ovulation it reaches peak height from the introitus with maximum softness and sufﬁcient dilation to admit a ﬁngertip. The cervix then descends and narrows rapidly early in the luteal phase, becoming once more closed, ﬁrm and closer to the vulva.
The ideal has to be to switch off one’s fertility at a certain time and then, maybe years later, to switch it on again when good and ready to conceive. Thus the ‘default state’ becomes one of staying contracepted, not conceiving! Note how the two most common methods used by young people – the pill and the condom – have the opposite and completely wrong ‘default state’. 100% reversible: reversed very simply, ideally without having to ask permission or get help to stop the method 100% safe: without unwanted effects, whether fatal, dangerous or simply annoying 100% maintenance-free: meaning it needs absolutely no medical or provider intervention (with potential pain or discomfort), whether initially or ongoing, or (as already said) to achieve reversal Acceptable: to every culture, religion and political view Used by or obviously visible to the woman (whose stakes in effective contraception are obviously greatest): although an effective noncondom reversible male option would be welcome!