RESUMEN
Aim This official guideline was published and coordinated by the DGGG, OEGGG and SGGG with the involvement of other medical societies. The aim was to provide a consensus-based overview of non-hormonal forms of contraception based on an evaluation of the relevant literature. The first part of these summarized statements and recommendations presents natural family planning methods such as lactational amenorrhea, barrier methods and coitus interruptus. The second part will focus on intrauterine devices and sterilization methods. Methods This S2k-guideline was developed by representative members from different medical professions on behalf of the guidelines commission of the DGGG, OEGGG and SGGG using a structured consensus process. Recommendations The guideline provides recommendations on the indications for, safety of use, benefits, and limitations of the different methods as well as recommendations on providing advice and other aspects of non-hormonal contraception. Natural family planning methods, lactational amenorrhea, barrier methods and coitus interruptus are discussed.
RESUMEN
Aim This official guideline was published and coordinated by the DGGG, OEGGG and SGGG with the involvement of other medical societies. The aim was to provide a consensus-based overview of non-hormonal forms of contraception based on an evaluation of the relevant literature. The first part of these summarized statements and recommendations presents natural family planning methods such as lactational amenorrhea, barrier methods and coitus interruptus. The second part focuses on intrauterine devices and sterilization. Methods This S2k-guideline was developed by representative members from different medical professions on behalf of the guidelines commission of the DGGG, OEGGG and SGGG using a structured consensus process. Recommendations The guideline provides recommendations on the indications for, safety of use, benefits, and limitations of the different methods as well as recommendations on providing advice and other aspects of non-hormonal contraception. This summary presents recommendations and statements about intrauterine devices and female and male sterilization.
Asunto(s)
Anticonceptivos Orales Combinados/efectos adversos , Anticonceptivos Hormonales Orales/efectos adversos , Acetato de Ciproterona/efectos adversos , Progestinas/efectos adversos , Tromboembolia Venosa/inducido químicamente , Europa (Continente) , Femenino , Humanos , Medición de Riesgo , Salud de la MujerAsunto(s)
Anticonceptivos Orales Combinados/efectos adversos , Anticonceptivos Hormonales Orales/efectos adversos , Acetato de Ciproterona/efectos adversos , Progestinas/efectos adversos , Tromboembolia Venosa/inducido químicamente , Europa (Continente) , Femenino , Humanos , Medición de Riesgo , Salud de la MujerRESUMEN
OBJECTIVES: Explorative pilot study with the aim of gaining insight into the contraceptive counseling practices and possible gender differences of a selected group of male and female gynecologists. DESIGN: Semi-structured telephone-interviews of 48 gynecologists concerning the content and strategies of their contraceptive counseling with special focus on aspects relevant to patient adherence. RESULTS: Male and female gynecologists inform equally frequently about various methods and reproductive health aspects such as risks, the advantages and disadvantages of the methods and side effects. Male physicians speak more often about the efficiency and benefits of the methods, while their female colleagues emphasize STI and emergency contraception. Sexual health aspects were seldom mentioned as issues of discussion. For the choice of a contraceptive method efficiency was considered very important by 100%, reversibility by 83%, side effects by 85% and convenience by 79%. Naturalness and costs were more often quoted as important by female, and benefits by male gynecologists. Side effects are considered the most important factor for patient adherence by 60%, counseling and information is predominantly cited by female, and patient's character and personality by male doctors. CONCLUSIONS: While contraceptive counseling by practising gynecologists includes basic information about available methods and their efficiency, as well as some reproductive health issues, sexual health issues are often neglected. Gender differences occasionally influence the choice of the topics as well as the attitude towards the patient.
Asunto(s)
Anticoncepción/métodos , Anticonceptivos/metabolismo , Consejo/métodos , Ginecología/métodos , Conocimientos, Actitudes y Práctica en Salud , Relaciones Médico-Paciente , Educación Sexual/métodos , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Pautas de la Práctica en Medicina , Atención Primaria de Salud/organización & administración , Factores Sexuales , Encuestas y Cuestionarios , SuizaRESUMEN
About 30% of women with completed family planning choose tubal ligation as a method of contraception. Contraceptive safety of tubal ligation, with a Pearl index of 0.18, is comparable to those of OC or modern intrauterine devices (IUD). Pregnancies that occur after tubal ligation are often ectopic, especially in young women. There is currently no evidence that tubal ligation causes menstrual abnormalities. The risk of breast cancer, cancer of the endometrium or cervix is not elevated after tubal ligation, whereas the risk of ovarian cancer is even reduced. The risk of post-sterilization regret is higher when the operation was performed in women with children aged younger than 30 years. Tubal ligation is recommendable for women over 35 years of age with completed family planning, especially if contraindications for the use of OC or IUD exist. In general, vasectomy should always be discussed as a possible alternative.