Case studies in contraception.

ABSTRACT

PIP: Presented and discussed are 3 cases illustrating the need for individualized decision-making in contraceptive prescription. In the 1st case, a 34-year-old woman with multiple sclerosis requested a contraceptive method with a lower failure rate than that associated with barrier methods. After discussion about potential risks and side effects, an IUD was inserted. The 2nd case involved a 17-year-old woman who presented for routine gynecologic care. She was satisfied with condom use, but admitted to episodes of unprotected intercourse--including one in the preceding 24 hours. After a negative pregnancy test, the woman was provided with emergency contraceptive pills and advised to return in 3 weeks to discuss a more reliable method of contraception. In the 3rd case, a 42-year-old woman presented with complaints of heavy and irregular menstrual periods, a 30-pound weight gain in the past year, and acne; she was not using any contraceptive method. Biopsy revealed a disorganized proliferative endometrium consistent with polycystic ovarian syndrome. The patient was placed on a weight reduction diet and given a triphasic norgestimate oral contraceptive.