This document is one of two evidence-based cornerstones of the World Health Organization's (WHO) new initiative to develop and implement evidence-based guidelines for family planning. The first cornerstone, the Medical eligibility criteria for contraceptive use (third edition) published in 2004, provides guidance for who can use contraceptive methods safely. This document, the Selected practice recommendations for contraceptive use (second edition), provides guidance for how to use contraceptive methods safely and effectively once they are deemed to be medically appropriate. The recommendations contained in this document are the product of a process that culminated in an expert Working Group meeting held at the World Health Organization, Geneva, 13-16 April 2004.
The mechanism of action, safety, and efficacy of IUDs were reviewed by a WHO Scientific Group in 1986. The Scientific Group concluded that the IUD should continue to be supported, in both developed and developing countries, as a safe, reliable method of fertility regulation. The newer copper-releasing devices are comparable to oral contraceptives in terms of safety and efficacy. When compared to women who use other reversible methods of contraception, IUD users have the lowest mortality resulting from deaths directly attributable to those methods or to the consequences of unwanted pregnancy. In the past decade, research has concentrated on the development of new devices that have both higher continuation rates and lower rates of expulsion and removal for bleeding abnormalities. An important recent concern has been the possible increased risk of pelvic inflammatory disease (PID) and subsequent tubal infertility associated with IUD use. However, it now appears that methodological problems have caused the IUD-associated risk of PID to be overestimated. The increased risk with IUDs seems to be limited to the 1st 4 months of use. No increased risk of tubal infertility has been found among IUD users in stable, monogamous sexual relationships. The use of a copper IUD after the 1st pregnancy is not associated with secondary infertility due to tubal disease. Finally, the newer copper IUDs have low rates of ectopic pregnancy.
Medical Eligibility Criteria for Contraceptive Use reviews the medical eligibility criteria for use of contraception, offering guidance on the safety and use of different methods for women and men with specific characteristics or known medical conditions. The recommendations are based on systematic reviews of available clinical and epidemiological research. It is a companion guideline to Selected Practice Recommendations for Contraceptive Use. Together, these documents are intended to be used by policy-makers, program managers, and the scientific community to support national programs in the preparation of service delivery guidelines. The fourth edition of this useful resource supersedes previous editions, and has been fully updated and expanded. It includes over 86 new recommendations and 165 updates to recommendations in the previous edition. Guidance for populations with special needs is now provided, and a new annex details evidence on drug interactions from concomitant use of antiretroviral therapies and hormonal contraceptives. To assist users familiar with the third edition, new and updated recommendations are highlighted. Everyone involved in providing family planning services and contraception should have the fourth edition of Medical Eligibility Criteria for Contraceptive Use at hand.
Extensive basic research and clinical trials have in some aspect of reproductive physiology, gyne been conducted on inert and medicated intrauterine cology, or family planning. There is in this volume devices. In the last decade, substantial progress has an attempt to provide a total coverage of current been made in understanding the modes of action progress in medicated intrauterine devices. The and the physiological mechanisms of IUDs - pro volume is intended for a broad readership, includ gress resulting from modern techniques and in ing physicians, medical workers, medical personnel, strumentation in microanatomy, immunology, pa and administrators in family planning. It is hoped thology, endocrinology, biochemistry and biophy that this volume will serve as a stimulus to basic sics. Such studies, however, are scattered in such a scientists and clinicians concerned with intrauterine wide spectrum of journals that the clinician and devices to intensify their research toward better family planner can hardly keep up to date with the contraceptive techniques. advances. An attempt is made in this volume to coordinate physiological and clinical parameters. Little is September 1980 known about the possible role of diet, diseases and environmental factors. E. S. E.
Many individuals worldwide initiate sexual activity during their adolescent and young adult (AYA) years and are in need of safe and effective contraceptive services. Because of their safety profile, ease of use, and privacy many international professional organizations recommend that long-acting reversible contraception (LARC), including intrauterine devices (IUDs), be included in contraception discussions with AYAs. IUDs are particularly advantageous because these methods are safe and highly effective (>99% efficacy), are easier to keep confidential because they are often undetectable to others, and do not require daily adherence or frequent visits for refills. Despite significant evidence of their safety, acceptability, and effectiveness among adolescents and AYAs, IUDs remain underutilized in this population. Written by experts in the field, Optimizing IUD Delivery for Adolescents and Young Adults provides a comprehensive framework that examines the history of IUDs, counseling, initiation, placement, and follow-up techniques that are unique to AYA populations. The text closes with resource chapters, including, expert clinical pearls for AYA IUD delivery, how to access IUD training, and information on IUD billing and reimbursement. In an effort to integrate the voice of youth, clinical case examples and patient stories are utilized throughout to provide both a clinical grounding for each chapter and context within which to apply the chapter material.
Se estudian las consecuencias sanitarias de los diferentes patrones reproductivos en la salud de la mujer y de los niños. Tambien se evaluan el riesgo y los beneficios de los diferentes metodos anticonceptivos, aunque algunos de los datos en los que se basa son de paises desarrollados, el nucleo central del informe son los paises en desarrollo.
The "contraceptive revolution" of the 1960s and 1970s introduced totally new contraceptive options and launched an era of research and product development. Yet by the late 1980s, conditions had changed and improvements in contraceptive products, while very important in relation to improved oral contraceptives, IUDs, implants, and injectables, had become primarily incremental. Is it time for a second contraceptive revolution and how might it happen? Contraceptive Research and Development explores the frontiers of science where the contraceptives of the future are likely to be found and lays out criteria for deciding where to make the next R&D investments. The book comprehensively examines today's contraceptive needs, identifies "niches" in those needs that seem most readily translatable into market terms, and scrutinizes issues that shape the market: method side effects and contraceptive failure, the challenge of HIV/AIDS and other sexually transmitted diseases, and the implications of the "women's agenda." Contraceptive Research and Development analyzes the response of the pharmaceutical industry to current dynamics in regulation, liability, public opinion, and the economics of the health sector and offers an integrated set of recommendations for public- and private-sector action to meet a whole new generation of demand.
Written with the busy practice in mind, this book delivers clinically focused, evidence-based gynecology guidance in a quick-reference format. It explores etiology, screening, tests, diagnosis, and treatment for a full range of gynecologic health issues. The coverage includes the full range of gynecologic malignancies, reproductive endocrinology and infertility, infectious diseases, urogynecologic problems, gynecologic concerns in children and adolescents, and surgical interventions including minimally invasive surgical procedures. Information is easy to find and absorb owing to the extensive use of full-color diagrams, algorithms, and illustrations. The new edition has been expanded to include aspects of gynecology important in international and resource-poor settings.
This book is a comprehensive, up-to-date reference on general and subspecialty gynecology. Covering all aspects of gynecology commonly encountered in day-to-day practice, this exhaustive and fully updated new edition provides a practical, one-stop reference work for clinicians working in the field. This carefully-designed volume includes ten sections, beginning with comprehensive coverage of office-based gynecology, and continuing on to present disease processes and management information by patient age group. Each chapter includes background information, current recommendations for screening, diagnostic criteria, common and uncommon associated problems, approach to diagnosis, summary of treatment options, and an overview of ICD-10 codes for specific diagnoses. Importantly, many areas that are covered in the handbook as subspecialty problems are pertinent and important information to many of the general practitioners who handle and develop some expertise in these areas. These include ovulation induction, medical management of incontinence, management of abnormal Pap smears, and work-up of abnormal bleeding. The handbook concludes with an easy-to-navigate presentation of minimally-invasive operations, surgical procedures, neoplasms, and pathology. Advantages and risks associated with management of particular diseases are covered, along with multiple tips for avoiding complications. This second edition is fully updated. With extensive updates on cervical cancer screening, pelvic organ prolapse, and more, many chapters will be completely rewritten to reflect the latest guidelines, procedures, and methods of care in women’s health. The text additionally includes two new chapters, covering the impact of COVID on gynecology care, and the work-up and surgical management of chronic pelvic pain. This is an ideal guide for practicing gynecologists, family and internal medicine physicians, physician assistants, nurse practitioners, fellows, residents, medical students, and all women’s health care providers.
