Discuss the contraceptive methods using the latest evidence-based guidelines that Karen would be medically eligible for.
Evidence-based guidelines from the American College of Obstetricians and Gynecologists (ACOG) (2019) indicate that women with pre-existing medical conditions should avoid the use of hormonal contraceptives. Nevertheless, there are various contraceptive methods, apart from condoms, which Karen is medically eligible for. The first option is using a non-hormonal intrauterine device (IUD), also known as the coil. Secondly is using a diaphragm; this is a cup-like device inserted into the vaginal canal to prevent sperm from passing through the cervix to the womb. A third option is the calendar method, whereby the patient calculates their safe days and avoids sex during ovulation (ACOG, 2019).
Identify one method that you feel would be most beneficial to Karen and discuss why you selected it.
Out of all the contraception methods discussed herein, the most beneficial for Karen is the IUD. Firstly, the American Cancer Society (2020) asserts that IUD reduces the risk of cervical cancer; this is important for Karen because she has a family history of the condition. Secondly, the IUD is non-hormonal; this is beneficial for Karen, with DVT and cardiac disease history. Thirdly, according to the case “Karen does not desire pregnancy soon,”; IUDs are effective for as long as 5-10 years.
Are there any methods that you would not recommend for Karen? Why?
There are contraception methods that are not recommended for Karen. These include combined-injectables like depo provera, hormonal implants, and combined patch/vaginal rings containing hormones like estrogen (ACOG, 2019). This is because the use of such contraceptives in women with a history of DVT and cardiac illness may increase their risk of thrombus formation or venous thrombus.
American Cancer Society (ACS) (2020, January 3). Risk factors for cervical cancer. American
Cancer Society. https://www.cancer.org/cancer/cervical-cancer/causes-risks-prevention/risk-factors.html
American College of Obstetricians and Gynecologists (ACOG) (2019). Use of hormonal
contraception in women with coexisting medical conditions. ACOG. https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2019/02/use-of-hormonal-contraception-in-women-with-coexisting-medical-conditions