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Contraception - Management
How does the presence of multiple risk factors for cardiovascular disease influence choice?
- Women with multiple risk factors for cardiovascular disease (e.g. older age, smoking, diabetes, hypertension, and obesity)
- Methods that can be used without restriction: copper intrauterine devices (IUDs), barrier methods, and natural family planning.
- Methods that can generally be used (advantages generally outweigh the risks): progestogen-only pill, progestogen-only implants, and the levonorgestrel-releasing intrauterine system (IUS).
- Sterilization can be used but should be done in a setting with experienced healthcare professionals and back-up medical support.
- Methods that are not usually recommended (risks usually outweigh the advantages): progestogen-only injectables.
- Methods that should not be used (because of unacceptable risk): combined oral contraceptives, combined contraceptive patch, and combined contraceptive vaginal ring.
Basis for recommendation
- These recommendations are based on guidelines published by the Faculty of Sexual and Reproductive Health Care (FSRHC), formerly the Faculty of Family Planning and Reproductive Healthcare (FFPRHC) [FSRH, 2009b].
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