Factors Affecting Choice of Contraceptive Method

FACTORS AFFECTING CHOICE  OF CONTRACEPTIVE METHOD

Although efficacy is important in the choice of contracep-tive methods, other factors to be considered include safety, availability, cost, and personal acceptability to patient and partner. Although we tend to think of safety in terms of sig-nificant health risks, for many patients this also includes the possibility of side effects. For a couple to use a method, it must be accessible and affordable for the patient. How and when the method is used also can determine accept-ability. Options vary from methods that are coitus-depen-dent (barriers) to methods that are placed by a healthcare provider and last for up to 10 years (intrauterine contracep-tion). Some women prefer methods they control. They can choose an oral daily preparation, while others consider the weekly transdermal (contraceptive patch) or the monthly transvaginal (contraceptive ring) forms easier to use suc-cessfully. Other women elect to use a method administered by their healthcare provider, such as injections, implants, or intrauterine contraception.

The ability of a contraceptive method to provide some protection against sexually transmitted diseases (STDs) may also be relevant. Career or other life choices, as well as plans for future fertility, may influence the type and duration of the method chosen. Finally, the couple’s feelings about which partner should take responsibility for contraception may be important. The clinician must be sensitive to all these factors that might influence the decision and provide factual information that fits the needs of the patient and her partner. A decision tree based on this concept is pre-sented in Figure 24.1.