Contraception in the Community
U.S. Pregnancies:
Unintended vs. Intended
Adolescents Who Have Had Intercourse
The Need for
Contraception
Unintended Pregnancies (%) by Age
The Need for
Contraception
Pregnancies Ending in Abortion by Age
Adolescent Pregnancy
An International Perspective—Developed Countries
Adolescents Delay Seeking Medical Contraceptive Services
FDA Advisory Committee’s Recommendation on Delay of Pelvic Exam
Adolescents’ Contraception at First Intercourse
Method Use, Last
Intercourse
Young Women, 14 to 22 years old
Properties of
Contraceptives
Desired by Women
Current Trends in Contraception
Levonorgestrel and
Norethindrone
Plasma Levels After Single Oral Dose
Drugs That Decrease the Effectiveness of OCs
Drugs That Do Not Decrease the Effectiveness of OCs
Noncontraceptive Benefits of OCs
Noncontraceptive Benefits of OCs
Studies Show OCs Reduce Risk of Ovarian Cancer
Ovarian Cancer and
OCs
Risk Reduction by Years of Use
OCs Protect Against Ovarian Cancer After Discontinuation
OCs Reduce Risk of Ovarian Cancer in High-Risk Women
Studies Show OCs Reduce
Risk
of Endometrial Cancer
OCs Reduce Risk of Endometrial Cancer By Years of Use
OCs Protect Against Endometrial Cancer After Discontinuation
Ovarian and Endometrial Cancers and Low-Dose OCs
Bone Mass and OC Use
Studies Examining Association
Higher Bone Density
More Likely in OC Users
Higher Bone Density
Association With Longer OC Use
Do 20 µg EE OCs Increase Bone Mineral Density?
Reductions in Inflammatory
Lesion Counts at Cycle 6*
EE 35 µg/NGM (Ortho Tri-Cyclen) vs.
Placebo
Reductions in Total Lesion
Counts at Cycle 6*
EE 35 µg/NGM (Ortho Tri-Cyclen) vs.
Placebo
Reductions in Inflammatory
Lesion Counts at Cycle 6
EE 20 µg/LNG 100 µg (Alesse) vs. Placebo
Reductions in Total Lesion
Counts at Cycle 6
EE 20 µg/LNG 100 µg (Alesse) vs. Placebo
Primary Dysmenorrhea
Incidence
OC Use in Adolescents
Decreased Dysmenorrhea and Compliance
How OCs Improve Primary Dysmenorrhea
OC Compliance
A Real Concern with Adolescents
Reported Pill Use vs. Actual Pill Use
OC Continuation Rates
All Ages
Reasons for OC
Discontinuation
All Ages
What Happens When
Women Discontinue OCs
Breakthrough Bleeding in OC
New Starts
35 µg EE OC vs. Two 20 µg EE OCs
Breakthrough Bleeding in OC
Switchers
35 µg EE OC vs. Two 20 µg EE OCs
Adolescents’ Anticipated
vs. Reported Side Effects
EE 20 µg/LNG 100 µg Formulation
Relative Risk of
Estrogen-Related Side Effects
35 µg EE OC vs. Two 20 µg EE OCs
Side Effects of EE 20 µg/LNG 100 µg (Alesse) vs. Placebo: No Significant Difference
Weight Gain Is Not A Trivial Concern for OC Users
Women’s Perceptions About Weight Gain and OCs
Controlled Studies Fail to Show Weight Gain Linked to OC Use
The Press Underreports Studies of OC Benefits
Management of Side Effects
Preventive/Anticipatory Guidance
How to Improve Successful Use of OCs
Improving Successful OC Use
Anticipatory Guidance
Comparison of New
Contraceptive Methods
Contraceptive Implant: Implanon
Implanon Efficacy, Safety and Tolerability
Levonorgestrel Intrauterine System: Mirena
Mirena Cycle Control,
Safety, and Tolerability
NuvaRing Cycle Control and Tolerability
NuvaRing Compared to
OC:
Irregular Bleeding
Contraceptive Patch: Ortho Evra
Ortho Evra Efficacy and Compliance
Ortho Evra Compared to OC:
Breakthrough Bleeding*