Nondaily contraceptive options user benefits, potential for high continuation, and counseling issues.

摘要

Advances in contraception over the past decade have included an increasing number of methods that do not require daily or coital administration. Currently available reversible nondaily options include the transdermal patch, vaginal ring, contraceptive progestin injection, subdermal etonogestrel implant, levonorgestrel intrauterine system (LNG IUS), and copper intrauterine device (IUD). These methods have the attributes of convenience, high efficacy, ease of use, noncontraceptive benefits, and reversibility. Each method offers reliable contraception, with its own adverse effects and benefit-risk profile. Clinicians should be well-versed in the available reversible contraceptive methods to adequately counsel their patients. This is particularly pertinent when counseling women about female and male permanent sterilization (tubal ligation or vasectomy). Counseling before tubal ligation or vasectomy should include a review of the benefits of permanent sterilization and the risks unique to these procedures, such as the risks associated with minor surgery, anesthesia, or sedation. Counseling before permanent sterilization should also include the possible loss of noncontraceptive benefits related to hormonal contraception, the permanence of the procedure, risk of regret, and a review of all available contraceptive alternatives. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians. LEARNING OBJECTIVES: After completion of this article, the reader should be able to summarize information about non-daily contraceptive options to allow patients to make well-informed decisions, distinguish differences between non-daily contraceptive choices to guide recommendations for care, and generate counseling plans and materials for contraceptive patients.