Pain! Raw, burning, scratchy, sharp, stabbing—down there! And the suffering has gone on for a few months. The patient may complain of pain with sex (and pain with sex is simply not normal), pain when using tampons, or with wearing certain types of clothing. You examine her vulva and see…nothing unusual. No sign of infection, trauma, hormonal deficiency, neoplasm, or anything suggesting a neurologic or inflammatory condition. It is hard to help, unless you can diagnose. However, your patient has given you enough clues to help guide you.
While psychotic disorders like schizophrenia, bipolar disorder, and borderline personality disorder occur less commonly among reproductive-aged women than do mood and anxiety disorders, these serious mental illnesses (SMIs) have important implications for patients’ family planning. Providers need to recognize and appropriately manage unique ethical considerations in addition to assessing whether the patient may successfully use any given contraceptive method due to cognitive/behavioral issues and to potential interactions between contraceptive methods and psychiatric or other drugs.
This new vaginal contraceptive system (Annovera) has unique features that combine to provide convenient, long lasting, rapidly reversible contraception with excellent cycle control. Developed by the Population Council, Annovera introduces a new progestational compound—segesterone acetate—which is partnered with ethynyl estradiol in sufficient quantities that one ring can be used cyclically (21/7 regimen) for up to one year (13 cycles). Women can initiate and discontinue the method themselves without any procedures or reliance on their clinician’s availability. The delivery system itself has a design that may enable other applications to be added in the future.
Now available in a new 21st edition, this well-known text with more than 2 million copies in print has been the leading family planning resource... Read more
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