How to prescribe?

I. Lete

Department of Gynaecology, Hospital Santiago Apóstol, Vitoria, Spain

Prior to prescribing any contraceptive method we must consider some important issues related with the contraception.

First we should consider the contraceptive needs of women and men, but also the individual needs of the woman asking us for contraceptive counseling. Also we should consider the non contraceptive benefits of contraceptive methods and finally we must analyze all the information regarding the criteria of evidence based medicine.

The data of a US survey demonstrate that the first request for a contraceptive method is to be easy to use and then to be reliable. In the other hand the most important request to Spanish women is the reliability of the method. Matching the two surveys we can conclude that the needs of women are: efficacy, no side effects, comfortability and confidence.

At the moment of the contraceptive counseling, it is necessary to obtain a complete clinical history and to discuss the efficacy, explaining the different Pearl Index, the possibility of side effects and the need, to some methods, of a good compliance. This information can help the woman to clarify her first option.

It is very important to analyze the non contraceptive benefits of contraception with the aim of extend the possibilities of the contraception (i.e. to treat the acne, to treat the menorrhagia, to prevent STD or to prevent genital neoplasm) . To give further and veritable information, we have some tools and the most important of them are the medical eligibility criteria of the World Health Organization.