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Long acting contraception to whom and why

Long acting contraception to whom and why. Øjvind Lidegaard. Gynaecological Clinic Rigshospitalet Copenhagen University. Long acting contracpetion. Long acting contraceptive methods Use pattern today To whom and why. Li/10. Long acting contracpetion. Long acting contraceptive methods

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Long acting contraception to whom and why

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  1. Long acting contraceptionto whom and why Øjvind Lidegaard Gynaecological Clinic Rigshospitalet Copenhagen University

  2. Long acting contracpetion • Long acting contraceptive methods • Use pattern today • To whom and why Li/10

  3. Long acting contracpetion • Long acting contraceptive methods • Use pattern today • To whom and why Li/10

  4. Length of effect of different contraceptive methods after application Life long 5 years 3 years 3 months 4 weeks 1-2 days 1 day <1 hour Hours Li/10

  5. Long acting contracpetion • Long acting contraceptive methods • Use pattern today • To whom and why Li/10

  6. Depo-provera and implanone 05-09 1000 DDD www.laegemiddelstyrelsen.dk Li/10

  7. Implanone in Denmark 2009 DDD per 1,000 per day www.laegemiddelstyrelsen.dk Li/10

  8. Depo-provera in Denmark 2009 DDD per 1,000 per day www.laegemiddelstyrelsen.dk Li/10

  9. Sale hormone-IUD in Denmark 2009 Number www.laegemiddelstyrelsen.dk Li/10

  10. Use of oral contraceptives according to ageDDD/100 women/day at different ages www.laegemiddelstyrelsen.dk Li/10

  11. Hormonal contraception according to estrogen dose and progestagen type Progestogen type EENETA Norgestimate Gestodene CPA Dose Levonor Desogestrel Drospire- In ug gestrel Etonogestrel none 50 ug 30-40ug 15-20ug POP Injection Stick EVRA 1st gen 3rd gen NuvaRing 4th gen 2nd gen Cerazette MPA Implanone Li/10

  12. Per cent age distribution of differentcombined contraceptive pills 2009 % www.laegemiddelstyrelsen.dk Li/10

  13. Per cent age distribution of differentcombined contraceptive pills 2009 % www.laegemiddelstyrelsen.dk Li/10

  14. Per cent age distribution of differentcombined contraceptive pills 2009 % www.laegemiddelstyrelsen.dk Li/10

  15. Per cent age distribution of differentcombined contraceptive pills 2009 % www.laegemiddelstyrelsen.dk Li/10

  16. Per cent age distribution of differentcombined contraceptive pills 2009 % www.laegemiddelstyrelsen.dk Li/10

  17. Hormonal contraception DK 2009 DDD/day CPA Low-dose OC Middle dose OC Sale statistics. www.laegemiddelstyrelsen.dk Li/08

  18. Hormonal contraception DK 2009 Impla-none POP Low-dose OC Middle dose HC Sale statistics. www.laegemiddelstyrelsen.dk Li/08

  19. Conditions to take into accountwhen deciding type of contraception • Risk of venous thrombosis - family disposition - previous thrombosis - adiposity • Risk of arterial thrombosis - smoking, diabetes, hypertension - migraine, with or without aura • Contraceptive compliance • Sexual practice / social situation

  20. OC and VTE: Progestagen typeadjusted for duration of use ug EE Neta Levo Norg Deso Gest Dros Cypr 50 1.4 1.2 na na na na na 1.0-2.1 0.9-1.7 30-40 1.0 Ref 1.2 1.8 1.9 1.6 1.9 0.7-1.4 1.0-1.5 1.5-2.2 1.6-2.2 1.3-2.1 1.5-2.4 20 na na na 1.5 1.5 na na 1.3-1.8 1.2-1.9 POP na 0.3 0.2-0.5 0.5 0.2-1.7 Mirena na 0.4 0.3-0.6 Lidegaard et al. BMJ 2009; 339; b2890 Li/09

  21. OCs and thrombosisCurrent status June 2010 CTAAMIVTE Non use111 2nd gen: 2.51.5 2.5 3rd gen: 1.5 1.5 4.0 4th gen: nana4.0 5th gen: ?? ? Li/10

  22. Adiposity in Danish women and men in 1994 and 2005 Adiposity: BMI >25 Li/07 www.si-folkesundhed.dk

  23. Severe adiposity in Danish women in 1994, 2000 and 2005 Adiposity: BMI 30 Li/07 www.si-folkesundhed.dk

  24. Induced abortions in DK 1998-2008 Number per 1,000 20-24 25-29 30-34 15-19 35-39 10-14 40-44 www.TiGrAb.dk Li/10

  25. Leiden V mutations, prevalence Larsen et al. Thrombosis Res 1998; 89: 211-15

  26. Long acting contraception could be considered in women with • Difficulty in remembering to take a daily pill • Wish of high degree of protection against pregnancy • Women who due to thrombotic predisposition could not take combined OC • Women concerned about the risk of VTE • Adipose women

  27. Thank you for your attention Presentation at www.Lidegaard.dk

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