Consequences of contraceptive methods encountered in practice

About 1/3rd of Finish women in fertile age turn to family planning centers for advice on contraceptives whose regular monitoring is performed under guidelines issued by the Ministry of Health. A medical checkup 3 and 12 months after fitting an IUD should include a blood hemoglobin test and the monitoring of side effects. The IUD-induced menorrhagia of 40-80% higher volume and up to 2 days longer duration is in part caused by prostaglandins (PG). Agents inhibiting PG synthesis can be useful in favorably influencing excessive flow but changing the IUD can be equally beneficial. Iron deficiency occurring in every 5th IUD user can be treated with appropriate medications. A slight bleeding during mid-cycle is still acceptable. The position of the IUD or inflammation can cause constant lower abdominal pain or painful coitus. Nonspecific vaginitis appears in about 20% of IUD users which can be treated with metronidazole of tinidazole. During pelvic examination the position of the IUD and the length of the thread has to be checked sensitivity of the uterus can be symptomatic of endometriosis. 7-8 days after the last coitus the IUD should be removed if side effects persist. Instructions of hormonal contraceptives have to be followed to avoid improper timing and ommission. Low-dose minipills of 1 component or subcutaneous capsules have fewer side effects (bleeding disorders) still checkups at 6-12-24 month intervals and at least 3 times for those under 18 are recommended. Psychological complaints associated with combination pills require switching to another pill often pyridoxine treatment helps or PG-inhibiting agents in migraine headaches. During checkup the breasts the face and epidermis hair should be examined. Slight increase of blood pressure and weight gain of 2-3 kg is acceptable. Every 1 or 2 years cytological tests and in nulliparas aminotransferase determination should be performed 3-6 months after pill use starts (S-ALAT or S-ASAT).