Book contents
- Contraception
- Contraception
- Copyright page
- Contents
- List of contributors
- Foreword
- Preface
- 1 Whatwomen want from their contraceptives… and what we can offer
- 2 Mythsand misconceptions about sex and con(tra)ception
- 3 Thehistory of contraception
- 4 Physiologyof the menstrual cycle and natural family planning
- 5 Theoestrogen component of currently used steroidal contraceptives
- 6 Therisk of oestrogens in contraceptives
- 7 Progestogensused in contraceptives
- 8 Thecontraceptive consultation
- 9 Menarcheand associated problems
- 10 Adolescence:contraception in the teenage years
- 11 Contraceptionin the20-somethings
- 12 Contraception in the 30-somethings
- 13 Contraceptionin the 40-somethings
- 14 Contraception in the50-somethings
- 15 Whatis the risk of cancer with hormonal contraception?
- 16 Newdevelopments in female sterilization
- 17 Malesterilization
- 18 Emergency contraception
- 19 Sexuallytransmissible infections and pelvic pain: what you really need to know
- 20 Medicaltermination of pregnancy
- 21 Surgicaltermination of pregnancy
- 22 Primary care treatment of subfertility and what every health professional needs to know about assisted reproductive technology
- 23 Sexualassault
- 24 Future developments incontraception
- Index
13 - Contraceptionin the 40-somethings
Published online by Cambridge University Press: 05 August 2013
Edited in consultation with
Book contents
- Contraception
- Contraception
- Copyright page
- Contents
- List of contributors
- Foreword
- Preface
- 1 Whatwomen want from their contraceptives… and what we can offer
- 2 Mythsand misconceptions about sex and con(tra)ception
- 3 Thehistory of contraception
- 4 Physiologyof the menstrual cycle and natural family planning
- 5 Theoestrogen component of currently used steroidal contraceptives
- 6 Therisk of oestrogens in contraceptives
- 7 Progestogensused in contraceptives
- 8 Thecontraceptive consultation
- 9 Menarcheand associated problems
- 10 Adolescence:contraception in the teenage years
- 11 Contraceptionin the20-somethings
- 12 Contraception in the 30-somethings
- 13 Contraceptionin the 40-somethings
- 14 Contraception in the50-somethings
- 15 Whatis the risk of cancer with hormonal contraception?
- 16 Newdevelopments in female sterilization
- 17 Malesterilization
- 18 Emergency contraception
- 19 Sexuallytransmissible infections and pelvic pain: what you really need to know
- 20 Medicaltermination of pregnancy
- 21 Surgicaltermination of pregnancy
- 22 Primary care treatment of subfertility and what every health professional needs to know about assisted reproductive technology
- 23 Sexualassault
- 24 Future developments incontraception
- Index
Summary
This chapter presents a case study of a 42 year old female (Alison), who suffered from heavy painful periods. Alison's situation is far from unusual for this age group, where the risk of relationship breakdown is high. It is apparent that Alison's first priority is a highly effective contraceptive method. However, she requires much more from her method: effective control of bleeding and dysmenorrhoea; restoration of menstrual predictability and/or amenorrhoea. A bimanual examination for Alison is undertaken to assess for uterine enlargement (fibroids, adenomyosis), uterine mobility and adnexal masses and/or tenderness. Alison was advised about how the levonorgestrel-releasing intrauterine system (LNG-IUS) works by profound endometrial glandular and stromal suppression, cervical mucus changes and a foreign body effect within the endometrium. Progestogen-only pills (POPs) would be an option for Alison if she has contraindications to taking oestrogens.
Keywords
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- ContraceptionA Casebook from Menarche to Menopause, pp. 111 - 119Publisher: Cambridge University PressPrint publication year: 2013