In 2010 the Centers for Disease Control and Prevention (CDC) overhauled their safety recommendations for the all the various methods of birth control, both prescription and non prescription. It’s a great document because there are a variety of recommendations depending on the medical condition, the age of the patient, and other variables. For example, with migraines the recommendations vary both my age and by the presence of aura and after bariatric surgery the recommendations vary by type of procedure.
I keep the PDF on my desk top for handy access at work, but the document is long and a little cumbersome in layout given the amount of data and the extensive detailing of references. However, the data is also available as an app which makes accessing info on contraception that much easier. And it’s free (yeah, CDC).
While not especially sexy in layout or snazzy in color combinations the app does the job. You can search by medical condition or method of birth control. There is also special mention of the conditions where pregnancy poses a much higher risk for serious health consequences and so reliance on barrier or behavior-based methods of birth control (think withdrawal or rhythm) alone is not the safest medically. Some examples include bariatric surgery within the past two years, a history of stroke, or lupus.
There is data on essentially every medical condition from more common health problems, such as depression, obesity, and migraines to less common conditions, such as organ transplants and blood clotting disorders.
Risk is scored on a scale of one to four, with four being the riskiest and the method of birth control contraindicated. The app also details pregnancy rates with various methods, breaking it down by average use and perfect use (as an aside, we might all like to think we are perfect users but in reality most of us, gynecologists included, are not). There are also explanations of the abbreviations and acronyms, which otherwise might seem interpretable unless you are a women’s health practitioner.
All health care providers should consider the app, not just women’s health practitioners. So often when a woman has a major health issue she spends so much time seeing specialists that routine medical care gets pushed to the side. This is understandable when you are trying to live your life squeezed between numerous medical appointments and/or are feeling unwell and your doctors are consumed with your health condition. However, women with all manner of health conditions are still sexually active and in my experience transplant surgeons, bariatric surgeons, oncologists, rheumatologists, neurologists etc don’t always ask about contraception and sex and even if they do they may not have an in-depth familiarity of the methods. Unfortunately, safe sex can get lost in the shuffle and despite multiple visits with multiple providers women whose health and even life could be jeopardized by pregnancy can and do get pregnant, often with disastrous consequences. And then of course there are women with serious health conditions that don’t have access to care.
Another consideration is the less frequent pap smear. While contraception should not be tied to pap smears, the reality was when women came in annually for pap smears it was also an opportunity to review contraception and find out what had changed medically in the past year. With more years between pap smears there is more of a chance to develop a medical condition and what was safe to use two years ago may not be safe now. I’m not advocating more frequent paps or typing paps to contraception, it just means that more creativity and patient education is required (nether of which are bad things at all!).
This app is also useful for every woman who is sexually active and does not want to be pregnant. It details pregnancy rates (good data to have when selecting birth control) and also reviews all the methods of birth control. Not every woman is offered every method when she sees her provider, so knowing the data on everything out there is empowering. However, this app is especially useful for women with medical conditions who can double-check to make sure the method of birth control that they are using is safe or research your options before you see your health care provider.
If you have female patients of reproductive age or are a woman of reproductive age and have a male partner then this app is for you. And it’ s free (I know I mentioned that, but considering rising co payments being empowered with good data can help maximize outcomes and reduce office visits).
Helping women find the safest method of birth control is a good thing.