Review Question - QID 103378

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Contraception Barrier Contraceptives Male condom QID: 103378 (M2.GN.12.15)

QID 103378 (Type "103378" in App Search)

A 23-year-old woman presents to her primary care physician for a wellness checkup. She has been treated for gonorrhea and chlamydia 3 times in the past 6 months but is otherwise healthy. She smokes cigarettes, drinks alcohol regularly, and wears a helmet while riding her bicycle. The patient is generally healthy and has no acute complaints. Her vitals and physical exam are unremarkable. She is requesting advice regarding other forms of contraception and her sexual health. The patient has been taking oral contraceptive pills for the past year without issues. Which of the following would be the most appropriate recommendation for this patient?

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Additional use of condoms

24%

25/104

Switching to etonogestrel implant

5/104

Switching to intrauterine device

61%

63/104

Pull out method

4/104

Tubal ligation

6/104

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This patient has a history of multiple STIs and is requesting advice regarding other forms of contraception and her sexual health while already being on oral contraceptive pills (OCPs). Additional use of condoms would be a viable option for this patient who is already stably on OCPs and has a history of repeat STIs.

Contraception should be discussed with female patients who are sexually active. Generally, the most reliable methods include intrauterine devices (IUDs) and implants. However, these methods of contraception offer no protection against STIs and may actually increase the incidence of STIs given that patients tend to engage in more unprotected sex when using them. Condoms are a safe form of contraception that have no side effects and lower the transmission of STIs. The main drawback of condoms is non-compliance leading to pregnancy; however, condoms should be recommended for patients, in particular, when they present with repeat STIs.

Incorrect Answers:
Answer 1: Etonogestrel implant is a more reliable form of contraception than this patient's current oral contraceptive pills; however, given the patient has a history of many STIs and plans to be more sexually active, protection against STIs is paramount.

Answer 3: Intrauterine device is another form of contraception that is more reliable than this patient's current oral contraceptive pills; however, given the patient has a history of many STIs and plans to be more sexually active, protection against STIs is paramount.

Answer 4: Pull out method is not a reliable method of contraception and offers no protection against STIs. This method should not be advised to patients.

Answer 5: Tubal ligation is a definitive and reliable method of contraception; however, it would not be optimal in a young patient who may want children in the future and it offers no protection against STIs.

Bullet Summary:
Condoms are a form of birth control that protect against the transmission of STIs.

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