Treatment Guidelines from The Medical Letter
Choice of Contraceptives
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The choice of which contraceptive to use may vary from one stage of reproductive life to another.1 Intrauterine devices (IUDs), progestin implants and sterilization are the most effective contraceptive methods available to women. Hormonal contraceptives, when used correctly, are also highly effective in preventing pregnancy. Barrier and fertility-based methods have the highest rate of failure.


Most oral contraceptives available in the US are a combination of the estrogen ethinyl estradiol and a progestin. The estrogen and progestin content of these pills has been reduced over the years in an effort to decrease the incidence of common and serious adverse effects. The lower dose formulations (≤20 mcg of ethinyl estradiol) are effective, but they may have a higher risk of failure and changes in bleeding patterns (irregular, frequent or ... more      

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