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Re: Birth Control

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So  suppose  she declines any other method  Suppose she maintains nl bone desnity- that is what the black box warning is about Suppose there  is more of a risk then  of an unwanted pregnancy than bone loss? Warning are not absolute contraindications theya re warnings

 what would  th e  rest of you do?MAking our  way through decision making....

 

My thoughts exactly (IUD).

SharonSharon McCoy MDRenaissance Family MedicineIrvine, CAwww.SharonMD.com

 

Why not an IUD?

Seto

South Pasadena, CA

29 year old patient comes to me as new pt today.

Wants to continue on DepoProvera but she has been on it 8 years!

Dexa scan normal 2 years ago.

Smokes 1/2 - 1ppd since age 19.

Gained 60-80 pounds since starting Depo.

Declines pills because she forget them and that's how she ended up with son 8 years ago.

Declines Nuva ring.

Has boyfriend and infrequently sexually active.

 

I'm trying to think out of the box but be safe.

Would adding Estrogen Patch reduce the risks of osteoporosis for her?

If so how do I determine a dose?

She is trying to quit smoking and we did discuss a plan of action.

She is adopted so we do not have any data on family in regards to breast or uterine cancer.

Last GYN 3 months ago was normal.

 

Any and all thoughts welcomed!

 

 

 

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