Week 8 Pharm DQ

After exploring the scenario, the patient’s uterus seems to be intact, revealing that progesterone therapy can be applied. According to the World Health Organization, various contraceptives are classified as top-tier methods regarding their efficiency. They include progestin and copper IUDs, sterilization, and progestin implants. As Allen et al. (2013) argues, contraceptives have a lower failure rate in older women, and in such a case, short-acting and less effective methods can be used. For example, coitally-dependent methods, including condoms, oral contraceptives, and diaphragms, are highly recommended.

Since progestin-only contraceptive never increases venous thromboembolism and offers safe options for women at risk of developing cardiovascular issues, they should be used in Margret’s case. The choice is also safe for people with other physical conditions, such as diabetes mellitus and high blood pressure. As indicated in the case scenario, the patient comes from a family with a history of diabetes mellitus and an increased risk of developing the condition. Estrogen only products are not recommended (contradicted) for women with an intact uterus, that smoke, and over 35 years. As Woo & Robinson (2016) note, smoking increases thromboembolic risk in patients taking estrogen and should not be used.

Progesterone, on the other hand, is linked with weight gain. Also, giving progesterone to women over 35 years and them that smoke increases their morbidity and mortality. In this case, the patient should be encouraged to exercise regularly and quit smoking. After the exam, the normal pelvic presence was evident, which qualifies Margret to use intrauterine devices and vaginal contraceptive ring. In this case, she should consider the intrauterine devices that are reliable revisable birth control forms. She can also use the diaphragm or other barriers, including condoms (female or male).

References

Allen, R., Cwiak, C., & Kaunitz, A. (2013). Contraception in women over 40 years of age. CMAJ : Canadian Medical Association Journal, 185(7), 565–573. http://doi.org/10.1503/cmaj.121280

Woo, T. M., & Robinson, M. V. (2016). Pharmacotherapeutics for advanced practice nurse prescribers (4thed.). Philadelphia, PA, F. A. Davis Company