An outpatient gynecology clinic is evaluating several women for contraceptive counseling. Match each patient's clinical profile with the most appropriate primary contraceptive method according to the United States Medical Eligibility Criteria (US MEC) for Contraceptive Use.
- A 32-year-old woman with idiopathic heavy menstrual bleeding and severe dysmenorrhea.Levonorgestrel-releasing intrauterine device (LNG-IUD)
- A 31-year-old woman with recently diagnosed, active breast cancer.Copper intrauterine device (Cu-IUD)
- A 38-year-old woman who smokes 25 cigarettes daily and declines any intrauterine device.Subdermal etonogestrel implant
- A 24-year-old woman with active, mucopurulent chlamydial cervicitis.Combined oral contraceptive pills (COCPs)
Answer
The 32-year-old with heavy bleeding matches with the Levonorgestrel-releasing IUD. The 31-year-old with breast cancer matches with the Copper IUD. The 38-year-old smoker matches with the Subdermal etonogestrel implant. The 24-year-old with chlamydial cervicitis matches with Combined oral contraceptive pills.
Each match correctly applies the Medical Eligibility Criteria for contraceptive use. The LNG-IUD provides targeted treatment for heavy bleeding; the Cu-IUD serves as a necessary hormone-free option for the breast cancer patient; the progestin implant offers estrogen-free contraception for the >35-year-old smoker while respecting her IUD refusal; and COCPs provide safe systemic contraception when an active cervical infection contraindicates IUD placement.
Step-by-Step Solution
Key Concept
Selection of contraception based on the Medical Eligibility Criteria (MEC), prioritizing safety by identifying absolute contraindications such as estrogen in >35 heavy smokers, all hormones in breast cancer, and IUD insertion in active pelvic infections.