From the Division of General Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, LY318, Boston, MA 02215.
At the Obstetrics and Gynecology Grand
Rounds held in February 1998, Herbert Peterson, MD, discussed options
for contraception in a 40-year-old nurse who is married and has 3
children.1 Despite using several methods of contraception,
including an intrauterine device, a diaphragm, a combination of
diaphragm and condoms, and oral contraceptives, Mrs B had 5
pregnancies, only 1 of which was planned. Eighteen months prior to the
Grand Rounds, she developed severe premenstrual emotional lability.
This was alleviated by oral contraceptives which, on occasion, she
would forget to take. They also seemed to induce intermittent
headaches, relieved by ibuprofen. Mrs B was eager not to become
pregnant again, and she and her husband were considering various
options, including vasectomy.
Delbanco T, Hartman EE. A 40-Year-Old Woman Considering Contraception, 1 Year Later. JAMA. 1999;281(4):374. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-4-jxu80010