Contraception allows the user th have sexual relations without becoming unwillingly pregnant. Many contraceptive advisers treat contraception as if it were completely separate from sexuality. Embarrassment can hinder what may be a crucial aspect of a discussion about a particular contraceptive. Conflicting attitudes and expectations about sex itself can result in a major understanding between counselor and advisee. Equally important is the question on information about contraception. Anyone involved in the provision of information needs to be up-to-date with current developments. This discussion offers an update on current contraceptive methods, highlighting areas of particular concern for the user and adviser. The methods discussed include oral contraceptives (OCs); Depo-Provera; barrier methods -- cervical cap, condom, contraceptive sponge; postocoital contraception; IUD; "safe period" methods; spermicides used alone; coitus interruptus; and sterilization. Each woman needs the opportunity to weigh the risks and benefits of OC use. Those who continue OC use need to be well informed about how to take it reliably. Depo-Provera, a long-acting progestogen that is injected into a muscle and has a contraceptive effect for 3 or more months, is approved for use only for women who just have been immunized against rubella or whose partners have had a vasectomy, yet it is prescribed in other circumstances. Depo-Provera can cause menstrual disturbance and weight gain. There are 4 designs of cervical cap all of which are inserted before intercourse together with a spermicide. Wthe condom is a very reliable barrier method, especially when used with a spermicide, but reliability depends on knowing how the method should be used. A contraceptive sponge called "Today is likely to be available in the UK later in the year. Postcoital pills must be taken within 72 hours of unprotected intercourse. The method is very reliable, but there is a theoretical risk of ectopic pregnancy in the rare cases in which it is ineffective. The IUD offers good protection against pregnancy, and is trouble free for most women. The risk of pelvic infection is increased if the woman is young or has more than 1 sexual partner. Individuals with religious objections to contraception may be willing only to use safe period. Greater understanding of what happens during the menstrual cycle has improved the reliability of these methods. Spermicides used alone offer some protection but are often unreliable. Giving advice about sterilization requires great sensitivity.

作者：R, Shapiro

来源：Community outlook 1984 年