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Contraception


Women travelling or living for prolonged periods abroad should be advised to find out what contraceptive services are available to them in the country/countries they are visiting. The International Planned Parenthood Federation (IPPF) and the Family Planning Association of Britain can provide extra information.

The Combined Oral Contraceptive Pill

Stomach upsets and severe diarrhoea reduce absorption and may leave inadequate protection. If vomiting occurs within three hours of taking the Pill a barrier method should be used as well, throughout the stomach upset and for seven days after it has ended i.e. the seven day rule.

Contraception and antibiotics

Note 01/03/11: New Guidance on Antibiotics and Combined Hormonal Contraceptives In their latest guidance on Drug Interactions with Hormonal Contraception, the Royal College of Obstetricians and Gynaecologists have stated that women on non-enzyme inducing antibiotics are no longer required to take additional precautions during or after the course. The use of additional precautions does apply if vomiting or diarrhoea occurs as a result of antibiotic use or underlying illness. This important change is of relevance to women travellers on combined hormonal contraception who plan to take doxycycline (a non-enzyme inducing antibiotic) as antimalarial prophylaxis.

The Progestrogen Only Pill (POP)

For women taking the progestrogen only Pill the same rules apply as with the combined Pill. It is slightly less effective, 96 - 98%, and must be taken at the same time each day - this can pose problems when crossing time zones. However, it does have the advantage of not being affected by antibiotics.

Injectable/Implant/IUD Methods of Contraception

This includes Depo-Provera, Noristerat, Implanon and Merina. Injectable contraception and implants are not affected by time zones, gastrointestinal upsets and antibiotics.

Condoms

Reliable condoms are often hard to find in the poorer parts of the world. If the condoms carry the British Kite Mark or the new European CE mark it means that they have been tested to a strict safety standard. Rubber perishes with age, and heat, and should be discarded if it displays any signs of being brittle, sticky or discoloured.

Diaphragms/Caps

They should be stored in a cool dry place in an airtight container, severe heat can perish rubber. Spermicides may lose their efficacy if not stored in cool, dry containers. Creams may melt and be difficult to apply and pessaries, which are designed to melt at body temperature, impossible to use.
     
     
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