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Clinical Practice
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Volume 358:1262-1270 March 20, 2008 Number 12
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Hormonal Contraception in Women of Older Reproductive Age
Andrew M. Kaunitz, M.D.

Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.

A healthy, lean 46-year-old woman who is a nonsmoker requests advice about contraception. She notes that her menstrual periods are less regular than previously, and she also reports intermittent bothersome hot flashes. She is in a new relationship after a divorce, and she is sexually active. She asks if she can begin to use an oral contraceptive. What would you advise?

The Clinical Problem

During . . . [Full Text of this Article]

Strategies and Evidence

Contraceptive Efficacy

Safety

            Venous Thromboembolism

            Myocardial Infarction and Stroke

            Breast Cancer

Noncontraceptive Benefits

            Irregular and Heavy Uterine Bleeding

            Vasomotor Symptoms

            Skeletal Health

            Cancer

Areas of Uncertainty

Guidelines from Professional Societies

Conclusions and Recommendations


Source Information

From the Department of Obstetrics and Gynecology, University of Florida College of Medicine–Jacksonville, Jacksonville.

An audio version of this article is available at www.nejm.org.




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