FMGE 2022 — OB/GYN

Question 1: A 34-year-old woman presents at 6 weeks of delivery. She wants contraception for the next 3 years. What will be the best contraceptive method in this case?

• A. Nothing besides lactation amenorrhea
• B. IUCD with progesterone
• C. Injectable progesterone
• D. Copper T (Correct Answer)

Explanation: ***Copper T*** - A **Copper T intrauterine device (IUD)** is an excellent choice for long-term contraception (up to 10 years), making it suitable for her 3-year requirement. - It's **non-hormonal**, making it safe for breastfeeding mothers and avoiding potential hormonal side effects. *Nothing besides lactation amenorrhea* - **Lactational amenorrhea method (LAM)** is effective for only the first six months postpartum, provided the mother is exclusively breastfeeding and her periods have not returned. - It is not a reliable method for contraception beyond six months postpartum or for the requested 3-year duration. *IUCD with progesterone* - An **intrauterine device (IUD) with progesterone** (e.g., Mirena) can be a good long-term option, but it releases hormones which can potentially affect breastfeeding, especially if initiated very early postpartum. - While generally safe for breastfeeding, a non-hormonal option like the copper T is often preferred if there are concerns about hormonal exposure or side effects. *Injectable progesterone* - **Injectable progesterone** (e.g., Depo-Provera) is an effective contraceptive, but it needs to be administered every 3 months. - While safe for breastfeeding, it's not considered as convenient for a 3-year duration as a single-insertion IUD, and some women experience side effects like irregular bleeding or weight gain.