Question

Melissa is a 31-year-old, recently married female who presents to your office for an annual visit. She has three children ages 2, 5, and 8. Her new husband wants to wait at least a year before they try to have a child of their own. She has used combined oral contraceptives (COCs) for more than 10 years. Since the birth of her last child, she has been using COCs intermittently. She finds it too difficult to remember to take the pills regularly and wants an easier method. Menses are regular, although her periods seem heavier than usual, and she gets more irritable when she is not taking the COCs. She rarely exercises and admits to smoking and drinking occasionally. She is overweight. She has no medical history.

What additional information do you need to obtain?

Discuss her options and provide evidence for your rationale. Include patient education in your discussion.

Answer 1