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Addressing common dilemmas in contraception.


 Personal preference rather than the existence of contraindications usually determines the contraceptive methods women choose to use. There are, however, a number of situations in which a more thorough assessment of the suitability of available methods is demanded. These cases include women with a previous history of pelvic inflammatory disease, breast-feeding women, women being given hormone replacement therapy, and women who feel that no method is appropriate for them. Women with a previous history of pelvic inflammatory disease need to avoid contracting any additional sexually transmitted disease (STD). Condom use has been shown in several studies to effectively protect against the transmission of STDs. Diaphragms are a potential alternative to condoms, but their protective effect against STDs could use further study, while spermicides may increase the effectiveness of barrier methods in preventing STDs. All currently available contraceptives, except for the combined oral contraceptive pill, are suitable for breast-feeding women.
