Catherine Street Medical Centre 18 Catherine Street, Waterford www.catherinestreetmedicalcentre.com Phone:051-875338/877317 Fax: 051-878265 Dr. Tony Lee M.R.C.G.P. M.I.C.G.P. D.Obs. D.C.H. Dip. H.S.W. D.C.H. MC 06090 Dr. Aine Hennigan D.Obs.,D.Psych.,D.Derm,M.I.C.G.P., L.F.O.M. MC 17496 Dr. Sarah O’Brien M.B. , B.Ch., M.R.C.P.I., M.I.C.G.P., D.C.H. MC 22900
LONG - ACTING REVERSIBLE CONTRACEPTION (LARC)
Types Depo – provera (injection every 3 months)
Implanon (small device injected under the skin in the upper arm - lasts 3 yrs) Intra - uterine device (IUD/ copper coil lasts up to 10 years )
Intra - uterine system (Mirena - last 5 years )
The main points (LARC = long acting reversible contraception)
LARC methods have the best efficacy vs any other method eg the pill/ condoms. All LARC methods are more cost effective than the pill at one year of use. Age alone is not a contra- indication for any LARC method. Younger women are more at risk of an unplanned pregnancy and should consider changing to a non-user dependant method - “Fit and forget”. DEPO- PROVERA This is an injection of a hormone called progesterone every 12 weeks, It prevents ovulation, has a very low failure rate and will likely result in no periods whilst on it.
However, it may cause irregular bleeding in some people and may delay return to fertility by up to one year. It may effect bone density ie calcium in bones / bone strength BUT there is no increased fracture risk and the bone density returns to normal very quickly after stopping it. (Adolescents and those over 40 years or those with significant risk of osteoporosis - most at risk and possibly should avoid / not first choice) For further information visit IMPLANON NXT This white match-stick type shaped device is injected under the skin in the upper-arm. It is very effective and extremely unlikely to fail. It stops ovulation, lasts for 3 years and fertility returns as soon as it is removed. It may cause irregular periods (up to 50% of people) , improves period pains generally and is not associated with weight gain, mood changes or headaches. For further information visi COPPER IUD This is a small device inserted into the womb/uterus. There are no hormones with this method,it is highly effective, last up to 10 years and can be used for emergency contraception i.e. after intercourse where risk of pregnancy is high / feared. It prevents an egg being fertilized by sperm and the survival of a fertilized egg. It works as soon as inserted, stops working as soon as it is removed . It may cause period pains/heavy periods. It may be necessary to have a test done first with the Doctor to make sure you have no genital infection. It can be used in teenagers, those who have no children, breast feeding and when oestrogen hormone cannot be used. For further information visi
MIRENA IUS This small t-shaped device contains progesterone hormone which is inserted into the womb / uterus. It is very safe, effective and of huge benefit for the management of heavy periods. It lasts for 5 years and prevents ovulation/ fertilization. You may need to be tested before insertion to out rule a genital infection. It can be used in any age group and in those who have had no children. For further information visi It is always necessary to make an appointment with the Doctor to discuss long acting contraception +/- examination to ensure you make the correct choice. There may be good reasons from a health and safety viewpoint to choose one type over the others and your Doctor can help you with this. Please note the links above for each method to get more information - The Doctor / Surgery will have leaflets available also. (The above information is based on data available in September 2013)
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Simvastatin vs Therapeutic Lifestyle Changes and Supplements: Randomized Primary Prevention Trial DAVID J. BECKER, MD; RAM Y. GORDON, MD; PATTI B. MORRIS, RD; JACQUELINE YORKO, MED;Y. JEROLD GORDON, MD; MINGYAO LI, PHD; AND NAYYAR IQBAL, MD, MSCEOBJECTIVE: To compare the lipid-lowering effects of an alternativeWe have used a combination of fish oil and red yeastregimen (lifestyle changes