First, the family doctor should perform several tests on J.L. The doctor should check on her medical history and blood pressure measurement. Since J.L is experiencing heavy menses, it is a clear indication that she has hormonal imbalances. Therefore, she requires some screening for any presence of sexually transmitted diseases. For instance, a urine sample can be taken. The doctor can also do a pelvic exam with a pap test or even a bimanual and cervical inspection (Abedin, 2020). Breast examination can also be taken to screen for breast cancer since it can affect hormonal contraceptives.
The three most effective contraceptives that the J.K can be a contraceptive implant, intrauterine device (IUD), and female condom. The implant has almost 99% effective in preventing pregnancy in women and works for a longer time (Beaugureau, 2018)). It works by releasing the hormone progestin, which thickens cervical mucus and lines the Uterus, leading to ovulation suppression. According to Abedin (2020), IUD works by making it impossible for male gamete to fertilize the egg due to the presence of copper in the device. It also has 99% effectiveness and lasts for a long time, making it more preferable. Another advantage is that IUD is non-hormonal, and therefore no medications can stop the device from working. Finally, J.K can be advised to use female condoms since it protects both pregnancy and STIs, and it is almost 95% effective in preventing pregnancy.
However, each contraceptive has some disadvantages and side effects that J.L needs to understand and report to the doctor if the effects persist. According to Beaugureau (2018), the implant can cause irregular bleeding, persistent back pain, and severe headaches. IUD is also associated with irregular periods or longer periods and back pain (Beaugureau, 2018). On the other hand, female condoms have minimal side effects only to the females allergic to latex. J.L should note that it is only female condoms that can prevent both pregnancy and STIs among the three contraceptives.
Abedin, S. (2020). Best Birth Control. WebMD. Retrieved from https://www.webmd.com/sex/birth-control/best-effective-birth-control.
Beaugureau, M. (2018). Birth Control Implant. Retrieved from https://www.healthline.com/health/birth-control-implant
She needs a pelvic exam and Pap test having little medical history. Pap test examines signs of cancer in the cervix while pelvic exam looks at infections. The doctor should do sexually transmitted disease tests using urine and blood samples (Pelvic Exams, Pap Tests, and Oral Contraceptives, 2017). Other essential examinations include checking blood pressure and confirming if she is smoking or has a history of blood clots. The information about her father history of cardiovascular diseases, which is characterized by Blood-clot and blood vessel structural problems, is essential before the OCP regimen. The choice of contraceptives depends on underlying health conditions such as heavy menses and a family history of Blood-clot. Other factors are the result of the Pap test, blood test, and Pelvic examination. The best method to use also depends on effectiveness, considering how many women get pregnant out of 100. The following are 99% effective; contraceptive implant (lasting for 3 yrs), intrauterine system (last for five years), coil (last for ten years). She can also use contraceptive injection lasting for 8 to 12 weeks; it is 95% effective if used correctly (“Which method of contraception suits me?,” 2017). The implant, injection, and IUD or IUS are reliable because the patient will not use contraceptives with estrogen due to blood clot issues, and after using, her fertility will return to normal condition. Sometimes she may experience period changes because previously she had heavy menses; she can now experience lighter and infrequent periods. Contraceptive injection application for more than two years may lead to slight weight gain and hormones changes. She can also visit the doctor if her fertility takes longer than one year to return to normal after removing the contraceptive.
Pelvic Exams, Pap Tests and Oral Contraceptives. (2017). Retrieved November 2, 2021. American Acadmy of Family Physicians. https://www.choosingwisely.org/patient-resources/pelvic-exams-pap-tests-and-oral-contraceptives/
Which Method of Contraception Suits Me?: Your Contraceptive Guide. (2019). NHS. https://www.nhs.uk/conditions/contraception/which-method-suits-me/