Several researchers have tried to find a counseling approach that leads women to stick with their contraceptive method longer. So far, the results are disappointing! A recent Cochrane review of 8 contraceptive counseling interventions found only 1 success: a Mexican trial that used a structured counseling technique prior to initiating injected progestin (Depo-Provera). The women who received structured counseling (including detailed, audiovisual information about side effects) continued Depo-Provera longer than women who received the usual care at that clinic.

What’s the take-home message for busy clinicians?
Educating patients about common side effects enhances adherence to a new contraceptive. However, many women who experience side effects – even those who were warned in advance, and who know that these side effects represent no threat to their health – decide to stop their method. To prevent unintended pregnancy, clinicians must make themselves readily available to patients who have problems with their chosen method. Patients who can reach their clinician easily to have their questions answered are less likely to give up on birth control completely when their method causes them trouble.

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