Date: 25 Apr 2020
Start time: 09:00AM
End time: 01:00PM
Venue: John Innes Centre
Norwich Research Park
Cost: £30Book now
MediConf UK Ltd
Professor John Guillebaud Practical tips revealed from this speaker’s 50-year journey - some new, some rediscovered
The following will be covered, during the presentation as time permits, otherwise by the supplementary Manual provided:
A. First, things to be ‘unlearned’: for example, that combined hormonal contraception (CHC) taken in the 21/7 regimen as marketed for the past 60 years is a good choice. There are better regimens (63/4 & 365), also methods that are better. Above all, IUCs (generic for IUDs, IUSs and the new IUB) are seen as contraceptive ‘jewels’ by many women, once tried, including - contrary to past teaching - nulliparae. How can it be, that IUCs are now rarely offered in UK General Practice and IUC-trained providers are becoming deskilled?
B. Things to learn: the new methods, which to fight for, to use in selected cases - and which are not of special interest? Also fresh insights on how to provide the old ones, including establishing ‘open house’ protocols to replace routine follow-ups.
C. Consideration of contraceptive choices:
- in preventing teenage conceptions: much more to it than optimum use of current contraceptive technology, though the LARCs certainly help.
- for women around the menopause: and when to cease, if using a menses-masking method
- after abortion, full-term pregnancy and in lactation
- whenever there is no reliable LMP: the Proving Not Pregnant Protocol when ‘quick-starting’ and ‘bridging’: as should now be the norm
- for emergency contraception (EC): how can any service be ‘adequate’ if the most effective (copper) EC method is essentially not available in a timely way?
- when there is problematic bleeding with any method especially implants: the ‘D Check-list’ to diagnose, avoidance of norethisterone to treat
- during assorted diseases and common ‘dis-eases’: the Principle of Summation and Maintaining Risk-Benefit Difference, and egs - migraine aura, high body mass
- when there are potential drug interactions: the other drug reducing the efficacy of a CHC or the reverse, its own efficacy (or safety) altered by the CHC
- where exceptional efficacy needed [= IUC or implant]: valproate, oral retinoid Rx
- including vasectomy by no-scalpel methods: 5 times as effective as female sterilization. NB: World Vasectomy Day is November 17!
- in a concluding summary: 20+ messages which may change your practice (or not, if you were already up to speed!)
|09:00-09:30||Registration, Coffee and Exhibition|
|11:00-11:30||Coffee, Biscuits and Exhibition|