Family Nurse Practitioner Exam

Which birth control method is recommended for a 35-year-old smoker with a history of PID and an embolic episode?

1. Condoms and the vaginal sponge (Today Sponge)

2. Estrogen patches

3. Intrauterine device

4. Depo-Provera (depot medroxyprogesterone)

The correct answer is: Condoms and the vaginal sponge (Today Sponge)

The recommendation of condoms and the vaginal sponge for a 35-year-old smoker with a history of pelvic inflammatory disease (PID) and an embolic episode takes into account several critical health considerations. First, smoking is a significant risk factor for cardiovascular complications, especially in women over 35. Birth control methods that contain estrogen, such as the estrogen patches or hormonal contraceptives, can further elevate risks for thrombosis, making them less suitable for this individual. Additionally, the history of PID suggests a potential for complications with intrauterine devices (IUDs), as they can increase the risk of further infections, which would not be ideal for someone with that medical background. The Depo-Provera injection is a hormonal method that does not contain estrogen, thus being somewhat safer than estrogen-containing methods for this patient demographic. However, it still carries risks that may not be ideal given the patient’s history of embolic episodes. Condoms provide a barrier method that does not involve hormones and thus poses no risk of exacerbating existing health issues. The vaginal sponge also serves as a non-hormonal option, offering additional protection against unwanted pregnancies without the risks associated with hormonal contraception. Thus, using condoms and the vaginal sponge is a