RT Journal
A1 Delbanco T, Hartman EE
T1 A 40-year-old woman considering contraception, 1 year later
JF JAMA
JO JAMA
YR 1999
FD January 27
VO 281
IS 4
SP 374
OP 374
DO 10.1001/jama.281.4.374
UL http://dx.doi.org/10.1001/jama.281.4.374
AB 
At the Obstetrics and Gynecology Grand
Rounds held in February 1998, Herbert Peterson, MD, discussed options
for contraception in a 40-year-old nurse who is married and has 3
children.1 Despite using several methods of contraception,
including an intrauterine device, a diaphragm, a combination of
diaphragm and condoms, and oral contraceptives, Mrs B had 5
pregnancies, only 1 of which was planned. Eighteen months prior to the
Grand Rounds, she developed severe premenstrual emotional lability.
This was alleviated by oral contraceptives which, on occasion, she
would forget to take. They also seemed to induce intermittent
headaches, relieved by ibuprofen. Mrs B was eager not to become
pregnant again, and she and her husband were considering various
options, including vasectomy.