When considering dual-method use, the provider and the client
must deal with the question of what is the primary method. Most
family planning programs that recommend dual-method use offer
a primary method that is highly effective for pregnancy prevention
and add a barrier method, usually the male condom, for STD prevention.
Important challenges exist for this approach to dual-method
use. Providing two methods is more costly; even one method may
be expensive for many programs and couples. Clients may not
understand the need to use both methods consistently and correctly.
In order for dual-method use to be effective, counseling is
needed for both methods, and a high degree of user motivation
Another approach to dual-method use is to use the male condom
as the primary method for both STD and pregnancy prevention.
A back-up method, emergency contraception, can be added if the
condom is not used or if it breaks or slips off during intercourse.
Emergency contraception is usually provided in the form of low-dose
combined oral contraceptives. The current recommended regimen
is to take four low-dose combined pills within 72 hours after
unprotected intercourse, and repeat the same dose 12 hours later.
A woman must have easy access to emergency contraception and
be counseled to use it if she chooses this option.
Learner Note: The most commonly
used pills are those containing levonorgestrel (LNG)
and 30 mcg of ethinyl estradiol.