There are number of contraceptives that Karen can use based on her situation and condition. First, Karen can use injections such the use of depomedroxyprogesterone acetate (DMPA), which is a synthetic hormone that are injected after every three months in order to prevent ovulation. The advantage with this contraceptive is that it other medications that the patient may be taking do not affect its efficacy, and has 99.03 percent efficacy (Zapata et al., 2015). In addition, this contraceptive lowers the challenge if irregular periods as well as reducing the risk of endometrial cancers. However, this contraceptive becomes effective twenty-four hours after the injection. Moreover, Karen can use intrauterine device (IUD), especially due to the fact that this one of the most reliable contraceptive to such an extent that only 8 women out of 1000 are likely to get pregnant during their first year of usage (American College of Obstetricians and Gynecologists, 2016).
The method that I would highly recommend
I would advise Karen to use intrauterine device (IUD) and this is due to a number of reasons. For example, this contraceptive becomes effective immediately after it is inserted, and can be removed at any time. moreover, this method has 99.9 percent efficacy rate (Wildemeersch et al., 2013). In addition, the efficacy of this contraceptive is not affected by cigarette smoking or other medications, and it reduces the problem of prolonged and painful periods.
Contraceptive Methods that I would not Recommend
There are a number of contraceptives that I cannot recommend Karen to use. For example, I cannot advise Karen to use implants which are inserted on the upper left arm. This is due to the fact that one of the precautions of this contraceptive is that the client is not support to be a heavy smoker, and considering that Karen smokes half pack cigarettes per day, using this method can be ineffective or have more side effects to her (Blocker, 2018). In addition, this method is not recommended to individuals who have a history of migraine, depression, heart disease and high blood pressure. I would also not encourage Karen to use birth control pills, due to the fact that she has to remember to take the pills daily, it has a number of risks to heavy smokers, and increases the risk of breast cancer (Centers for Disease Control and Prevention, 2017).
Centers for Disease Control and Prevention, (2017). How Effective are Birth Control Methods: Pills. Retrieved from, https://www.cdc.gov/reproductivehealth/contraception/index.htm
Wildemeersch, D., Pett, A., Jandi, S., Hasskamp, T., Rowe, P., & Vrijens, M. (2013). Precision intrauterine contraception may significantly increase continuation of use: a review of long-term clinical experience with frameless copper-releasing intrauterine contraception devices. International journal of women's health, 5, 215.
American College of Obstetricians and Gynecologists, (2016). Immediate Postpartum Long-Acting Reversible Contraception (IUD). Retrieved from, https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Immediate-Postpartum-Long-Acting-Reversible-Contraception
Blocker W., (2018). Birth Control Types (Effectiveness and S