These data are assessed through a careful clinical history and examination. Findings and risks are important for step 4 (see below) in the structured process. Information about preexisting physical complaints and elements of quality of life are significant for step 5 (see below).

The psychosocial history, the open interview, and the assessment of present complaints provide this information. Of special importance are the behavioral characteristics and preexisting emotional problems for step 4 and step 5 (see below).

Especially the sociocultural background and the present relationship characteristics are important elements of this part of the clinical interview, and they have an impact on step 4 (see below).

This question can be answered by a visual aid showing the efficiency of the methods if used by 100 women for 1 year.

The typical information to be given refers to the lowest expected percentage of women with a pregnancy during the first year of use [6, 15].

Highly effective methods:

Medium effective methods:

Methods with low effectiveness:

The discussion of this issue points to the discrepancy between theoretical and typical Pearl index and allows a classification with respect to the necessary compliance and discipline [6, 15].

Methods with high demand on compliance:

Methods with low demand on compliance:

This is a crucial part of the information exchange process. It is important to give a risk background and to describe risks in absolute numbers or give some points of reference [15, 23, 27].

High risk: between >1 and 1 in 100

Moderate risk: between 1 in 100 and 1 in 1,000

Low risk: between 1 in 1,000 and 1 in 10,000

Very low risk: between 1:10,000 and 1:100,000

After the general understanding of risk, the patient should be informed about the typical risks or the methods [15, 24, 27–34].

Combined OCs:

Progestogen only:

IUDs copper:

Levonorgestrel IUS:

This information helps the patient to understand her personal nonmodifiable and modifiable risks. She can learn about the impact of a healthy lifestyle on her individual risk during the use of different contraceptives [15, 27, 35, 36].

It is important to give not only information about risks but also about possible noncontraceptive health benefits of the methods.

For example, condoms diminish considerably the risk to acquire a sexually transmitted disease (for HIV with consistent use at about 97 %, against HSV highly effective, against HPV not very effective) [37].

For example, OC benefits are less endometrial cancer, less ovarian cancer, fewer ectopic pregnancies, more regular menses (less flow, less dysmenorrheal, less anemia), less salpingitis, increased bone density, probably less endometriosis, possibly less benign breast disease, possibly less rheumatoid arthritis, possibly protection against atherosclerosis, possibly fewer fibroids, and possibly fewer ovarian cysts [15, 38].

For example, levonorgestrel IUD reduces blood loss in hypermenorrhea, possibly diminishes fibroma size, and may protect against PID [34].

It is important to comment on possible negative and positive side effects at the same time. Many of the effects observed by the patient are very individual and cannot be predicted. Mentioning possible negative effects is important to avoid unnecessary anxiety, disappointment, and insecurity.