Starting oral contraceptives – which, when and how?

1992 ◽  
Vol 30 (11) ◽  
pp. 41-44

About one quarter of women in Britain aged 18–44 use oral contraceptives,1 and almost half of those aged 20–29.2 Many will use more than one type during their years of sexual activity. Changes will occur as new products are introduced and new risks identified or in response to unwanted effects. Decisions may also be prompted by the need to restart oral contraception after a break as part of planned parenthood. Oral contraception is chosen chiefly because it is reliable and does not interrupt spontaneous sexual activity. Whether a combined oral contraceptive pill (COC) or a progestagen-only pill (POP) would be the more appropriate depends mainly on the woman’s medical history, smoking habits and age. Most women will want good cycle control, and a few will prefer to take an inactive pill for a few days in each cycle rather than have a pill-free interval. This article discusses the choice when starting, restarting or switching oral contraception.

2021 ◽  
Vol 3 (5) ◽  
pp. 184-188
Author(s):  
Katie Boog

Although often transient, side effects are the most common reason for individuals to discontinue contraception. The evidence to prove causality is limited, as is evidence-based guidance on how to manage these side effects. This article summarises the available evidence. For individuals who have new or worsening acne on progestogen-only contraception (POC), switching to combined hormonal contraception (CHC) is likely to improve their skin. Continuous or extended CHC use may be beneficial for individuals with premenstrual mood change, and for those who experience headaches in the hormone-free interval. Unpredictable bleeding patterns on POC are common. Injectable users can try reducing the interval between injections to 10 weeks. Implant, injectable or Intrauterine system users can be offered a 3-month trial of a combined oral contraceptive pill (COC). CHC and POP users with unpredictable bleeding may benefit from switching to an alternative preparation.


2010 ◽  
Vol 2 ◽  
pp. CMT.S4661
Author(s):  
Radhika Rible ◽  
Ram Parvataneni ◽  
Angela Chen

Extended-cycle combined hormonal contraception has become a common practice among women seeking effective contraception and menstrual regulation. Extended cycle regimens have the benefit of decreasing scheduled bleeding as compared to traditional combined oral contraceptive (COC) regimens containing 21 days of hormones followed by a 7-day hormone-free interval (HFI) by reducing the frequency of the HFI. The newest FDA approved product in this family of contraceptive regimens is a 91-day COC regimen containing 0.02 mg ethinyl estradiol (EE) and 0.1 mg levonorgestrel (LNG) for 84 days followed by a 7-day interval with 0.01 mg EE. This regimen has been evaluated in one pivotal trial and demonstrated to have efficacy and a side effect profile similar to the other currently available FDA approved 91-day extended-cycle regimens. This is the first 91-day regimen formulated with 0.02 mg EE and offers women an effective option for contraception and menstrual cycle control.


2021 ◽  
Vol 32 (6) ◽  
pp. 226-231
Author(s):  
Katie Boog

Side effects are the most common reason for the discontinuation of contraceptive methods. Dr Katie Boog summarises the available evidence on how to manage them Although often transient, side effects are the most common reason for individuals to discontinue contraception. The evidence to prove causality is limited, as is evidence-based guidance on how to manage these side effects. This article summarises the available evidence. For individuals who have new or worsening acne on progestogen-only contraception (POC), switching to combined hormonal contraception (CHC) is likely to improve their skin. Continuous or extended CHC use may be beneficial for individuals with premenstrual mood change, and for those who experience headaches in the hormone-free interval. Unpredictable bleeding patterns on POC are common. Injectable users can try reducing the interval between injections to 10 weeks. Implant, injectable or intrauterine system users can be offered a 3-month trial of a combined oral contraceptive pill (COC). CHC and POP users with unpredictable bleeding may benefit from switching to an alternative preparation.


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