Abstract
The combined oral contraceptive pill is the most popular method of contraception worldwide, with modern low-dose formulations significantly improving tolerability. Breakthrough bleeding is the most significant adverse event associated with the low-dose combined oral contraceptives. Monophasic, biphasic, triphasic and progestogen-only preparations are available, and the choice of formulation should be tailored to best suit the patient. Any areas of uncertainty or concern that the patient has should be addressed, and the patient should be clearly informed of how to use the oral contraceptive effectively, the likely initial adverse effects and what to do if a pill is missed.
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