Prescribing the oral contraceptive pill: key considerations for primary care physicians.

Abstract

Despite the apparent simplicity in the two options available, the combined oral contraceptive pill (COCP) vs. the progestogen-only pill (POP), choosing the right oral contraceptive pill can be challenging. With an increasing number of preparations and their inherently varying pharmacological properties, several factors require consideration when prescribing in the primary care setting.1 Assuming this is the most appropriate method of contraceptive cover, the aim of this article is to provide primary care physicians (PCPs) with a series of key considerations when counselling women on the oral contraceptive pill. One of the initial considerations for all PCPs is deciding between the COCP or POP. With detailed guidance on the safety profile of the oral contraceptive pill available from the UK Medicine Eligibility Criteria (UK MEC),2 a summary of the key patient characteristics and medical conditions favouring the use of the POP, over the COCP, has been listed in Table 1. View this table: Table 1. Summary of patient characteristics and medical conditions more suitable for POP compared with COCP However, compared with the COCP, PCPs must be clear when counselling women of the higher risk of unscheduled bleeding along with the implication of a ‘missed pill’ with the POP.3 While desogestrelcontaining POPs have a longer window for …