Combined OCPs Choosing the right one for your patient ā MM1604
With so many combined oral contraceptive pills available, each patient must beĀ assessed individually to choose the right one. Noncontraceptive effects and sideĀ effect profiles must be considered when making this choice.
The progestogen component is responsible for the primary contraceptiveĀ effect in a contraceptive preparation, while the oestrogen component of theĀ combined oral contraceptive pill (COCP) is associated with the more seriousĀ side effects of venous thromboembolism and cardiovascular and cerebrovascularĀ events; however, it is responsible for the noncontraceptive benefits of theĀ COCP, such as improvements in acne, hirsutism and cycle control.Ā The qualities of a COCP are governed by the dose of the compounds it containsĀ and the interactions between them.
When starting a COCP, a woman should generally be commenced on a preparationĀ containing either levonorgestrel or norethisterone; however, if the initialĀ choice does not suit the patient or noncontraceptive benefits drive the decision,Ā a preparation containing one of the newer progestogens could be considered.Ā Monitoring for minor and major risk factors should occur every six months.
Modern Medicine ā AprilĀ 2016
