Adapted from Prescribing Oral Contraceptives, Current Therapeutics, April 1995 by Dr Edith Weisberg (Family Planning
Counseling prior to starting oral contraceptives
To encourage women to take their pill correctly , counseling prior to starting OC use is needed. Women should be shown exactly how to take the pill since packaging varies between many contraceptives brands. If an active pill is taken on day 1 of the cycle (i.e. the first day of menstrual bleeding ), the patient has immediate contraceptive cover. If started later in the cycle the patients need to either to avoid intercourse or use another method of contraception for 7 days. It is preferable to have the different pill packages available so that the patient can be shown the one it is proposed she use, and to check that she knows exactly where to start the pill and which are the inactive pill if a 28-day pack is used. Women need to be warned about the likelihood of breakthrough bleeding an increased breast tenderness in the first few cycles, and that periods will be lighter and shorter and that the blood lost may be darker in colour than in natural cycle. Any specific concerns that a woman has should be addressed. It is important that anyone prescribing OCs provides the woman with backup written material, in language that is easily understandable, to take home. Ideally, for women unable to read, other forms of information such as audiotapes should be available. (these are provided by some manufacturers).
|
No |
Examples |
|
1 |
Aviane® |
|
2 |
Apri® |
|
3 |
Brevicon® |
|
4 |
Demulen® |
|
5 |
Desogen® |
|
6 |
Estrostep® |
|
7 |
Genora® |
|
8 |
Jenest® |
|
9 |
Leylite® |
|
10 |
Lo/Oyral® |
|
11 |
Microgestin® |
|
12 |
Modicon® |
|
13 |
Nortrel® |
|
14 |
Ogestrel® |
|
15 |
Oycon® |
|
16 |
Seasonale® |
|
17 |
Trivora® |
|
18 |
Yasmin® |
|
19 |
Triphasil® |
|
20 |
Zovia® |
Adapted from Prescribing Oral Contraceptives, Current Therapeutics, April 1995 by Dr Edith Weisberg (Family Planning
Oral contraceptives provide a very effective and save method of contraception provided that a careful medical history is taken. The choice of formulation for individual women depends upon her medical history, with use of the lowest dose which is consistent with good cycle control and fewest metabolic changes recommended.
Careful counseling is required when women start OCs, with instruction on how to take the pill and what to do if there is a missed pill or if there is inter-current drug use such as antibiotics.
By providing adequate information, counseling and careful selection of an appropriate formulation as well as dealing appropriately with adverse effects such as breakthrough bleeding, the failure and continuation rates of OCs can be improved.