Oral contraceptives

There are a plethora of different combined oral contraceptive (COC) formulations marketed in Australia, containing variable doses of ethinyloestrodiol and different progestogens, which clinically may have different effects. The number available will be further increased as new preparations are marketed.

This article aims to provide guidelines to assist general practitioners in prescribing COCs for women with different clinical conditions and needs.

Although for the majority of healthy women who take COCs, any low dose combined pill will be appropriate, women with risk factors or certain conditions such as epilepsy need to be given careful consideration when prescribing. Venous thromboembolism, although rare, is the commonest serious side effect associated with COC use. The risk increases with age, obesity, smoking, and a variety of medical conditions. These women need to be advised of the risk associated with different progestogens and be involved in the decision about which pill to take.