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Initiation of oral contraceptives using a quick start compared with a conventional start: a randomized controlled
Carolyn Westhoff1, Stephen Heartwell, Sharon Edwards
1Department of Obstetrics and Gynecology, Columbia University, New York, New York, USA.
Obstetrics and Gynecology
|June 2, 2007
Summary
Starting oral contraceptive pills immediately (Quick Start) improved short-term continuation compared to waiting for menses. This approach was acceptable to most young women and did not increase adverse events, aiding contraceptive initiation.
Area of Science:
- Reproductive Health
- Contraception
- Public Health
Background:
- Initiating oral contraceptive pills (OCP) often involves waiting periods.
- These waiting protocols may act as barriers to consistent contraceptive use.
- Optimizing OCP initiation is crucial for preventing unintended pregnancies.
Purpose of the Study:
- To compare continuation rates and pregnancy rates between immediate OCP initiation (Quick Start) and conventional initiation.
- To assess the acceptability and safety of the Quick Start method in young women.
Main Methods:
- A randomized controlled trial involving 1,716 women under 25 years old initiating OCPs.
- Participants were assigned to either Quick Start (immediate pill intake) or conventional start (waiting for menses).
- Follow-up interviews were conducted at 3 and 6 months to assess outcomes.
Main Results:
- Quick Start improved continuation to the second OCP pack but not overall 3- or 6-month continuation.
- Pregnancy rates were slightly lower in the Quick Start group (HR 0.90).
- 81% of women found Quick Start acceptable or preferable, with low adverse event rates.
Conclusions:
- Waiting to start oral contraceptives is a significant barrier to initiation.
- Directly observed, immediate initiation (Quick Start) enhances short-term OCP continuation.
- Quick Start is an acceptable and safe method for initiating oral contraceptives.
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