Starting the new patient on oral contraceptives

There are many considerations prior to starting a patient on oral contraceptives (OCs). A careful history and physical examination should be obtained, as should laboratory studies where indicated. In addition to the absolute and relative contraindications to OCs, the benefits should be reviewed with the patient. During therapy, the patient should be advised regarding potential minor side effects as well as serious signs and symptoms. There appears to be little difference in efficacy or side effects of monophasic vs. multiphasic contraceptives. It is recommended that a pill containing the lowest hormonal content, and thus with the least potential for side effects (ie, 35 micrograms of ethinyl estradiol), be utilized.