FFPRHC Guidance (October 2003): First Prescription of Combined Oral Contraception

Journal of Family Planning and Reproductive Health Care 2003: 29(4) What is combined oral contraception (COC)? Combined oral contraception (COC) is the most commonly used contraceptive method by women aged 16 to 49 years.2 This Guidance provides evidence-based recommendations and good practice points for clinicians advising women considering their first prescription of COC. A holistic approach to contraceptive provision involves considering the individual’s overall sexual and reproductive health needs. By informing women of potential risks, benefits and uncertainties in language they can understand, clinicians can enable women to reach their own contraceptive choices. Access for women can be enhanced by service innovations such as nurse prescribing, Patient Group Directions and convenient clinic times. In current practice, low-dose COCs, containing 20–35 micrograms (mg) ethinyl oestradiol (EE) in combination with a progestogen, have generally replaced older COCs containing 50 mg EE or more. In this Guidance, the term COC refers to low-dose (20–35 mg EE) monophasic preparations, unless otherwise stated. Progestogens include: norethisterone and levonorgestrel; desogestrel and gestodene; norgestimate; and the newest progestogen, drospirenone. The terms ‘second’ and ‘third’ generation can be confusing and unhelpful and so will not be used in this Guidance.