Evidence-based reproductive health: testing times for treatments.

Journal of Family Planning and Reproductive Health Care 2003: 29(3) Clinical scenario A 30-year-old woman consults you. She has been successfully using a progesterone-only pill (POP) containing levonorgestrel (LNG) (Microval®) but is anxious that her POP has a higher failure rate than her previous combined oral contraceptive pill (COC). She would prefer to continue some form of POP, having disliked depot medroxyprogesterone acetate (DMPA) in the past. She is unable to use combined oral contraception (COC) due to migraine with focal aura and has recently heard that a better POP is now available. You recall attending a recent update meeting on contraception where a couple of colleagues were enthusiastically advocating the new POP (Cerazette®), which contains 75 mg (microgrammes) desogestrel (DSG) and apparently has the efficacy of a COC. During lunch you had visited pharmaceutical company stalls and picked up the usual useful freebies, including some literature on Cerazette, a pocket calculator and a pen that writes a message backwards in Mandarin: