COCP

Question 1

What is COCP?

Answer 1

Combined oral contraceptive pill containing oestrogen and progesterone hormones

• 99% effective if taken correctly
• EG: MICROGYNON

Question 2

What is the MOA of COCP?

Answer 2

Main: Stops ovulation

Also

• Increases cervical mucus (reduces chance of sperm getting through)
• Thins endothelium (reduces chance of implantation

Question 3

What advice should be given about how to take the COCP?

Answer 3

STARTING

• If start within first 5 days of period no need for additional protection
• If not need to use condom for 7 days

COURSE

• Take pill everyday for 21 days then 7 days without pill and withdrawal bleed
• Only protected during withdrawal if start pill on time

MISSED PILL

• Miss 1 = take asap even if taking two on one day then resume normal
• Miss 2 = take asap + extra protection for 7 days
• Miss pills on week 1 = emergency contraception
• Miss pills week 2 = no emergency needed
• Miss pills week 3 = continue taking w/o withdrawal period

ANTIBIOTIC USE
-No longer need for extra protection

Question 4

What are contraindications to COCP?

Answer 4

• Smoker >35yrs
• > 50 yrs
• Migraine with aura
• Hx of HTN/DVT/PE/MI/stroke/TIA
• FHx stroke
• Breast cancer
• BMI >40
• Enzyme inducers e.g. Rifampicin, antiepileptics, St John’s Wort, barbiturates

Question 5

What are the side effects and risks of taking COCP?

Answer 5

HORMONAL

• Mood changes, GI effects, headaches
• ?weight gain

RISKS

• Small clots
• MI/Stroke/TIA
• Breast & cervical cancer (back to normal when stop)

Question 6

What are the benefits of taking COCP?

Answer 6

• Acne
• Regular cycle
• Lighter periods
• Less painful periods
• Protects against ovary and womb cancer