Combined Contraceptive Pill: Counselling

Question 1

What should you advise regarding the harms and benefits of the COCP?

Answer 1

• The COC is > 99% effective if taken correctly
• Small risk of blood clots
• Very small risk of heart attacks and strokes
• Increased risk of breast cancer and cervical cancer
• It does not protect against STIs

Question 2

What advice should you give them regarding taking the pill?

Answer 2

• Timing the COCP with your Menstrual Cycle
  
  • If started within the first 5 days of the cycle –> no other contraception needed.
  • If it is started at any other point in the cycle then alternative contraception should be used (e.g. condoms) for the first 7 days
• Take at the same time everyday.
• Taken for 21 days then stopped for 7 days - similar uterine bleeding to menstruation
• Advice that intercourse during the pill-free period is only safe if the next pack is started on time.

Question 3

What discussion should you have regarding situations where the efficacy of the pil may be reduced?

Answer 3

• If vomiting within 2 hours of taking the COCP
• If taking liver enzyme inducing drugs

Question 4

Do precautions need to be taken when using antibiotics?

Answer 4

No

Except if using rifampicin