The COCP

Question 1

What is UK MEC 3 for COCP?

Answer 1

> 35 and smoking <15 cigarettes a day
BMI >35
Family history of VTE <45 years
controlled HTN
Immobility
Known carrier of BRCA
Gallbladder disease

Question 2

What is UK MEC 4 for COCP?

Answer 2

> 35 years old smoking> 15 day
Migraine with aura
History of VTE
History of stroke or IHD
Breastfeeding <6 weeks postpartum
Uncontrolled HTN
Current breast cancer
Major surgery with prolonged immobilisation
Positive anti-phospholipid antibodies

Question 3

When started what is the efficacy of the pill?

Answer 3

If taken within first 5 days of cycle then effective immediately if not require barrier contraception for 7 days

Question 4

When might the efficacy be reduced?

Answer 4

If vomiting within 2 hours of taking COC
Liver enzyme inducing drug
Medication that induces vomiting or diarrhoea e.g. orlistat

Question 5

What does COCP increase the risk of?

Answer 5

VTE
Breast cancer
Cervical cancer
Stroke
IHD

Question 6

What happens if you miss 1 pill?

Answer 6

Take pill as soon as remember even if taking 2 pills on same day
No additional contraception needed

Question 7

What happens if 2 or more pills missed?

Answer 7

Take last pill even if 2 on one day. Ignore any other missed pills
If missed in week 1- emergency contraception if unprotected sex in pill free interval or week 1
If week 2- no additional requirements
If week 3- finish current pack and omit pill free interval