What is the mode of action of Combined oral contraceptive pill?

Inhibits ovulation

Whats the failure rate of the Combined oral contraceptive pill?

< 1 per 100 woman years

What effect does the Combined oral contraceptive pill have on periods?

usually makes periods regular, lighter and less painful

Which cancers does Combined oral contraceptive pill have a protective effect against?

reduced risk of ovarian, endometrial, colorectal cancer

What effect may Combined oral contraceptive pill towards acne vulgaris?

may improve

Which cancers are you at increased risk of with Combined oral contraceptive pill?

breast and cervical cancer

What are the common temporary side effects of Combined oral contraceptive pill?

headache, nausea, breast tenderness

What are the main risks of taking Combined oral contraceptive pill?

• small risk of blood clots
• very small risk of heart attacks and strokes
• increased risk of breast cancer and cervical cancer

Regards to smoking what is an absolute (UKMEC 4) contraindications for taking Combined oral contraceptive pill?

more than 35 years old and smoking more than 15 cigarettes/day

What excising medical conditions are absolute contraindications (UKMEC 4) for taking Combined oral contraceptive pill?

• thromboembolic disease or thrombogenic mutation
• stroke or ischaemic heart disease
• uncontrolled hypertension
• current breast cancer
• positive antiphospholipid antibodies

When can you start taking Combined oral contraceptive pill if you are breastfeeding ?

6 weeks post-partum

Can you take Combined oral contraceptive pill with migraine with aura?

no, unacceptable health risk

What are the relative contraindications (UKMEC 3) of Combined oral contraceptive pill?

• more than 35 years old and smoking less than 15 cigarettes/day
• BMI > 35 kg/m^2*
• family history of thromboembolic disease in first degree relatives < 45 years
• controlled hypertension
• immobility e.g. wheel chair use
• carrier of known gene mutations associated with breast cancer (e.g. BRCA1/BRCA2)
• current gallbladder disease

When in the menstrual cycle would the Combined oral contraceptive pill need to be started for it to take immediate effect?

within the first 5 days

If not starting in the first 5 days of the menstrual cycle how long does someone need to use additional protection when starting the Combined oral contraceptive pill?

7 days

When is the conventional pattern of taking the Combined oral contraceptive pill?

conventionally taken for 21 days then stopped for 7 days

When may the Combined oral contraceptive pill effectiveness be reduced?

• vomiting within 2 hours of taking COC pill
• medication that induce diarrhoea or vomiting may reduce effectiveness of oral contraception (for example orlistat)
• if taking liver enzyme-inducing drugs

When taking the Combined oral contraceptive pill, what should be done after missing one pill?

take the last pill even if it means taking two pills in one day and then continue as normal

When taking the Combined oral contraceptive pill, what should be done after missing two or more pills?

• take the last pill even if it means taking two pills in one day, then continue taking as normal
• use additional protection until 7 tablets have been taken in a row