Sexual Health

June 2009

FocusSexual Health

Catching up on contraception

Volume 38, No.6, June 2009 Pages 380-382

Katrina Allen

Background

Providing contraceptive advice is a core activity in general practice. There have been numerous changes to the contraceptive options available in Australia over the past 10 years. It is important that general practitioners are aware of these changes so that they can advise patients appropriately.

Objective/s

This article examines the changes that have occurred in contraception over the past decade and discusses the implications of these changes to clinical practice.

Discussion

Up-to-date knowledge about how the combined oral contraceptive pill works is reflected in changes to packaging and formulations, with varying success. Other changes include the over-the-counter availability of emergency contraceptive pills and the new combined hormonal vaginal ring. There has been a resurgence in intrauterine device use and their insertion has Level 1 (nonprocedural) indemnity status in most medical defence organisations. Bleeding with long acting progestogen only contraception remains a problem and management options include antiprostaglandins, tranexamic acid, doxycycline, the combined oral contraceptive pill and removal of the device. Sterilisation remains an option for older men and women and newer methods are available.

Currently the most common contraceptive choice in Australia is the combined oral contraceptive pill (COCP) – known widely as ‘the pill’.1 Most doctors recognise the flexibility and simplicity of the monophasic preparations as the choice for first oral contraception.

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Correspondence afp@racgp.org.au

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