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