Oral contraceptive pills.

OCP is a combination of ethinyl oestradiol and progesterone. They inhibit ovulation and make the cervical mucus thick, there by inhibiting the sperm penetration.

Advantages: effective contraception; less painful periods; reduced premenstrual syndrome; decreased risk of ovarian tumours and endometrial carcinoma; ?PID and endometriosis.

Disadvantages: increased risk of arterial and venous disease i.e. DVT and MI. increased risk of breast cancer. It doesn't protect against STD.

How and when to start: day 1 of the menstrual cycle, on the day of ToP, 3 weeks postpartum, 2 weeks after full mobilization after major surgery.

Stopping the pill: stop the pill in case of sudden severe chest pain, sudden breathlessness, severe calf pain, severe stomach pain, unusual severe prolonged headache.

Absolute contraindications: cardiovascular disease, liver disease, focal migraine, undiagnosed uterine bleeding, gross obesity, immobility, abnormal lipid profile, and recent trophoblastic disease.

Relative contraindications: Prescribe with caution in those with a family history of MI, HTN, DVT and breast cancer; epilepsy, sickle cell disease, DM, severe migraine and oligomenorrhoea, heavy smokers, abnormal cervical smear.