CONTRACEPTION

Same-day start-up for OCs improves compliance

Westhoff C, Kerns J, Morroni C, Cushman LF, Tiezzi L, Murphy PA. Quick Start: a novel oral contraceptive initiation method. Contraception. 2002;66:141–145.

Many women never start the oral contraceptive we prescribe. They have to wait for their next menses, and they may fail to fill the prescription; 25% of study participants never start their oral contraceptives.

Quick Start starts the contraceptive in the clinic, after a negative pregnancy test, regardless of the day of the patient’s cycle. She is given at least 1 pack so she does not have to go to the drug store to fill the first prescription. Emergency contraception is given to patients who may need it. The continuation rate to the second cycle was higher in women beginning the pill in the clinic than those who started at any point in their cycle but waited to fill the prescription.

The original oral contraceptives were started on the first Sunday of a menstrual cycle so that it was known the woman was not pregnant and so she would bleed midweek. Waiting until menses assured a possible pregnancy was not exposed to hormonal contraceptives; however, the components of oral contraceptives are not teratogenic. The contraceptive can therefore be started at anytime during the cycle and starting in the clinic increases compliance. A pregnancy test can be performed if the anticipated menses at the end of the pill pack does not occur.

Disclosure

The author is on the speakers bureaus for Barr, Berlex, and Wyeth-Ayerst.