Progestin-only oral contraceptive pills (POPs) have fewer contraindications to use compared to combined pills. However, the overall prevalence of contraindications to POPs among reproductive-aged women has not been assessed.
We collected information on contraindications to POPs in two studies: (1) the Self-Screening Study, a sample of 1267 reproductive-aged women in the general population in El Paso, TX, and (2) the Prospective Study of OC Users, a sample of current oral contraceptive (OC) users who obtained their pills in El Paso clinics (n=532) or over the counter (OTC) in Mexican pharmacies (n=514). In the Self-Screening Study, we also compared women's self-assessment of contraindications using a checklist to a clinician's evaluation.
Only 1.6% of women in the Self-Screening Study were identified as having at least one contraindication to POPs. The sensitivity of the checklist for identifying women with at least one contraindication was 75.0% [95% confidence interval (CI): 50.6%–90.4%], and the specificity was 99.4% (95% CI: 98.8%–99.7%). In total, 0.6% of women in the Prospective Study of OC Users reported having any contraindication to POPs. There were no significant differences between clinic and OTC users.
The prevalence of contraindications to POPs was very low in these samples. POPs may be the best choice for the first OTC oral contraceptive in the United States.
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- Use of contraception in the United States, 1982–2008.Vital Health Stat. 2010; 23: 1-44
- Should oral contraceptives be available without prescription?.Am J Public Health. 1993; 83: 1094-1099
- Changing oral contraceptives from prescription to over-the-counter status: an opinion statement of the Women's Health Practice and Research Network of the American College of Clinical Pharmacy.Pharmacotherapy. 2011; 31: 424-437
- Should oral contraceptives be sold over-the-counter? No.Contemporary OB/GYN. 2008; 53: 63-74
- Cardiovascular disease and use of oral and injectable progestin-only contraceptives and combined injectable contraceptives: results of an international, multicenter, case-control study.Contraception. 1998; 57: 315-324
- U.S. medical eligibility criteria for contraceptive use.Morb Mortal Wkly Rep. 2010; 59: 1-86
- Contraindications to oral contraceptive use among women in the United States, 1999–2001.Contraception. 2007; 75: 355-360
- Accuracy of self-screening for contraindications to combined oral contraceptive use.Obstet Gynecol. 2008; 112: 572-578
- Contraindications to combined oral contraceptives among over-the-counter and clinic pill users.Obstet Gynecol. 2011; 17: 558-565
- Agreement between women's and providers' assessment of hormonal contraceptive risk factors.Contraception. 2006; 73: 501-506
- Clinic versus over-the-counter access to oral contraception: choices women make in El Paso, Texas.Am J Public Health. 2010; 100: 1130-1136
- Medical eligibility criteria for contraceptive use.3rd ed. WHO, Geneva2004
- Clinical calculator 1. From an observed sample: estimates of population prevalence, sensitivity, specificity, predictive values and likelihood ratios.(Available at:)
- Progestin-only pills for contraception.Cochrane Database Syst Rev. 2010; ([Art. No.: CD007541])https://doi.org/10.1002/14651858.CD007541.pub2
- Contraceptive failure in the United States.Contraception. 2011; 83: 397-404
- Considerations for the use of progestin-only contraceptives.J Am Acad Nurse Pract. 2010; 22: 81-91
- Progestin-only pills.in: Hatcher R.A. Trussell J. Nelson A.L. Contraceptive technology. 19th ed. Ardent Media, Inc., New York2007: 181-191
- Bleeding problems and progestin-only contraception.J Fam Plann Reprod Health Care. 2002; 28: 178-181
- A double-blind study comparing the contraceptive efficacy, acceptability and safety of two progestogen-only pills containing desogestrel 75 micrograms/day or levonorgestrel 30 micrograms/day.Eur J Contracept Reprod Health Care. 1998; 3: 169-178
- A comparison of the inhibition of ovulation achieved by desogestrel 75 μg and levonorgestrel 30 μg daily.Hum Reprod. 1999; 14: 982-985
- Maintenance of ovulation inhibition with the 75 μg desogestrel-only contraceptive pill (Cerazette) after scheduled 12-h delays in tablet intake.Contraception. 2005; 71: 8-13
Published online: February 27, 2012
Accepted: January 17, 2012
Received in revised form: January 16, 2012
Received: November 30, 2011
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.