Combined Oral Contraceptive Pill

Key points

• COCP: oestrogen + progestogen — inhibits ovulation (mainly progestogen effect on LH/FSH).
• Contraindications include: VTE history, migraine with aura, smokers ≥ 35 years (> 15/day), breast cancer, uncontrolled hypertension.
• Risks: VTE (small absolute risk), hypertension, stroke/MI (in smokers > 35).
• Missed pill rules depend on preparation; enzyme-inducing drugs reduce efficacy.
• Benefits: reduced ovarian/endometrial cancer risk, cycle control.

Decision points in this pathway

• Contraindication? (VTE history · migraine with aura · smoker ≥ 35 y · breast cancer · uncontrolled HTN)

The full step-by-step algorithm, including what to do at each branch, opens in the app for approved members.