[Summary of the practice guideline 'Hormonal contraception' (second revision) from the Dutch College of General Practitioners].
When choosing a method of contraception, a woman must consider the pros and cons of various methods together with her family physician. In this process, the doctor provides information on the advantages and disadvantages, while the woman decides. A sub-50 pill of the second-generation preparation is the oral contraceptive of choice. If the woman chooses a newly developed method of contraception, she must be carefully informed about the uncertainties with regard to reliability and safety. Oral contraceptives are absolutely contra-indicated in the following cases: a history of myocardial infarction, stroke (CVA), venous thromboembolism, a known coagulation-factor deficiency, breast or endometrial carcinoma or severe liver-function disorders. Non-hormonal methods of contraception are preferred in such a case. If there are two or more risk factors for cardiovascular disease, the doctor and the patient must consider the pros and cons of hormonal contraception. In this connection, stopping smoking is more effective than not using an oral contraceptive. A prescription for an oral contraceptive can be given without a physical examination, not even a measurement of the blood pressure; follow-up is only necessary in the case of side effects or questions. Progestagen-only contraceptives are absolutely contraindicated in the following cases: current venous thromboembolism, vaginal bleeding of unknown origin, progestagen-dependent tumours such as breast cancer, and severe liver function disorders.
Nederlands Huisartsen Genootschap, afd. Richtlijnontwikkeling en Wetenschapsbeleid, Postbus 3231, 3502 GE Utrecht.
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D003278:Contraceptives, Oral, Hormonal / Q000008:administration & dosage* / Q000009:adverse effects*; D000075202:Contraindications; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D009369:Neoplasms / Q000139:chemically induced / Q000453:epidemiology; D010821:Physicians, Family; D018570:Risk Assessment; D012449:Safety; D013923:Thromboembolism / Q000139:chemically induced / Q000453:epidemiology; D014652:Vascular Diseases / Q000139:chemically induced / Q000453:epidemiology
D003278:Contraceptives, Oral, Hormonal