title: Contraindications to progestin-only oral contraceptive pills among reproductive-aged women.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
authors.forename: Kari
authors.initials: K
authors.lastname: White
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Potter
authors.forename: Kristine
authors.initials: K
authors.lastname: Hopkins
authors.forename: Leticia
authors.initials: L
authors.lastname: Fernández
authors.forename: Jon
authors.initials: J
authors.lastname: Amastae
authors.forename: Daniel
authors.initials: D
authors.lastname: Grossman
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects; D000995:Antitubercular Agents / Q000009:adverse effects; D001943:Breast Neoplasms / Q000453:epidemiology; D057189:Checklist; D003278:Contraceptives, Oral, Hormonal; D000075202:Contraindications; D059026:Diagnostic Self Evaluation; D004347:Drug Interactions; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000453:epidemiology; D008800:Mexico; D008875:Middle Aged; D004366:Nonprescription Drugs; D055553:Prescription Drugs; D015995:Prevalence; D011372:Progestins; D011446:Prospective Studies; D013781:Texas / Q000453:epidemiology
chemical_list: D000927:Anticonvulsants; D000995:Antitubercular Agents; D003278:Contraceptives, Oral, Hormonal; D004366:Nonprescription Drugs; D055553:Prescription Drugs; D011372:Progestins