Abstract

About one quarter of women in Britain aged 18–44 use oral contraceptives,¹ and almost half of those aged 20–29.² Many will use more than one type during their years of sexual activity. Changes will occur as new products are introduced and new risks identified or in response to unwanted effects. Decisions may also be prompted by the need to restart oral contraception after a break as part of planned parenthood. Oral contraception is chosen chiefly because it is reliable and does not interrupt spontaneous sexual activity. Whether a combined oral contraceptive pill (COC) or a progestagen-only pill (POP) would be the more appropriate depends mainly on the woman’s medical history, smoking habits and age. Most women will want good cycle control, and a few will prefer to take an inactive pill for a few days in each cycle rather than have a pill-free interval. This article discusses the choice when starting, restarting or switching oral contraception.