••• Chapter 61^ Family Planning and Sterilization^613
❍ When should the woman prescribed emergency contraception expect her menses?
Within a few days of her normal menses. It may be a few days early or late. If >2 weeks pass with no menses, she
should take a pregnancy test.
❍ What to do when pills are missed?
Scenario What to Do? Backup Method Needed?
1 pill is missed Take pill as soon as possible and
resume scheduleNone needed2 pills missed in the first 2 weeks Take 2 pills on each of the next
2 days and finish packNeed for backup method minimal
but recommended for 7 days
2 pills missed in the 3rd week Start new pack or if Sunday
start—take one pill until Sunday
and start new packStart immediately and for 7 daysMore than 2 active pills are
missed at any timeStart new pack or if Sunday
start—take one pill until Sunday
and start new packStart immediately and for 7 days❍ What are noncontraceptive benefits of COCs?
Treats menstrual cycle disorders, acne, hirsutism; reduces risk of ovarian and endometrial, and colon cancers;
improves pain from endometriosis; and prevents development of functional ovarian cysts.
❍ How much is menstrual blood flow decreased by pill use?
Up to 43%. It is less effective than the levonorgestrel IUD (see section on IUD).
❍ Pill use decreases the incidence of functional cysts by?
80% to 90%. Oral contraceptives suppress follicle-stimulating hormone (FSH) and luteinizing hormone (LH)
ovarian stimulation. They do not make an existing cyst regress more quickly.
❍ For the treatment of PMS, which type of pill is more effective?
Oral contraceptives containing progestin, drospirenone, and those with a shorter pill-free interval are more
effective than placebo.
❍ For women using oral contraceptives, what is their reduction in risk of ovarian cancer?
The relative risk of developing ovarian cancer in women with any use of oral contraceptives is 0.73. Additionally,
the protective effect lasted 30 years after discontinuing the pills.
❍ For women using oral contraceptives for at least 2 years, what is the reduction in risk of endometrial cancer?
Women who use oral contraceptives for at least 12 months had a relative risk of 0.6. The protective effect lasted for
at least 15 years after discontinuing the pills.