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GPs go forth

GPs can safely prescribe a years’ worth of contraceptives at the first consultation

GPs can safely prescribe one years’ worth of combined hormonal contraception (CHC) - instead of three months’ worth - at the first consultation, according to new guidelines.

The updated recommendations from the Faculty of Sexual and Reproductive Healthcare (FSRH) also said consultations on CHC do not have to take place face-to-face, with online consultations also being acceptable.

This comes as a recent Public Health England survey found that 80% of women using contraceptive pills received them from the GP, although more than half would prefer to receive them elsewhere, such as in a pharmacy or online.

Under the new guidelines, women can also avoid monthly bleeding and the accompanying symptoms, by running pill packets together and taking fewer, or even no, breaks.

This is safe, and could potentially reduce the risk of pregnancy – as breaks can lead to pills, patches or rings being missed, the guidance said.

FSRH vice president for clinical quality Dr Diana Mansour said: ‘The riskiest time to miss pills is at the beginning and the end of a pill-free interval.

‘The guideline suggests that by taking fewer hormone-free intervals - or shortening them to four days – it is possible that women could reduce the risk of getting pregnant on combined hormonal contraception.’

Women on the combined contraceptive pill have traditionally taken a seven day break at the end of each 21-pill packet.

During this monthly break from pill-taking there is usually a bleed and some women have symptoms like period pain, headache and mood change.

In the same way, women using combined contraceptive patches or rings have taken a seven-day break after every 21 days of use.

Readers' comments (8)


    Easy to say when the prescriber carries medico-legal risk for complications and side effects
    keep it safe

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  • What about the patient with undetected Von Leiden deficiency ? The patient whose BP rises with oestrogen ? The patient who develops focal migraines ?

    For the majority this will be fine , but not for all patients.

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  • doctordog.

    Doctor, the dog has just eaten my years supply of pills.
    Can I have some more?

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  • i give 3 months initially to see if the patient likes it or not then given yearly scripts as 2 x 6m lots so can remind patient to come in for a annual pill check, not everyone gets on with the coc so its daft to supply 12m first off. some patients like having regular periods and some don't, giving people a choice that suits them is better at improving compliance.

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  • Oh, so now goal posts have moved again. Keeps bureaucrats in their jobs.

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  • Oh come on,
    We moan about extra work then we moan when it is taken away. What is the evidence against yearly scripts? Oh....... listen to the tumbleweeds. And do you check 3 monthly Viagra scripts? Thought not.

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  • first consultation is most important. give 3 months supply. if all ok then give 6 monthly script and annual review .

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  • I agree a pragmatic approach is needed. For women who have been on c.o.c. many years with no problems, then this suggests in future we can give them a 12 month supply and not have to force them to come in for a review every 6 months.

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