First ask a few questions

‘First, I need to ask a few questions about your health and relationships to decide which methods are most appropriate for you…’

• Age
• Relationship (regular partner/multiple partners)
• Menstrual history
• Previous contraception and chance of pregnancy
• Are they post-partum or breast feeding?
• PMHx: current conditions, past history, STIs, past obstetric history/previous ectopic pregnancies
• DHx
• Contraindications to COCP
  • Smoking (+ age >35)
  • Hx/FHx of
    • Venous thromboembolism
    • Breast/cervical cancer
    • Migraine with aura

What they like and what they know

• Ask them what they are hoping to get out of the consultation and what they know so far (let the patient lead the consultation)
• Try to determine which type of method will be most appropriate
  • Any preferences 
  • Preferred administration method
  • Ability to remember to take pills
  • Tolerance of injections

Describe a method in more detail

• How it works
• Treatment course
• Side effects/risks (and effects on menstrual cycles)
• Positives vs. negatives

Briefly discuss other options

• Mention alternatives

Ending

• Let the patient think about it and advise them they can return again if they wish to discuss other options
• Summarise
• Give leaflets and recommend websites

Learn about contraception here!

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1. Initiating the COCP
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