Review and update on oral contraceptives for the psychiatric practitioner

Abstract

Oral contraceptive therapy is used by many women of contraceptive age. Although an effective contraceptive, other uses include menstrual problems such as menorrhagia and dysmenorrhea and premenstrual syndrome. Because of the prevalence of use, psychiatric practitioners should be familiar with their components and educational tools that improve product selection and patient compliance. Oral contraceptives containing ethinyl estradiol 35 mcg or less are used by most women today. Much of the documentation of adverse effects are from the higher dose products used in the past. Many women are not aware of the many noncontraceptive benefits such as decreased incidences of breast and ovarian cancer and improvements in menstrual problems. Oral contraceptives are associated with increased thromboembolic disease, but the risk is less than the risk in pregnancy. Other health risks have not been conclusively proven or the increased risk is so small that the benefits often outweigh the risks. Drug interactions with commonly encountered concomitant drugs are also discussed.