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Practice guidelines for OC selection.


 Clinical practice guidelines are important to clarify the potential risks, benefits, and costs of available interventions. Although oral contraceptives (OCs) are the most popular reversible method of fertility control in the US, there are at present no evidence-based guidelines for OC selection. Toward this end, members of the Editorial Board of "Dialogues in Contraception" met to develop initial guidelines for OC selection that reflected both a reasonable interpretation of the available literature and the authors' clinical experiences. Today's OCs contain differing types and doses of estrogen. The central principle in OC prescribing should be that the formulation selected contains the least amount of estrogen and progestin that is possible given the patient's needs. These guidelines divide available OCs into categories of low, medium, and high androgenic activity of the progestin component. The low androgenic progestin-containing OCs are associated with reduced side effects, improved cycle control, improved lipoprotein profile, and enhanced tolerability. Included with the guidelines are tables that classify OCs by their composition, identify OCs with the potential to minimize or manage unwanted side effects, recommend formulations for women with medical conditions, and outline use of OCs for the treatment of gynecologic symptoms.
