Skip to main content
SpringerLink
Log in

Combination Oral Contraceptive Pills

  • Chapter
  • First Online:
The Handbook of Contraception

Part of the book series: Current Clinical Practice ((CCP))

  • 920 Accesses

Abstract

Combination oral contraceptive pills (COCs) have been available in the United States for over 50 years and are the most common single form of contraception used by US women. Up to 82% of women who have ever been sexually active have used COCs, and 19.4% of reproductive age women who use contraception report current COC use. Combined oral contraceptive pills have two hormonal components, an estrogen and a progestin. COCs are considered second-tier contraceptives due to their typical use failure rate of 7%. COCs have many noncontraceptive benefits and may be used by some women to improve menstrual patterns, lessen dysmenorrhea, or ameliorate acne.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Bibliography

  1. Amsden G, Mohamed M, Menhinick A. Effect of hormonal contraceptives on the pharmacokinetics of trovafloxacin in women. Clin Drug Investig. 2001;21(4):281–6.

    CAS  Google Scholar 

  2. Brinton LA, Vessey MP, Flavel R, Yeates D. Risk factors for benign breast disease. Am J Epidemiol. 1981;113(3):203–14.

    CAS  PubMed  Google Scholar 

  3. Brody SA, Turkes A, Goldzieher JW. Pharmacokinetics of three bioequivalent norethindrone/mestranol-50 micrograms and three norethindrone/ethinyl estradiol-35 micrograms OC formulations: are “low-dose” pills really lower? Contraception. 1989;40(3):269–84.

    CAS  PubMed  Google Scholar 

  4. Casper RF, Dodin S, Reid RL, Study Investigators. The effect of 20 μg of ethinyl estradiol/1 mg norethindrone acetate (Minestrin™), a low-dose oral contraceptive on vaginal bleeding patterns, hot flashes, and quality of life in symptomatic perimenopausal women. Menopause. 1997;49:47–55.

    Google Scholar 

  5. Centers for Disease Control and Prevention (CDC). U.S. medical eligibility criteria for contraceptive use, 2016. MMWR Recomm Rep. 2016;65(3):1–55.

    Google Scholar 

  6. Chasan-Taber L, Willett WC, Manson JE, Spiegelman D, Hunter DJ, Curhan G, Colditz GA, Stampfer MJ. Prospective study of oral contraceptives and hypertension among women in the United States. Circulation. 1996;94:483–9.

    CAS  PubMed  Google Scholar 

  7. Chiaffarino F, Parazzini F, La Vecchia C, Ricci E, Crosignani PG. Oral contraceptive use and benign gynecologic conditions. A review. Contraception. 1998;57(1):11–8.

    CAS  PubMed  Google Scholar 

  8. Christensen JT, Boldsen JL, Westergaard JG. Functional ovarian cysts in premenopausal and gynecologically healthy women. Contraception. 2002;66(3):153–7.

    PubMed  Google Scholar 

  9. Coffee AL, Sulak PJ, Kuehl TJ. Long-term assessment of symptomatology and satisfaction of an extended oral contraceptive regimen. Contraception. 2007;75(6):444–9.

    PubMed  Google Scholar 

  10. Combination oral contraceptive use and the risk of endometrial cancer. The Cancer and Steroid Hormone Study of the Centers for Disease Control and the National Institute of Child Health and Human Development. JAMA. 1987;257(6):796–800.

    Google Scholar 

  11. Committee on Adolescent Health Care Long-Acting Reversible Contraception Working Group, The American College of Obstetricians and Gynecologists, Committee opinion no. 539: adolescents and long-acting reversible contraception: implants and intrauterine devices. Obstet Gynecol. 2012;120(4):983–8.

    Google Scholar 

  12. Contraception for adolescents. Pediatrics. 2014;134(4):e1244–56.

    Google Scholar 

  13. Daniels K, Abma JC. Current contraceptive status among women aged 15–49: United States, 2015–2017. NHCS Data Brief No. 327, 2018.

    Google Scholar 

  14. Daniels K, Mosher WD. Contraceptive methods women have ever used: United States, 1982–2010. Natl Health Stat Rep. 2013(62):1–15.

    Google Scholar 

  15. Davis A, Godwin A, Lippman J, Olson W, Kafrissen M. Triphasic norgestimate-ethinyl estradiol for treating dysfunctional uterine bleeding. Obstet Gynecol. 2000;96(6):913–20.

    CAS  PubMed  Google Scholar 

  16. Dehlendorf C, Levy K, Kelley A, Grumbach K, Steinauer J. Women’s preferences for contraceptive counseling and decision making. Contraception. 2013;88(2):250–6.

    PubMed  Google Scholar 

  17. Dewis P, Petsos P, Newman M, Anderson DC. The treatment of hirsutism with a combination of desogestrel and ethinyl oestradiol. Clin Endocrinol. 1985;22(1):29–36.

    CAS  Google Scholar 

  18. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC). U.S. selected practice recommendations for contraceptive use, 2016. MMWR Recomm Rep. 2016;65(4):123–60.

    Google Scholar 

  19. Edelman A, Micks E, Gallo MF, Jensen JT, Grimes DA. Continuous or extended cycle vs. cyclic use of combined hormonal contraceptives for contraception. Cochrane Database Syst Rev. 2014;7:CD004695.

    Google Scholar 

  20. Effects of contraceptives on hemoglobin and ferritin. Task Force for Epidemiological Research on Reproductive Health, United Nations Development Programme/United Nations Population Fund/World Health Organization/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland. Contraception. 1998;58(5):262–73.

    Google Scholar 

  21. Foster DG, Hulett D, Bradsberry M, Darney P, Policar M. Number of oral contraceptive pill packages dispensed and subsequent unintended pregnancies. Obstet Gynecol. 2011;117(3):566–72.

    PubMed  Google Scholar 

  22. Franks AL, Beral V, Cates W Jr, Hogue CJ. Contraception and ectopic pregnancy risk. Am J Obstet Gynecol. 1990;163(4 Pt 1):1120–3.

    CAS  PubMed  Google Scholar 

  23. Fraser IS, McCarron G. Randomized trial of 2 hormonal and 2 prostaglandin-inhibiting agents in women with a complaint of menorrhagia. Aust N Z J Obstet Gynaecol. 1991;31(1):66–70.

    CAS  PubMed  Google Scholar 

  24. Friebel TM, Domchek SM, Rebbeck TR. Modifiers of cancer risk in BRCA1 and BRCA2 mutation carriers: systematic review and meta-analysis. J Natl Cancer Inst. 2014;106(6):dju091.

    PubMed  PubMed Central  Google Scholar 

  25. Gross TP, Schlesselman JJ. The estimated effect of oral contraceptive use on the cumulative risk of epithelial ovarian cancer. Obstet Gynecol. 1994;83(3):419–24.

    CAS  PubMed  Google Scholar 

  26. Hannaford P. Oral contraceptives and the risk of myocardial infarction. N Engl J Med. 2002;346(23):1826–9. author reply 9.

    PubMed  Google Scholar 

  27. Hannaford PC, Iversen L, Macfarlane TV, Elliott AM, Angus V, Lee AJ. Mortality among contraceptive pill users: cohort evidence from Royal College of General Practitioners’ Oral Contraception study. BMJ. 2010;340:c927.

    PubMed  PubMed Central  Google Scholar 

  28. Hatcher RA. Contraceptive technology. 20th rev. ed. New York, NY: Ardent Media; 2011. xxxvii, 906 p., 16 p. of plates p.

    Google Scholar 

  29. Hatcher R, Trussell J, Nelson A, Cates W, Kowal D, Policar MS, editors. Contraceptive technology. 21th ed. Atlanta, GA: Ardent Media; 2019.

    Google Scholar 

  30. Henney JE. Risk of drug interactions with St John’s wort. JAMA. 2000;283(13):1679.

    Google Scholar 

  31. Jemec GB, Linneberg A, Nielsen NH, Frolund L, Madsen F, Jorgensen T. Have oral contraceptives reduced the prevalence of acne? A population-based study of acne vulgaris, tobacco smoking and oral contraceptives. Dermatology. 2002;204(3):179–84.

    PubMed  Google Scholar 

  32. Jensen JT, Speroff L. Health benefits of oral contraceptives. Obstet Gynecol Clin N Am. 2000;27(4):705–21.

    CAS  Google Scholar 

  33. Jensen JT, Parke S, Mellinger U, Machlitt A, Fraser IS. Effective treatment of heavy menstrual bleeding with estradiol valerate and dienogest: a randomized controlled trial. Obstet Gynecol. 2011;117(4):777–87.

    CAS  PubMed  Google Scholar 

  34. Jones J, Mosher W, Daniels K. Current contraceptive use in the United States, 2006–2010, and changes in patterns of use since 1995. Natl Health Stat Rep. 2012(60):1–25.

    Google Scholar 

  35. Kaiser Family Foundation. Oral contraceptive pills. 2019 [cited 2019]. Available from: https://www.kff.org/womens-health-policy/fact-sheet/oral-contraceptive-pills/

  36. Khader YS, Rice J, John L, Abueita O. Oral contraceptives use and the risk of myocardial infarction: a meta-analysis. Contraception. 2003;68(1):11–7.

    CAS  PubMed  Google Scholar 

  37. Kriplani A, Periyasamy AJ, Agarwal N, Kulshrestha V, Kumar A, Ammini AC. Effect of oral contraceptive containing ethinyl estradiol combined with drospirenone vs. desogestrel on clinical and biochemical parameters in patients with polycystic ovary syndrome. Contraception. 2010;82(2):139–46.

    CAS  PubMed  Google Scholar 

  38. Lanes SF, Birmann B, Walker AM, Singer S. Oral contraceptive type and functional ovarian cysts. Am J Obstet Gynecol. 1992;166(3):956–61.

    CAS  PubMed  Google Scholar 

  39. Larsson G, Milsom I, Lindstedt G, Rybo G. The influence of a low-dose combined oral contraceptive on menstrual blood loss and iron status. Contraception. 1992;46(4):327–34.

    CAS  PubMed  Google Scholar 

  40. Lobo RA. The androgenicity of progestational agents. Int J Fertil. 1988;33(Suppl):6–12.

    PubMed  Google Scholar 

  41. London A, Jensen JT. Rationale for eliminating the hormone-free interval in modern oral contraceptives. Int J Gynaecol Obstet. 2016;134:8.

    CAS  PubMed  Google Scholar 

  42. Lopez LM, Newmann SJ, Grimes DA, Nanda K, Schulz KF. Immediate start of hormonal contraceptives for contraception. Cochrane Database Syst Rev. 2012;12:CD006260.

    PubMed  Google Scholar 

  43. Lucky AW, Henderson TA, Olson WH, Robisch DM, Lebwohl M, Swinyer LJ. Effectiveness of norgestimate and ethinyl estradiol in treating moderate acne vulgaris. J Am Acad Dermatol. 1997;37(5 Pt 1):746–54.

    CAS  PubMed  Google Scholar 

  44. Machado RB, de Melo NR, Maia H Jr, Cruz AM. Effect of a continuous regimen of contraceptive combination of ethinylestradiol and drospirenone on lipid, carbohydrate and coagulation profiles. Contraception. 2010;81(2):102–6.

    CAS  PubMed  Google Scholar 

  45. Marchbanks PA, Annegers JF, Coulam CB, Strathy JH, Kurland LT. Risk factors for ectopic pregnancy. A population-based study. JAMA. 1988;259(12):1823–7.

    CAS  PubMed  Google Scholar 

  46. Marchbanks PA, McDonald JA, Wilson HG, Folger SG, Mandel MG, Daling JR, et al. Oral contraceptives and the risk of breast cancer. N Engl J Med. 2002;346(26):2025–32.

    CAS  PubMed  Google Scholar 

  47. Modan B, Hartge P, Hirsh-Yechezkel G, Chetrit A, Lubin F, Beller U, et al. Parity, oral contraceptives, and the risk of ovarian cancer among carriers and noncarriers of a BRCA1 or BRCA2 mutation. N Engl J Med. 2001;345(4):235–40.

    CAS  PubMed  Google Scholar 

  48. Milsom I, Sundell G, Andersch B. The influence of different combined oral contraceptives on the prevalence and severity of dysmenorrhea. Contraception. 1990;42(5):497–506.

    CAS  PubMed  Google Scholar 

  49. Mishell DR Jr. Noncontraceptive health benefits of oral steroidal contraceptives. Am J Obstet Gynecol. 1982;142(6 Pt 2):809–16.

    PubMed  Google Scholar 

  50. Narod SA, Dube MP, Klijn J, Lubinski J, Lynch HT, Ghadirian P, et al. Oral contraceptives and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers. J Narod SA, Risch H, Moslehi R, Dorum A, Neuhausen S, Olsson H, et al. Oral contraceptives and the risk of hereditary ovarian cancer. Hereditary Ovarian Cancer Clinical Study Group. N Engl J Med. 1998;339(7):424–8.

    CAS  PubMed  Google Scholar 

  51. Natl Cancer Inst. 2002;94(23):1773–9.

    Google Scholar 

  52. Nelson AL, Westhoff C, Schnare SM. Real-world patterns of prescription refills for branded hormonal contraceptives: a reflection of contraceptive discontinuation. Obstet Gynecol. 2008;112(4):782–7.

    PubMed  Google Scholar 

  53. Ness RB, Grisso JA, Klapper J, Schlesselman JJ, Silberzweig S, Vergona R, et al. Risk of ovarian cancer in relation to estrogen and progestin dose and use characteristics of oral contraceptives. SHARE Study Group. Steroid Hormones and Reproductions. Am J Epidemiol. 2000;152(3):233–41.

    CAS  PubMed  Google Scholar 

  54. Nettleman MD, Chung H, Brewer J, Ayoola A, Reed PL. Reasons for unprotected intercourse: analysis of the PRAMS survey. Contraception. 2007;75(5):361–6.

    PubMed  Google Scholar 

  55. O’Neil-Callahan M, Peipert JF, Zhao Q, Madden T, Secura G. Twenty-four-month continuation of reversible contraception. Obstet Gynecol. 2013;122(5):1083–91.

    PubMed  Google Scholar 

  56. Ory H, Cole P, MacMahon B, Hoover R. Oral contraceptives and reduced risk of benign breast diseases. N Engl J Med. 1976;294(8):419–22.

    CAS  PubMed  Google Scholar 

  57. Parazzini F, Ferraroni M, Bocciolone L, Tozzi L, Rubessa S, La Vecchia C. Contraceptive methods and risk of pelvic endometriosis. Contraception. 1994;49(1):47–55.

    CAS  PubMed  Google Scholar 

  58. Pearlstein TB, Bachmann GA, Zacur HA, Yonkers KA. Treatment of premenstrual dysphoric disorder with a new drospirenone-containing oral contraceptive formulation. Contraception. 2005;72(6):414.

    CAS  PubMed  Google Scholar 

  59. Petitti DB. Hormonal contraceptives and arterial thrombosis--not risk-free but safe enough. N Engl J Med. 2012;366:2316.

    CAS  PubMed  Google Scholar 

  60. Practice Bulletin Committee – Gynecology, The American College of Obstetricians and Gynecologists, Practice Bulletin No. 110, Noncontraceptive Uses of Hormonal Contraception. Obstet Gynecol. 2010;115(1):206–218.

    Google Scholar 

  61. Practice Bulletin Committee – Gynecology, The American College of Obstetricians and Gynecologists, Practice Bulletin No. 206, Use of Hormonal Contraception in Women with Coexisting Medical Conditions. Obstet Gynecol. 2019;133(2):e128–e150.

    Google Scholar 

  62. Pregnancy Mortality Surveillance System. 2019. Available from: https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregnancy-mortality-surveillance-system.htm

  63. Redmond GP, Olson WH, Lippman JS, Kafrissen ME, Jones TM, Jorizzo JL. Norgestimate and ethinyl estradiol in the treatment of acne vulgaris: a randomized, placebo-controlled trial. Obstet Gynecol. 1997;89(4):615–22.

    CAS  PubMed  Google Scholar 

  64. Roach R, Helmerhorst FM, Lifjering WM. Combined oral contraceptives: the risk of myocardial infarction and ischemic stroke. Cochrane Database Syst Rev. 2015; CD011054.

    Google Scholar 

  65. Rosenberg L, Palmer JR, Zauber AG, Warshauer ME, Lewis JL Jr, Strom BL, et al. A case-control study of oral contraceptive use and invasive epithelial ovarian cancer. Am J Epidemiol. 1994;139(7):654–61.

    CAS  PubMed  Google Scholar 

  66. Rosenberg MJ, Waugh MS. Oral contraceptive discontinuation: a prospective evaluation of frequency and reasons. Am J Obstet Gynecol. 1998;179(3 Pt 1):577–82.

    CAS  PubMed  Google Scholar 

  67. Rosenstock JR, Peipert JF, Madden T, Zhao Q, Secura GM. Continuation of reversible contraception in teenagers and young women. Obstet Gynecol. 2012;120(6):1298–305.

    PubMed  PubMed Central  Google Scholar 

  68. Runnebaum B, Grunwald K, Rabe T. The efficacy and tolerability of norgestimate/ethinyl estradiol (250 micrograms of norgestimate/35 micrograms of ethinyl estradiol): results of an open, multicenter study of 59,701 women. Am J Obstet Gynecol. 1992;166(6 Pt 2):1963–8.

    CAS  PubMed  Google Scholar 

  69. Sangi-Haghpeykar H, Poindexter AN III. Epidemiology of endometriosis among parous women. Obstet Gynecol. 1995;85(6):983–92.

    CAS  PubMed  Google Scholar 

  70. Schlesselman JJ. Risk of endometrial cancer in relation to use of combined oral contraceptives. A practitioner’s guide to meta-analysis. Hum Reprod. 1997;12(9):1851–63.

    CAS  PubMed  Google Scholar 

  71. Shargil AA. Hormone replacement therapy in perimenopausal women with a triphasic contraceptive compound: a three-year prospective study. Int J Fertil. 1985;30(1):15. 8–28.

    CAS  PubMed  Google Scholar 

  72. Stuart JE, Secura GM, Zhao Q, Pittman ME, Peipert JF. Factors associated with 12-month discontinuation among contraceptive pill, patch, and ring users. Obstet Gynecol. 2013;121(2 Pt 1):330–6.

    PubMed  Google Scholar 

  73. Trussel J, Aiken A. Contraceptive efficacy. In: Hatcher R, Nelson A, Trussell J, Cwiak C, Cason P, Policar MS, Edelman A, Aiken A, Marrazzo J, Kowal D, editors. Contraceptive technology. 21st ed. Atlanta, GA: Ayer Company Publishers; 2018. p. 2175–7.

    Google Scholar 

  74. Walker GR, Schlesselman JJ, Ness RB. Family history of cancer, oral contraceptive use, and ovarian cancer risk. Am J Obstet Gynecol. 2002;186(1):8–14.

    PubMed  Google Scholar 

  75. Vessey M, Yeates D. Oral contraceptives and benign breast disease: an update of findings in a large cohort study. Contraception. 2007;76(6):418–24.

    CAS  PubMed  Google Scholar 

  76. Westhoff C, Kerns J, Morroni C, Cushman LF, Tiezzi L, Murphy PA. Quick start: novel oral contraceptive initiation method. Contraception. 2002;66(3):141–5.

    CAS  PubMed  Google Scholar 

  77. Winner B, Peipert JF, Zhao Q, Buckel C, Madden T, Allsworth JE, et al. Effectiveness of long-acting reversible contraception. N Engl J Med. 2012;366(21):1998–2007.

    CAS  PubMed  Google Scholar 

  78. World Health Organization. Hormonal contraceptive methods for women at high risk of HIV and living with HIV. 2014 Guidance statement. 2014 [cited 2014]. Available from: http://www.who.int/reproductivehealth/publications/family_planning/HC_and_HIV_2014/en/

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, UMass Memorial Medical Center and UMass Medical School, Worcester, MA, USA

    Luu D. Ireland

  2. Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, RI, USA

    Rebecca H. Allen

Authors
  1. Luu D. Ireland
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rebecca H. Allen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rebecca H. Allen .

Editor information

Editors and Affiliations

  1. Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Donna Shoupe

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Ireland, L.D., Allen, R.H. (2020). Combination Oral Contraceptive Pills. In: Shoupe, D. (eds) The Handbook of Contraception. Current Clinical Practice. Humana, Cham. https://doi.org/10.1007/978-3-030-46391-5_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-46391-5_2

  • Published:

  • Publisher Name: Humana, Cham

  • Print ISBN: 978-3-030-46390-8

  • Online ISBN: 978-3-030-46391-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation