Contraindications to progestin-only oral contraceptive pills among reproductive-aged women

Contraception. 2012 Sep;86(3):199-203. doi: 10.1016/j.contraception.2012.01.008. Epub 2012 Feb 24.


Background: Progestin-only oral contraceptive pills (POPs) have fewer contraindications to use compared to combined pills. However, the overall prevalence of contraindications to POPs among reproductive-aged women has not been assessed.

Study design: We collected information on contraindications to POPs in two studies: (1) the Self-Screening Study, a sample of 1267 reproductive-aged women in the general population in El Paso, TX, and (2) the Prospective Study of OC Users, a sample of current oral contraceptive (OC) users who obtained their pills in El Paso clinics (n=532) or over the counter (OTC) in Mexican pharmacies (n=514). In the Self-Screening Study, we also compared women's self-assessment of contraindications using a checklist to a clinician's evaluation.

Results: Only 1.6% of women in the Self-Screening Study were identified as having at least one contraindication to POPs. The sensitivity of the checklist for identifying women with at least one contraindication was 75.0% [95% confidence interval (CI): 50.6%-90.4%], and the specificity was 99.4% (95% CI: 98.8%-99.7%). In total, 0.6% of women in the Prospective Study of OC Users reported having any contraindication to POPs. There were no significant differences between clinic and OTC users.

Conclusion: The prevalence of contraindications to POPs was very low in these samples. POPs may be the best choice for the first OTC oral contraceptive in the United States.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Anticonvulsants / adverse effects
  • Antitubercular Agents / adverse effects
  • Breast Neoplasms / epidemiology
  • Checklist
  • Contraceptives, Oral, Hormonal*
  • Contraindications
  • Diagnostic Self Evaluation*
  • Drug Interactions
  • Female
  • Humans
  • Liver Diseases / epidemiology
  • Mexico
  • Middle Aged
  • Nonprescription Drugs
  • Prescription Drugs
  • Prevalence
  • Progestins*
  • Prospective Studies
  • Texas / epidemiology


  • Anticonvulsants
  • Antitubercular Agents
  • Contraceptives, Oral, Hormonal
  • Nonprescription Drugs
  • Prescription Drugs
  • Progestins