Published 5 October 2009, doi:10.1136/bmj.b4061
Cite this as: BMJ 2009;339:b4061

Letters

Contraception for women

First consultation for the pill

The first 150 words of the full text of this article appear below.

In their clinical review of contraception for women, Amy and Tripathi specifically advise asking about "a personal and family history of deep vein thrombosis and measuring blood pressure at baseline" at the first consultation for the contraceptive pill.1 However, limiting history and examination to just these checks seems to be unsafe and poor practice, putting patients at risk.

I was surprised to see that they did not mention that the combined contraceptive pill is completely contraindicated in women with a body mass index of 40 or more. This is stated clearly on the website of the Faculty of Sexual and Reproductive Healthcare (www.ffprhc.org.uk).

Amy and Tripathi state that migraine with aura is a complete contraindication to combined contraceptive pill use, so migraine should also be specifically asked about before prescribing.

St John’s wort was not included in box 1 in the list of liver enzyme inducing drugs that . . . [Full text of this article]

Nicola D Jones, general practitioner on doctors’ retainer scheme1

1 Roseneath Medical Practice, Buckley, Flintshire CH7 2JL

nicolajones@doctors.org.uk


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