Combined oral contraception

Combined estrogen-progestogen oral hormonal contraception. Pearl index 0.3 per 100 woman-years with perfect use, 7–9 with typical use. Additional effects: cycle regulation, dysmenorrhea control, acne and hirsutism management.

ICD-10 Z30.01 drug

Also known as: COC

Drugs used for this condition

ADrospirenone + ethinylestradiolFirst line · Combined oral contraceptives — antimineralocorticoid progestinFirst-line hormonal contraception per WHO MEC 2015 and CDC US-MEC. Pearl index 0.3 per 100 woman-years with perfect use, 7–9 with typical use due to missed pills. Drospirenone-containing COCs are preferred in patients with acne, mild hirsutism, or fluid retention tendencies. Contraindicated in prior VTE, severe migraine with aura, uncontrolled hypertension, and smokers over 35.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit