From the Guidelines
The nurse should tell the patient to use another form of contraception for the first 7 days after starting the oral contraceptive pills. When starting monophasic combination oral contraceptives on the first Sunday after the onset of menstruation (Sunday start method), the patient is not immediately protected against pregnancy. This is because it takes approximately 7 days for the hormones in the pills to effectively suppress ovulation and create the other contraceptive effects, such as thickening cervical mucus and thinning the endometrial lining. During this initial week, there is still a risk of ovulation occurring, which could lead to pregnancy if unprotected intercourse takes place. After the first 7 days of consistent pill-taking, the contraceptive will provide effective protection against pregnancy. This recommendation ensures the patient has adequate contraceptive coverage while the hormonal method becomes fully effective, as supported by the CDC's key recommendations for contraception use 1. Some key points to consider include:
- The patient should be advised to use a backup method, such as condoms or abstinence, for the first 7 days after starting the oral contraceptive pills 1.
- If the patient has had unprotected intercourse during the first week of taking the pills, emergency contraception should be considered 1.
- The nurse should emphasize the importance of taking the pills consistently and correctly to ensure effective contraception. It is also important to note that the patient's individual circumstances, such as the timing of her menstrual cycle and any potential interactions with other medications, should be taken into account when providing guidance on contraception use 1.
From the Research
Patient Instructions for Monophasic Combination Oral Contraceptives
The nurse will instruct the patient on the proper use of monophasic combination oral contraceptives, which the patient will begin taking on the first Sunday after the onset of her next period.
- The patient should be informed that protection from pregnancy will not begin immediately, but rather after 7 days of consecutive pill taking 2, 3.
- The patient should be advised to use another form of contraception, such as condoms, for the next month to ensure protection from pregnancy during this time 3, 4.
- It is essential to emphasize the importance of taking the pills as directed and not missing any doses to ensure maximum effectiveness 2, 5.
- The nurse should also discuss the potential risks and benefits associated with oral contraceptive use, such as the increased risk of venous thrombosis, and provide guidance on how to minimize these risks 2, 3.