The Editorial Executive Committee welcomes letters, which should be less than 250 words. Before a decision to publish is made, letters which refer to a published article may be sent to the author for a response. Any letter may be sent to an expert for comment. When letters are published, they are usually accompanied in the same issue by their responses or comments. The Committee screens out discourteous, inaccurate or libellous statements. The letters are sub-edited before publication. Authors are required to declare any conflicts of interest. The Committee's decision on publication is final.
Letter to the editor
Editor, – I was fortunate to read the excellent article about missed doses (Aust Prescr 2002;25:16-8) but I did find myself questioning the advice given in the table 'Information for consumers' for progestogen only contraceptives. This indicated that if a dose of the progestogen only pill is delayed for more than three hours then back-up contraception is required for 14 days. This would seem contrary to the evidence that the cervical mucus protection afforded by this method begins after only about three hours and that the suppressive effect on the endometrium only takes a few days to occur. It is accepted practice in most family planning organisations worldwide that women are advised that should they be more than three hours late taking a dose of their progestogen only pill they should use additional contraceptive cover for two days, not 14 as stated in the article. I agree that many of the recommendations around the use of progestogen only contraceptives are 'fuzzy' to say the least!
Perhaps at some stage in the future someone will have the energy to apply to the appropriate authorities to lift the restrictions on the use of progestogen-only contraceptives in women who are lactating or have thrombophilia. It is hard enough for the poor doctor just trying to do the right thing without having product information that is palpably inaccurate as well.
Medical Director FPA Health