Question: Can I start COC on the girl of 11, who has been experiencing perimenarche dysfunctinal uterine bleeding as the treatment, whose mother is so worried that as she has mild degree of cerebral palsy and is vulnerable as she is sexually active according to her mother. The other non-hormonal treatment of non-steroidal drugs and tranexamic acid tablets were discussed with the mother who insisted that her daughter would have COC.
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Answer: The UK Medical Eligibility Criteria for Contraceptive Use (1) says that combined hormonal contraceptives, including COCs are category 1 for women from Menarche to age <40 years., i.e. a condition for which there is no restriction for the use of the contraceptive method. An additional note is made that "Theoretical concerns about the use of combined hormonal contraceptives among young adolescents have not been substantiated."
(Evidence level IV)
Reference:
- Faculty for Sexual and Reproductive Healthcare. UK Medical Eligibility Criteria for Contraceptive Use. 2009
Search date: May 2010
Classification of evidence levels
Ia Evidence obtained from meta-analysis of randomised controlled trials.
Ib Evidence obtained from at least one randomised controlled trial.
IIa Evidence obtained from at least one well-designed controlled study without randomisation.
IIb Evidence obtained from at least one other type of well-designed quasi-experimental study.
III Evidence obtained from well-designed non-experimental descriptive studies, such as comparative studies, correlation studies and case studies.
IV Evidence obtained from expert committee reports or opinions and/or clinical experience of respected authorities.
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