Prevalence of contraindications to progestin-only contraceptive pills in a multi-institution patient database

Objective: We calculated the prevalence of contraindications to progestin-only pills (POPs) among reproductive age women to evaluate the safety of over the counter provision. Study Design: This descriptive study queried a multi-institution US database to identify women ages 10 to 45 presenting for preventive care, and a subset of this initial cohort also presenting for contraceptive services, to estimate the prevalence of contraindications to POPs using diagnosis and procedure codes. Results: Among 813,888 females seeking preventive care between 2009 and 2015, 4.36% had a condition associated with a potential risk or unacceptable risk for initiation of POPs, compared to 2.29% of the 71,216 women seeking both preventive care and contraceptive services. Current breast cancer, the only condition classified as an unacceptable risk for initiation, was listed as a diagnosis for 2.67% and 0.57% in each respective group. Conclusion: The prevalence of contraindications to POPs among reproductive age women is low. This finding supports the relative safety of an over the counter progestin-only contraceptive pill. (C) 2021 Elsevier Inc. All rights reserved.