RHRU/Baragwanath Hospital Progestin-only contraceptive pills are a good option for breastfeeding mothers who want oral contraception. This South African brochure explains how progestin-only pills work, their side effects, and advantages and disadvantages.

Multiphasic Combined OCs In the 1970s and 1980s multiphasic OCs were developed. These pills have become popular in some developed countries but are not widely available in developing countries. The doses in multiphasic OCs change during each pill cycle to keep hormone doses low (78). Like other low-dose OCs, multiphasics appear to provide highly effective contraception when taken correctly. Some clinical trials have observed that multiphasics produce minimal breakthrough bleeding, spotting, and amenorrhea (14, 125, 154, 349). There is little evidence that risks of serious health problems are less with multiphasics than with other low-dose OCs (437).

Also, as many as half of all new users stop using the pill within a year, and many use the pill intermittently for a few months at a time. While some may not need continuous contraception, this discontinuation rate suggests that many women are having difficulties taking the pill regularly or are dissatisfied. Just as researchers and providers have concentrated on making pill use safer, providers need to focus their attention on making pill use easier. The next issue of Population Reports will discuss this need and how it can be met.