Oral Contraceptive Pills

A 28-year-old woman attends the contraception clinic in Delhi seeking oral contraceptive pills (OCPs). She has no contraindications to hormonal contraception. What is the most common reason for discontinuation of OCPs in the first year of use?

A 28-year-old woman from Delhi presents to the gynaecology clinic requesting contraception. She has a 3-year history of migraine with aura, occurring 2–3 times per month, typically preceded by visual scotomata and photophobia. Her menarche was at age 12, cycles are regular (28 days), and she has no other medical comorbidities. She is a non-smoker and has never been pregnant. On examination, vital signs are normal and neurological examination is unremarkable. She asks about starting combined oral contraceptive pills (COCPs). What is the most appropriate counselling regarding COCPs in this patient?

A 32-year-old woman from Mumbai attends the family planning clinic with her husband. She has been on combined oral contraceptive pills (30 μg ethinyl estradiol + levonorgestrel) for the past 4 years with good compliance and no side effects. She is now on day 18 of her current cycle when she develops acute gastroenteritis with severe diarrhoea (6–8 stools per day) lasting 3 days. She is concerned about contraceptive failure. She has no other medical conditions, is a non-smoker, and takes no other medications. What is the most appropriate counselling and management regarding her contraceptive efficacy?

A 28-year-old woman on combined oral contraceptive pills (COCPs) for 6 months presents with sudden onset severe unilateral leg pain, swelling, and warmth. On examination, there is calf tenderness and a positive Homan's sign. Which investigation is most appropriate to confirm the suspected diagnosis?

A 32-year-old woman has been using combined oral contraceptive pills for 3 years and now presents with recurrent headaches with visual disturbances and photophobia. On fundoscopy, papilledema is noted. Which investigation is most appropriate to evaluate the suspected complication of COCP use?