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Contraceptive Pearl: Do You Quick Start?

When a patient wants to start hormonal contraception, many clinicians use the Sunday start method – but Sunday start isn’t the only way. Quick Start means initiating contraception on the day of an office visit, at any point in the patient’s menstrual cycle.

Why Quick Start?

Quick Start lowers the risk of pregnancy while women wait to begin contraception. Studies show that women are 3 times more likely to adhere to contraception using Quick Start than Sunday start, and Quick Start causes no more spotting than the traditional Sunday start method. Numerous studies show that birth control pills aren’t teratogenic – so undiagnosed early pregnancies won’t be harmed by Quick Start.

Only 13% of family physicians and 27% of community health centers use Quick Start. Try it in your office! Use the Quick Start Algorithm as a guide.

Keys to Quick Start success:

  • Women who have had unprotected intercourse in the past 5 days should take emergency contraception (EC) the same day they start their new contraceptive method;
  • Women should use a barrier method during the first week after Quick Start.

 

Helpful Resources

Quick Start Algorithm

Medical Eligibility for Initiating Contraception

Your Birth Control Choices Fact Sheet

 

Sources

Edwards R, Zieman M, Jones K, Diaz A, Robilotto C, Westhoff C., Initiation of Oral Contraceptives – Start Now! Journal of Adol Health. 2008 Nov;43(5):432-436.

Landry D, Wei J, Frost JJ, Public and private providers’ involvement in improving their patients’ contraceptive use, Contraception. 2008 Jul;78(1):42-51.

Lesnewski R, Prine L., Initiating Hormonal Contraception, Am Fam Physician. 2006 Jul 1;74(1):105-12. Review. PMID: 16848384

Morroni C, Grams M, Tiezzi L, Westhoff C. Immediate monthly combination contraception to facilitate initiation of the depot medroxyprogesterone acetate contraceptive injection. Contraception. Jul 2004;70(1):19-23.

Sneed R, Westhoff C, Morroni C, Tiezzi L. A prospective study of immediate initiation of depo medroxyprogesterone acetate contraceptive injection. Contraception. Feb 2005;71(2):99-103.

Westhoff C, Osborne LM, Schafer JE, Morroni C. Bleeding patterns after immediate initiation of an oral compared with a vaginal hormonal contraceptive. Obstet Gynecol. Jul 2005;106(1):89-96.

Zurawain R, Ayensu-Coker L, Innovations in Contraception: A Review. Clinical Obst and Gyn Jun 2007:50(2):425-39.

 

Pharma-free

The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.

Contraceptive Pearls

This monthly clinical e-newsletter highlights evidence-based best practice for contraceptive care

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