Is an adolescent ever too young to start the combined oral contraceptive pill (OCP)?
There is no lower age limit for prescribing an oral contraceptive. The medical and social risks of unplanned pregnancy exceed the risks of taking oral contraceptives, even if menstruation has not started or if cycles are irregular. There is no evidence that the contraceptive steroids in current low-dose pills have any effect on growth or subsequent neuroendocrine development. The combined OCP should probably not be started, however, prior to the onset of puberty. If a prepubertal female is requesting the combined OCP a careful and thorough discussion regarding motives for initiating the OCP should be undertaken and referral or counselling given. If there is any evidence of delayed puberty an appropriate investigation should be carried out prior to initiating the combined OCP.
