[Rationale for prescribing oral contraceptives].

Strategies for prescribing oral contraceptives (OC) are explained with particular emphasis on individual conditions which can be helpful to optimize the selection process out of the numerous on the market. While contraceptive efficacy unequivocally is regarded as high additional non-contraceptive benefits become substantial criteria for an individual decision. Antiandrogenic properties of progestogens like cyproteroneacetate clearly determine their preference in the presence of unwanted clinical signs and symptoms of hyperandrogenism. In most of the non androgen-related conditions the estrogenicity of a preparation as a result of the dose of ethinylestradiol and dose as well as antiestrogenic potency of the progestogen accounts for the majority of non contraceptive effects. Different progestogens are evaluated with respect to their antiestrogenic property. It is suggested to start treatment after selection of an appropriate progestogen with the lowest daily dose of both hormonal components and to continue intake at least for 3 to 4 cycles as long as no serious adverse events occur. In cases of persisting problems i.e. bleeding irregularities doses or dosing-schemes should be altered preferentially without switching to another gestagen.