A woman who has been taking a COCP for 2 months tells the primary care NP that she has had several headaches, breakthrough bleeding, and nausea. The NP should counsel the woman:
a. to change to a progestin-only pill.
b. to stop taking the COCP immediately.
c. to use a backup form of contraception.
d. that these effects will likely decrease in another month.
D
Breakthrough bleeding, nausea, and headaches are common during the first 3 months of therapy and should improve without intervention. Progestin-only pills are used for lactating women only. Prolonged bleeding and severe headache would warrant discontinuation of the COCP. Backup contraception is not indicated.
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