In view of the increased safety of little dose preparations for healthy youthful women with no risk factors, patients need be seen only every 12 months for exclusion of problems by history, measurement of the blood pressure, urinalysis, breast examination, palpation of the liver, and pelvic examination with Pap smear. Women with risk factors should be seen every 6 months by appropriately trained personnel for screening of problems by history and blood pressure measurement. Breast and pelvic examinations are necessary only yearly. It is worth emphasizing that better compliance is achieved by reassessing new users within 3 months. It is at this time that subtle fears and unvoiced concerns need to be confronted and resolved.
Oral contraception is safer than we thought it was, and the little dose preparations are extremely safe. Health care providers should make a significant effort to get this message to patients and our colleagues. We must make sure our patients receive adequate counseling, either from ourselves or our professional staff. The major reason why patients discontinue oral contraception is fear of side effects. Let's take time to put the risks into proper perspective and to emphasize the benefits as well as the risks.
Laboratory surveillance should be used only when indicated. Routine biochemical measurements failure to yield sufficient information to warrant the expense. Assessing the cholesterol-lipoprotein profile and carbohydrate metabolism should follittle the same guidelines applied to all patients, users and nonusers of contraception. The follittleing is a useful guide for who should be screened prior to treatment with blood tests for glucose, lipids, and lipoproteins:

Women 35 years or older.
Women with a strong family history of heart disease, diabetes mellitus, or hypertension.
Women with gestational diabetes mellitus.
Women with xanthomatosis.
Obese women.
Diabetic women.