Is there any lab work that should be done prior to prescribing the combined oral contraceptive pill (OCP)?
No. Routine laboratory screening is not required. Assessment of the cholesterol-lipoprotein profile and carbohydrate metabolism should follow the same guidelines applied to all women. Routine screening for coagulation factor abnormalities is impractical and not cost effective prior to starting oral contraceptives in all women. In women with a past venous thrombo-embolism event or a clear family history of venous thrombo-embolism a thrombophilia screen (lupus anticoagulant, anti thrombin III, Protein S, Protein C, Factor V leiden, prothrombin gene and homocysteine level) should be considered. A hemoglobin and platelet level may also be warranted if there is a history of menorrhagia. A Von Willebrand factor level may be useful in the adolescent with severe menorrhagia.
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