Overview
Hormonal contraception with the pill is one of the most widely used methods of birth control in Germany. Many women take their preparation for years with good tolerability and simply need a new prescription at regular intervals. This is exactly what the video consultation is well suited for: you describe to the doctor which preparation you are taking, how well you tolerate it and whether your health situation has changed. Following a medical assessment, a private prescription can then be issued, which you can redeem at any pharmacy. The consultation is billed as a private service under the German medical fee schedule (GOÄ); privately insured patients can submit the invoice to their insurer. Important to know: a prescription is never issued automatically. In every individual case, the doctor reviews risk factors such as smoking, age, migraine or a history of thrombosis, and may decline the prescription or recommend an in-person examination.
Common causes
The most common reason for an online contraception consultation is a used-up prescription: the pack is running out, but the next appointment at the gynaecological practice is still weeks away or, after moving to a new city, has not yet been arranged at all. Other typical concerns are uncertainties after intake errors – such as a missed pill, vomiting or diarrhoea – as well as questions about interactions with newly prescribed medicines, for example certain antibiotics or St John's wort preparations. Some women wish to switch preparations because of side effects such as breakthrough bleeding, breast tenderness or mood changes. Finally, there is often a need for advice on alternatives when life circumstances or risk factors have changed – from progestogen-only preparations to the vaginal ring, hormonal IUD and non-hormonal methods.
When to see a doctor
An in-person visit to a gynaecological practice is advisable if you want to take the pill for the first time, if new risk factors such as high blood pressure, migraine with aura or heavy smoking have emerged, or if unusual bleeding, pain during intercourse or palpable changes in the breast occur. Regular gynaecological screening should also be attended independently of any online prescription request. Call the emergency number 112 immediately if warning signs of thrombosis or embolism occur while using hormonal contraception: sudden shortness of breath, pain or tightness in the chest, one-sided swelling or pain in the leg, sudden very severe headache, or vision, speech or paralysis symptoms. In these situations every minute counts – do not wait for a video consultation appointment.