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Dianette or equivalent cyprterone pills are not offered through MyClinic.ie due to high risk of VTE. Patients
requesting this contraceptive should be directed to their own GP for a face to face consultation.

Doctors should adhere to appropriate guidelines for contraceptive prescribing.
https://www.fsrh.org/standards-and-guidance/current-clinical-guidance/

Doctors should assess patient’s risk using UK MEC guidelines.

https://www.fsrh.org/ukmec/
Special consideration should be given to patient’s over 35 years with risk factors on Combined contraceptive or
for females over 40 years of age.
https://www.fsrh.org/standards-and-guidance/current-clinical-guidance/contraception-for-specific-
populations/

A doctor must satisfy themselves that the patient meets appropriate clinical criteria for the type of contraceptive
they have requested.

A patient should have an annual face to face contraceptive check with their doctor. This is to get an up to date
blood pressure check and BMI check. The patient can upload recent results of Blood Pressure check, weight and
height to their patient Electronic health record for the doctor to review. If the patient has requested a repeat
prescription, please advise the patient to provide this information prior to issuing the prescription. It is the
responsibility of the prescribing doctor to ensure the relevant information is on file.
If the patient changes UK MEC category the assessing doctor should advise the patient about this.

The patient will fill out a safety questionnaire for the type of contraceptive they require. This will be a combined
contraceptive or progesterone only contraceptive. The patient will select the specific pill/ patch/ vaginal ring
they wish to get in the pharmacy. Patients can request for the prescription to be faxed to their nominated
pharmacy. This is indicated at the end of the questionnaire. The aim of the questionnaire is to obtain the
information to ensure the patient does not carry increased risk on the form of contraceptive they request. If
they are identified to be at a higher risk, the patient should be informed of this and the patient should be directed
to book in with their General Practitioner for a face to face consultation.

Patient’s should not be commenced on oral contraception without a face to face consultation with their own
GP.

If a patient has completed a safety questionnaire and the consulting doctor feels the patient requires a face to
face consultation, then it can be appropriate to provide a single month supply to the patient to allow them time
to get into their own GP. This should be communicated to them via email or telephone conversation.

2) Erectile dysfunction

Erectile dysfunction is a common problem affecting men. A Cologne study reported that ED was the most
prevalent of the male sexual dysfunctions (prevalence age 30-80 years) at 19.2% as compared to 31% for all
types of male sexual dysfunction. This study equates to about 26 new cases annually per 1,000 men. This a
significant condition likely to present regularly to a GP, on average between 1 and 4 times per month.

Medications PDE5i (Phosphodiesterase-5 inhibitors) can be used to treat this problem effectively. It is important
that patients are assessed with a face to face consultation for erectile dysfunction. This is important to explore
a thorough history and examination as well as arrange blood tests as appropriate. Once established on a
medication without side effect and patient can avail of a repeat prescription through MyClinc.ie. Occasionally
patients can get an initial short course of treatment if they have recent normal BP check and no contraindication
to the medication. They should be directed to engage with their GP for the appropriate examination and
investigation to rule out any underlying treatable cause for the Erectile dysfunction.

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