The Clinical Effectiveness Unit of the Faculty of Sexual and Reproductive Healthcare currently advises that larger women need not take a higher dose of the progestogen-only contraceptive pill (POP) for effective contraceptive cover. However, a case report in the Faculty's journal casts doubt on this advice. Dr Chris Barclay reviews the paper and comments: 'I drew two conclusions from this interesting paper. First heavier women, >60-70 kg, using POP contraception, should be included in the decision about dosage. Second, that evidence-based medicine does not address every facet of day-to-day medical practice. Deploying clinical wisdom as the authors did here is, in my view, to be commended.' [With external links to current evidence]