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Contraindications for Oral Contraceptive Use

written by: Dr. Kristie Leong • edited by: BStone • updated: 12/24/2010

Oral contraceptives are safe for most women, but there are exceptions. What are the contraindications for oral contraceptive use?

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    Many women prefer the ease of taking an oral contraceptive pill for birth control. Not only are birth control pills effective, they offer certain health benefits. Studies show that they reduce the risk of cancer of the ovaries, uterus and colon. In addition, they boost bone density, and reduce the risk of pelvic inflammatory disease. Overall, oral contraceptives are safe for most women, but they aren’t for everyone. What are the contraindications for oral contraceptive use?

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    Low Dose Oral Contraceptives Are Safer

    Oral contraceptives contain lower doses of estrogen and progestin compounds these days, which makes them safer than birth control pills of the past. The risk of complications such as blood clots, heart attack and stroke are small, but there are still certain women who shouldn’t take them.

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    Absolute Contraindications for Oral Contraceptive Use

    The package insert contains a list of contraindications for oral contraceptive use. In addition, the World Health Organization has established additional guidelines that should preclude use of birth control pills.

    Women who have a history of certain medical conditions shouldn’t use oral contraceptive pills. These include a history of blood clot or thrombophlebitis, a history of cerebrovascular disease, coronary artery disease, tumor of the liver, or a history of any type of estrogen-dependent cancer such as breast cancer or cancer of the uterus.

    If a woman has been pregnant in the past and had jaundice during her pregnancy or developed jaundice while taking oral contraceptives, she should also not take them. A woman who has any type of genital bleeding or is suspected of being pregnant shouldn’t use oral contraceptives and should seek appropriate medical care. A history of an allergic reaction to any component of birth control pills is also a contraindication.

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    Additional Contraindications for Use of Birth Control Pills

    The World Health Organization also suggests that women with valvular heart disease, vascular disease, significant blood pressure elevations, severe cirrhosis of the liver, angina or who has had diabetic complications or diabetes at for at least 20 years shouldn’t take birth control pills.

    Women with migraine headaches should be closely evaluated before taking birth control pills since women who have migraines with neurological symptoms or who are 35 and over shouldn't take them.

    Women who are lactating shouldn’t take birth control pills until six weeks after giving birth. If a woman requires surgery that will involve long periods of bed rest, birth control pill shouldn’t be used due to the increased risk of blood clots.

    Age isn’t always an issue, but women over the age of 35 who smoke at least fifteen cigarettes a day shouldn’t take oral contraceptives.

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    The Bottom Line?

    Contraindications for oral contraceptive use have been carefully studied over the years, and women who fall into certain categories are safest using an alternative form of birth control. Talk to your doctor about whether you’re a good candidate for birth control pills.

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    References

    Medscape.com. “Oral Contraceptives: An Update on Health Benefits and Risks"

    Physician’s Desk Reference. 2010.

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