Oral contraceptives are an effective means of birth control, but they may have adverse effects. If contraindications are present, then an alternative means of contraception should be used.


Absolute contraindications:

(1) cigarette smoking and >= 35 years of age

(2) pregnancy

(3) presence of active liver disease

(4) uncontrolled hypertension

(5) diabetes mellitus with vasculopathy

(6) prolonged immobilization of the lower extremity

(7) history of thromboembolic events or thrombophlebitis

(8) history of coronary artery disease

(9) history of stroke

(10) history of estrogen-dependent malignancy

(11) history of a liver adenoma

(12) history of cholestatic jaundice of pregnancy


Relative contraindications:

(1) heavy cigarette smoking and < 35 years of age

(2) amenorrhea of undiagnosed cause

(3) migraine headaches

(4) depression



• Women who (1) smoke or (2) have cardiovascular risk factors and who use oral contraceptives with >= 50 µg estrogen have an increased risk of death from circulatory diseases including myocardial infarction and stroke.


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