When considering the use of birth control pills, absolute and relative contraindications must be considered. Absolute contraindications include :
Relative contraindications to contraceptives include:
Over the last 30 years we have seen a continuous reduction in the estrogen dose contained in combination birth control pills. Ethinyl estradiol is added to birth control pills to help in the suppression of the gonadotropin secretion and also to allow cycle control. Vascular events have been directly related to the dosage of ethinyl estradiol.
Credits: Meade, et al Brit. Med. J. 1980
Presently, all birth control pills contain 50 ug or less of ethinyl estradiol. In choosing a birth control pill, we recommend that patients be initiated on < 35 ug dose of ethinyl estradiol. Occasionally, patients may require a pill with more ethinyl estradiol to obtain adequate cycle control.
Smoking definitely increases the risk of cardiovascular events.
Credits: TO RCOP, Lancet 1961
In women over age 35 who smoke, oral contraceptives are not an appropriate choice. The risk of cardiovascular events begins to increase at 30 years and becomes significant at age 35.
Once a patient is on birth control pills, development of any of the following conditions should cause the physician to re-evaluate the use of birth control pills. These contraindications include: