Are there times when the combined oral contraceptive pill should be prescribed only with special caution?
Yes, there are times when a patient has medical problems such that the combined oral contraceptive pill can be prescribed but only with special caution. More careful monitoring is required. Examples are:
- moderately elevated blood pressure (hypertension) requiring medication (patients with a history of high blood pressure in pregnancy can be given the combined oral contraceptive pill but again the blood pressure should be checked more frequently).
- obesity (greater than 50% above ideal weight for height) is a reason for caution. Calorie control and exercise should be encouraged with a view to ensuring weight loss.
- hormones may, on occasion, aggravate depression.
- sickle cell disease (an inherited cause of anaemia found generally in people of Afro-Caribbean origin); this was regarded as a contraindication for the combined oral contraceptive pill as there is an increased risk of thrombosis; some authorities now suggest that the combined oral contraceptive pill can be given with caution. It may be prudent to discontinue the combined oral contraceptive pill during any episodes of immobilisation.
- some medical conditions when they are mild but not if they are severe. Examples are diabetes, systemic lupus (SLE), Crohn's disease and renal disease.
Varicose vein problems are not a contraindication for the combined oral contraceptive pill. Varicose veins are more frequently found in association with obesity and this would be a reason for caution. The pill should be stopped if you need injection treatment.
When a woman has a medical problem that may be affected by the combined oral contraceptive pill, the doctors involved in her care will usually liaise to ensure consistency of advice. Ultimately it is for the doctors caring for the woman to provide her with the information that she requires to make an informed choice.
Please click on the required question.
- 1 What are the different types of combined oral contraceptive pills?
- 1a What is the new Evra Patch?
- 2 What are the benefits and problems of the phasic pills?
- 3 How will my doctor help me to decide which is likely to be the best pill for me?
- 4 Whilst I am taking the combined oral contraceptive pill, what monitoring should I receive?
- 5 A member of my family has a history of a deep venous thrombosis (DVT) or pulmonary embolism (thromboembolism). Should I have a screening blood test?
- 6 Does an aeroplane journey increase the risks of taking the combined oral contraceptive pill?
- 7 Are there times when the combined oral contraceptive pill should be prescribed only with special caution?
- 8 Are there any contraindications to taking the combined oral contraceptive pill?
- 9 On which day of my menstrual cycle should I start my first course of the combined oral contraceptive pill?
- 10 Can I start the combined oral contraceptive pill whilst I am breast-feeding?
- 11 Can I take the combined oral contraceptive pill if I have had episodes when I did not see my periods (amenorrhoea)
- 12 Can I start the combined oral contraceptive pill if I am not currently seeing my periods?
- 13 Does it matter if I do not see a period whilst taking the combined oral contraceptive pill?
- 14 What is the advice when my changing pill preparation?
- 15 What should be done if breakthrough bleeding occurs whilst I am taking the combined oral contraceptive pill?
- 16 Can my pill withdrawal bleed be planned to avoid weekends?
- 17 Can I take the combined oral contraceptive pill without a seven-day pill-free gap?
- 18 What should be done if a pill is missed?
- 19 Could I conceive whilst I am taking the combined oral contraceptive pill?
- 20 Can combined oral contraceptive pills interact with other medication?
- 21 I am taking the combined oral contraceptive pill. Will this reduce my future fertility?
- 22 I have been on the combined oral contraceptive pill for sometime. Is there any need to take a break from it?
- 23 I am due to have an operation. Should I stop taking my pill?
- 24 What is the advice with regard to third generation combined oral contraceptive pills?
- 25 Until what age can I take the combined oral contraceptive pill?
- 26 I have taken the combined oral contraceptive pill. Will this change the time when I will go through the menopause?
- 27 I am taking the combined oral contraceptive pill. How will I know if I have reached my menopause?
- 28 In what circumstances should the combined oral contraceptive pill be stopped immediately?
- 29 What symptoms are commonly associated with taking the oral contraceptive pill?
- 30 Should the combined oral contraceptive pill be discontinued if I develop headaches?
- 31 If I have varicose veins can I take the combined oral contraceptive pill?
- 32 I have developed vomiting and diarrhoea. How does this affect my pill taking?
- 33 How long before starting a pregnancy should I stop taking the combined oral contraceptive pill?
- 34 Family Planning Support Groups.
- 35 Support Groups.
Thank you for choosing to visit us.
This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.
