Oral contraception in disease states

Article Abstract:

The continued use of oral contraceptives by patients who develop certain diseases or who undergo other drug therapy is necessary and appropriate to consider. The absolute and relative contraindications to oral contraceptive (OC) use are discussed in this article. Because there is an increase in risk toward clot formation (thrombosis) in OC users, patients who have or develop thrombosis in veins or arteries, coronary artery disease, stroke, or cerebral (brain) hemorrhage, should absolutely not receive OCs. Similarly, patients who tend to have increased blood clotting due to genetic defects should also be excluded from OC use. Patients with these diseases often require long-term anticlotting therapy and may be subject to abdominal hemorrhage following ovulation. Ovulation in these patients may be prevented by use of gonadotropin-releasing hormone analogs, which act on the pituitary cells which release reproductive hormones. Because OC use is associated with increased blood pressure, hypertensive patients should also not use OCs, nor should those with elevated blood cholesterol levels. Patients with severe liver diseases and estrogen-dependent breast cancer should be similarly excluded from OC treatment. In addition, patients who undergo surgery have an increased risk of clots, and it may be advisable to curtail OC use around the time soon before and after surgery. Disease states in which OC use should probably be curtailed include migraine, diabetes, Crohn's disease, epilepsy, and sickle cell disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Modern oral contraceptives and cardiovascular disease

Article Abstract:

Recent studies have shown that women taking the latest oral contraceptives are at a smaller risk for heart attack than those taking first-generation contraceptives. The risk for heart attack may have been three times higher in women taking a previous formulation compared to no increased risk with the latest formulation. However, underlying risk factors may have masked true risk in some of these comparisons. There does not appear to be any increased risk for stroke among low-risk women taking current oral contraceptive combinations.

Risk factors, Heart attack, Stroke (Disease), Stroke

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