Absolute contraindication for combined oral contraceptive pill

Combined oral contraceptive pills (COCs) contain synthetic versions of estrogen and progestin hormones and are commonly used for contraception.

Get the full solved assignment PDF of MME-302/As-6 of 2024 session now.

While COCs are generally safe and effective for most women, there are certain medical conditions that represent absolute contraindications to their use due to an increased risk of serious adverse effects. Absolute contraindications for COCs include:

1. History of Venous Thromboembolism (VTE):

• Women with a history of deep vein thrombosis (DVT), pulmonary embolism (PE), or other venous thromboembolic events should not use COCs due to the increased risk of recurrent VTE.

1. History of Arterial Thromboembolism (ATE):

• Women with a history of stroke, myocardial infarction (heart attack), or other arterial thromboembolic events should not use COCs due to the increased risk of recurrent ATE.

1. Current or History of Known Thrombogenic Mutations:

• Women with known thrombogenic mutations, such as Factor V Leiden mutation or prothrombin gene mutation, have an increased risk of thrombosis and should avoid COC use.

1. Active or Recent (within 1 year) Liver Disease:

• Women with active liver disease, including acute hepatitis, severe cirrhosis, or hepatocellular adenoma, should not use COCs due to the risk of hepatic complications and impaired drug metabolism.

1. Known or Suspected Breast Cancer:

• Women with known or suspected breast cancer should avoid COC use due to concerns about the potential for estrogen exposure to promote tumor growth and metastasis.

1. Uncontrolled Hypertension (≥160/100 mmHg):

• Women with uncontrolled hypertension (blood pressure ≥160/100 mmHg) should not use COCs due to the increased risk of cardiovascular complications, including stroke and myocardial infarction.

1. Migraine with Aura:

• Women with a history of migraine with aura have an increased risk of ischemic stroke and should avoid COC use, as estrogen-containing contraceptives may further elevate this risk.

1. Severe Diabetes with Vascular Complications:

• Women with severe diabetes mellitus complicated by vascular disease, nephropathy, retinopathy, or neuropathy should not use COCs due to the increased risk of cardiovascular and thrombotic events.

1. Current or History of Estrogen-dependent Tumors:

• Women with current or history of estrogen-dependent tumors, such as estrogen receptor-positive breast cancer or endometrial cancer, should avoid COC use due to the potential for estrogen exposure to stimulate tumor growth.

1. Known Hypersensitivity to Components of COCs:
   • Women with known hypersensitivity or allergy to any components of COCs, including estrogen or progestin hormones or other inactive ingredients, should not use COCs.

It’s important for healthcare providers to carefully assess a woman’s medical history and individual risk factors before prescribing COCs to ensure that they are safe and appropriate for her. Women with absolute contraindications to COC use may be candidates for alternative forms of contraception, such as progestin-only contraceptives, non-hormonal methods, or long-acting reversible contraceptives (LARCs).