Contraindications
Dr. Álvaro Monterrosa Castro, MD
ANDIn 1995, the World Health Organization defined the medical eligibility criteria for the initiation and continuation of the use of contraceptive methods. (186).
Oral Contraceptives Contraindications
In the first class, no restrictions for the use of the pill are included.
Age – from menarche to 40 years old -. Obesity. Previous history of pregnancy-induced hypertension. Cervical ectropion, history of ectopic pregnancy or hydatidiform mole or benign breast disease. Uterine fibroids, irregular menstrual bleeding, dysmenorrhea. In addition to chronic diseases such as: epilepsy, malaria, tuberculosis and thyroid diseases.
(Read Also: Oral Contraceptives in Adolescence)
In the second class, the beneficial effects outweigh the risks.
Smokers under 35 years of age. Healthy women over 40 years of age. Migraines without focal neurological symptoms, sickle cell disease. Superficial phlebitis and pre-cancerous lesions of the cervix.
In the third class, the risks outweigh the advantages.
Heavy smokers under 35 years of age, history of breast cancer or labile high blood pressure. Use of anticonvulsants and some antibiotics. Consequently, for conditions included in the second and third classes the decision to use oral contraceptives may be difficult.
Additionally, the use of other planning methods should be included in the counseling. And if contraceptives are prescribed, careful medical surveillance must be carried out. (186).
In the fourth class are the conditions in which oral contraceptives are contraindicated.
The first and obvious contraindication is suspicion or evidence of pregnancy (7,186).
Likewise, formal contraindication to the use of estrogens. Heavy smoking women – more than 20 cigarettes/day -, and especially if they are over 35 years old. Diabetics, hypertension, lipid metabolism disorders, liver disease.
In addition, they are contraindicated in those who suffer from cardiovascular pathologies. Rheumatic heart disease, cardiomyopathy or coronary artery disease (twenty). Also, they have a history of thrombo-embolic phenomena. Myocardial infarction, thrombophlebitis, stroke. Likewise, blood abnormalities (polycythemia or leukemia) or conditions that predispose to these problems (7,20,186).
Finally, although there are conflicting positions, oral contraceptives should not be used in lactating patients or in women with a history of genital tract cancer.
When the presence of episodes of abnormal genital bleeding is detected in the contraceptive counseling consultation. An adequate study must be carried out and an etiological diagnosis reached before recommending the pill. (7).
Finally, the onset of migraine, exacerbation of pre-existing migraine. Severe and unusually frequent headaches. Likewise, acute visual or auditory disturbances. Also, significant increases in blood pressure or jaundice. These are reasons to discontinue the use of oral contraceptives. (7,186).
Dr. Álvaro Monterrosa Castro, MD
