| CONDITION |
Age |
| RATIONALE |
Sexually active adolescents, regardless of how young they
are, may safely use COCs or CICs. Use of COCs or CICs by women over age 35 is not
associated with increased health risk unless one of the following risk factors is present:
- smoking;
- diabetes;
- a mother, father, sister or brother who had a heart attack or stroke before age 50; or
- family history of increased lipids (hyperlipidemia).3
|
| CONDITION |
Diabetes (uncomplicated
or < 20 years duration) |
| RATIONALE |
Although glucose (carbohydrate) tolerance (and insulin
requirements) may change slightly, both insulin-dependent and noninsulin-dependent
diabetics can use COCs or CICs (WHO class 2) unless they have or develop vascular
disease or have had diabetes for more than 20 years. (WHO class 4) |
| CONDITION |
Endometriosis |
| RATIONALE |
COCs and CICs do not worsen endometriosis and may decrease
symptoms (pelvic pain and dysmenorrhea). (WHO class 1) |
| CONDITION |
Genital tract cancers
(cervical, endometrial or ovarian) |
| RATIONALE |
COCs and CICs significantly decrease the risk of
endometrial and ovarian cancers and there is little concern that they affect the course of
these cancers. In addition, there is only theoretical concern that they increase the risk
of progression of cervical cancer (CIS to invasive cancer). |
| CONDITION |
High blood pressure (mild
hypertension) |
| RATIONALE |
Women with BP < 160/100 can use COCs or CICs. (WHO
class 2) |
| CONDITION |
Pregnancy-related
benign jaundice (cholestasis) |
| RATIONALE |
Although a history of benign jaundice in pregnancy may
predict an increased risk of developing COC- or CIC-related cholestasis, there is no
known risk for using COCs or CICs in clients with this history. (COCs—WHO class
2; CICs—WHO class 1) |
| CONDITION |
Trophoblastic
disease (benign or malignant) |
| RATIONALE |
There is no evidence that use of COCs or CICs alters
progression of the disease; these women need highly effective contraception. (WHO class 1) |
3Although familial hyperlipidemia is a risk factor for vascular disease, routine
screening is not indicated because of its rarity.
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