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a) No, a "rest period" is not necessary. A woman may use COCs for as long as she is at risk of pregnancy.
b) Stopping COCs 2 weeks before major elective surgery or after serious accidents that necessitate immobilization of the legs and resuming COCs once the woman is mobile is optimal, if she has a reliable alternative method.
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a) A rest period would disrupt the woman's preferred and successful method of contraception.
b) Due to the fact that estrogen may slightly increase the risk of post-operative thrombosis, it may be reasonable to stop COCs for 2 weeks before major elective surgery and resume COCs once the woman is mobile, before she resumes sexual activity. However, this small risk must be weighed against the risk of pregnancy and whether the client has a reliable alternative method.
- Quinn DA, Thampson BR, Terrin ML, Thrall JH, Athanasoulis CA, McKusick KA, Stein PF, Hates CA. A prospective investigation of pulmonary embolism in women and men. Journal of the American Medical Association 1992;268(13):1689-1696.
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