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Recommendations for Contraceptive Use |
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Combined Oral Contraceptives (COCs) |
Q.6. Is there a minimum age to
receive COCs? A maximum?
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| COCs may be used at any age at
which the woman is at risk of pregnancy (e.g., past menarche and through menopause). |
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| a) Women over age 40 can take
COCs, provided other risk factors have been considered (e.g., smoking, high blood
pressure, diabetes). |
a) Cardiovascular risks from COC
use are minimal in healthy, non-smoking, older women.
- Speroff L, Glass RH, Kase NG. Clinical
Gynecologic Endocrinology and Infertility, 4th edition. Baltimore, Williams
& Wilkins, 1989, p 487.
- Guillebaud J. Contraception for women
over 35 years of age. British Journal of Family Planning 1992;17:115-118.
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| b) Use of COCs does not
compromise future fertility. |
b) On average, the return to
fertility after discontinuing COCs is about 2 months longer than for non-hormonal methods.
The risk of amenorrhea after discontinuing COCs is small and more common in women who had
irregular menses prior to COC use. Rather than causing "post-pill amenorrhea,"
COCs mask the irregular pattern by inducing cyclic withdrawal bleeding. Women who have
irregular menses are more likely to develop secondary amenorrhea whether they take COCs or
not.
- Bracken MB, Hellenbrand KG, Holford
TR. Conception delay after oral contraceptive use: The effect of estrogen dose. Fertility
and Sterility 1990; 58:21-7.
- Speroff L, Glass RH, Kase NG. Clinical
Gynecologic Endocrinology and Infertility, 4th edition. Baltimore, Williams
& Wilkins, 1989, p 481.
- American College of Obstetricians and
Gynecologists. Safety of oral contraceptives for teenagers. International Journal of
Gynaecology and Obstetrics 1992;37:309-312.
- Jacobs HS, Knuth UA, Hull MGR, Franks
S. Post-"pill" amenorrhea - Cause or coincidence? British Medical Journal
1977;2:940-942.
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