Absolute contraindications to OCs

a. Previous thromboembolic event or stroke b. History of an estrogen-dependent tumor c. Active liver disease d. Pregnancy e. Undiagnosed abnormal uterine bleeding f. Hypertriglyceridemia g. Women over age 35 years who smoke heavily (greater than 15 cigarettes per day)

2. Screening requirements. Hormonal contraception can be safely provided after a careful medical history and blood pressure measurement. Pap smears are not required before a prescription for OCs.

E. Efficacy. When taken properly, OCs are a very effective form of contraception. The actual failure rate is 2 to 3 percent due primarily to missed pills or failure to resume therapy after the seven-day pillfree interval.

Noncontraceptive Benefits of Oral Contraceptive Pills


Functional ovarian cysts


Benign breast cysts


Ectopic pregnancy

Premenstrual syndrome




Ovarian and endometrial


F. Drug interactions. The metabolism of OCs is accelerated by phenobarbital, phenytoin and rifampin. The contraceptive efficacy of an OC is likely to be decreased in women taking these drugs. Other antibiotics (with the exception of rifampin) do not affect the pharmacokinetics of ethinyl estradiol.

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