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Is the combined oral contraceptive pill (OCP) always contraindicated, in women over 35 who smoke, if no other contraceptive options are acceptable?

April 26, 2017combined contraceptive contraindicated ocp Options oral Pill smoke women

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Is the combined oral contraceptive pill (OCP) always contraindicated, in women over 35 who smoke, if no other contraceptive options are acceptable?

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No. The use of combined OCPs may be an acceptable option if the potential benefits outweigh the risks. It is important for the prescriber to inform women that the combination of smoking and the OC particularly at older ages is associated with a substantial increase in risk in acute myocardial infarction and hemorrhagic stroke. The additional mortality associated with combined OCP use is 1.4/100,000 users per year, less than that associated with smoking (5.4/100,000 users per year) or the combination of the two (14/100,000 combined OCP users who smoke). The major harmful effects are due to smoking and not due to the contraceptive steroids. Women who smoke are best advised to quit smoking.