Hormonal Contraceptives in Women with Medical Disorders

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Dr. Surveen Ghumman
Dr. Pinkee Saxena

Abstract

Combined oral contraceptives and progesterone only pills form an important mode of contraception for all ages. However, these hormones impact the lipid profile, coagulation, blood sugar and metabolic status of women taking them and thus indirectly impact women with associated morbidities like hypertension, diabetes, cardiovascular disease, thrombotic disorders, migraines, liver and gall bladder disease, inflammatory bowel disease and sickle cell anaemia. These hormones may also impact drug levels to treat certain disorders like epilepsy through liver metabolism. Since these hormonal contraceptives are associated with side effects and risks especially due to their estrogenic content giving them in women with medical disorders requires caution and adequate knowledge both of the diseases and side effect of the methods used. The WHO has a medical eligibility criterion for use of these contraceptives It classifies conditions into four categories according to whether risks out weigh benefits or vice versa with stress on clinical judgment in taking decisions. There are certain conditions where these contraceptives are clearly contraindicated and they fall in category four. Before prescribing any hormonal contraceptive a complete medical history and a focused physical examination of the women should be done, to find out if the hormonal contraceptives will benefit her or not. By doing this one can identify those women who are at increased risk of adverse events, such as stroke or venous thromboembolism arising from use of these hormones.



Keywords: Combined Oral Contraceptives; Progesterone; WHO; Hypertension

Published Apr 2, 2019

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