Box 1.

Contraindications To Combined Oral Contraceptives In Menopausal Women

Absolute Contraindications Current breast cancer and estrogen dependent neoplasia Hypertension >160/100 History of cerebrovascular accident, ischemic heart disease History of prolonged diabetes or complications of diabetes Acute or recurrent deep vein thrombosis, Pulmonary embolism Known thrombophilia, antiphospholipid syndrome Known thrombogenic mutations Prolonged immobilization Smoking more than 15 cigarettes a day Migraine with focal neurological signs History of severe liver disease

Relative Contraindication Hypertension- Systolic 140–159, Diastolic- 90–99mm Hg Dyslipidemia Age>35 yrs Concomitant hepatotoxic drugs History of cholestasis or current gall bladder disease Migraine without focal neurological signs Past history of breast cancer more than 5 years