Table 1.

Absolute and Relative Contraindications of Combined Oral Contraceptive Use

Absolute contraindications	Relative contraindications
First 6 weeks postpartum, if breastfeeding  First 21 days postpartum if not breastfeeding but having other risk factorsa for VTE	Six weeks to <6 months postpartum, if breastfeeding  First 21 days postpartum, if not breastfeeding  First 42 days postpartum, if not breastfeeding but having other risk factorsa for DVT
Age ≥35 years and smoking ≥15 cigarettes per day	Age ≥35 years and smoking <15 cigarettes per day
Hypertension with BP measurements ≥160/100 mm Hg	Hypertension controlled with medication or BP measurements between 140–159/90–99 mm Hg
History of current diagnosis of ischemic heart disease or history of stroke Having multiple risk factors for cardiovascular disease Complicated valvular heart disease	Dyslipidemia
Diabetes >20 years duration Diabetes with microvascular complications Acute hepatitis Severe cirrhosis Liver tumors (hepatocellular adenoma or carcinoma)	Symptomatic gall bladder disease History of cholestasis related to oral contraceptive use Using rifampicin or rifabutin Using anticonvulsant medications
Migraine with aura	Migraine without aura
Current diagnosis of cancer	History of breast cancer cured for ≥5 years
History or current diagnosis of deep venous thrombosis or pulmonary embolism Prolonged immobilization due to major surgery Known thrombogenic mutations Systemic lupus erythematosus with positive or un-known phospholipid antibodies

Adapted from World Health Organization [39].

VTE, venous thromboembolism; DVT, deep vein thrombosis; BP, blood pressure.

^aPrevious VTE, thrombophilia, immobility, transfusion at delivery, body mass index >30 kg/m², postpartum hemorrhage, immediately after cesarean delivery, pre-eclampsia, and smoking.