Many relative contraindication of Pills

We have to remove the unnecessary medical barriers to effective contraceptives with some calculated risk after proper counseling. Then , based on that philosophy what will be the choiced contraceptives for following sick women who did not have tubectomy done or husband decline to use barrier or undergo vasectomy: :

COC are not usually prescribed in following set up like

1)         Multiple risk factors for   atheroscelerosis  

2)         Personal   history of thrombosis    or high risk for thrombosis

3)         Thromboembolism   thrombophlebitis deep  vein thrombosis

4)         Polycythemia vera

5)         Known or suspected   inherited  clotting disorder(absolute)     

6)         Cigarette  smoking in women older than 35

7)         Cancer    of the breast (absolute)

8)         Any current  estrogen   dependent   neoplasia

9)         Known  or suspected pregnancy

10)                        Migraine headaches   with localizing  neurological signs  including scotomata at  any age ,Migraine  without  aura over   age 35,  

Worsening migraines  during use of  OC . Non  migraines  headaches mild or severe  during use.

11)                        Acute  or  chronic  liver disease

12)                        Active   viral hepatitis  abnormal liver  functions severe  cirrhosis

13)                        Benign  hepatic  adenomas / liver   carcinoma

14)                        Prolonged immunobilization  major surgery

Hypersensitivity to any component of the pill

15)                        History  of  OCP   induced cholestatic   jaundice   or current  symptomatic  gall bladder  disease   treated  medically

16)                        Mild   compensated cirrhosis

17)                        Postpartum less than  21 days or less  than  6 months  if primarily breastfeeding

18)                        Cigarette smoking of less than  15  cigarettes  per day in women 35 years or older or older .

19)                        History    of hypertension   in which blood pressured cannot be   monitored    or moderately   elevated systolic blood  pressure   140-159   mmHg   or diastolic    blood pressure  90-99 mmHg

20)                        Hypertriglyceridaemia  known   hyperlipidaemia 

Previous    breast cancer but no evidence  of current  disease for 5 years.,

21)                        Certain antibiotics   or anticonvulsants

22)                         Unexplained    vaginal bleeding before   evaluation 

23)                        Undiagnosed breast  mass

24)?? Varicose veins

25) Cigarette   smoking by women   younger  than age 35 

26) ? Age  over 40

27) Prolactin secretion pituitary  microadenoma

28) Valvular heart disease  uncomplicated

29) Unexplained amenorrhea after evaluation

30)? Diabetes with no vascular    disease  in women

Under   35 years of  age and less  than 20 years duration of diabetes

31) Surgery   without   prolonged immobilization

32) Known   hyperlipidaemia   with no other   risk factors  for cardiovascular   disease.

33) On  antiretinoviral   therapy 

34) On  Griseofulvin

35) Obesity   body mass index 30 kg / m or more

36) Cervical   cancer awaiting   treatment

Cervical   intraepithelial neoplasia

37) Sickle   cell disease or trait.

38) Symptomatic   gall bladder   disease treated with cholecytectomy or asymptomatic ,Gall bladder disease or history  of pregnancy     induced cholestatic jaundice  

39) ? History   of pregnancy   induced hypertension 

40) Family history  in first  degree relative of deep  vein  thrombosis / pulmonary embolism.

41)?? Superficial thrombophlebitis.