What risk factors will you ask her about before discussing birth control pills as a treatment
option?
What will be an ideal response?
• Does she smoke? Smokers older than age 35 are encouraged not to use birth control methods
containing estrogen because of the increased risk of blood clots associated with estrogen.
• Does she have a personal or family history of blood clots? Oral contraceptives increase the
incidence of deep vein thrombosis (DVT), pulmonary embolus (PE), and stroke if women smoke or
have a history of clots.
• Has she ever had high BP, heart disease, liver disease, breast cancer or breast lumps, migraine
headaches with neurologic symptoms, diabetes mellitus (DM), or gallbladder disease? If she has
any of these problems, she might still be able to take low-dose contraceptives. The physician
would have to weigh the benefits versus the risks.
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