A review of the use of hormonal contraception in women with non-cardiovascular coexisting medical conditions. A comprehensive review

INTRODUCTION: Previously, the American College of Obstetrics and Gynecology (ACOG) had published an excellent practice bulletin addressing the use of hormone contraception in women with pre-existing medical conditions. This practice bulletin became out of date. The Centers for Disease Control and prevention (CDC) of the USA subsequently developed a point form guideline for the use of oral contraceptives in women with coexisting medical conditions. EVIDENCE ACQUISITION: Although this acts as a guide, it leaves the clinician without an understanding of why they are doing what they are doing. This article is one of two related to women with coexisting medical conditions. EVIDENCE SYNTHESIS: In this article we will provide an update of the scientific knowledge since the publication of the ACOG guideline (2006). It is to be used as a supplement for those who desire more information than that found in the CDC guidelines. CONCLUSIONS: Although some recommendations have remained unchanged over the years, the development of lower dose contraceptive pills as well as the increased incidence of comorbid conditions, such as metabolic syndrome, in younger women seeking contraception has brought along new research and new evidence to guide clinicians in the prescription of these medications.