Medical cause for concern for women on CHC

Box 2: Medical cause for concern for women on CHC (adapted from FSRH guidelines on combined hormonal contraception February 2019)

Advise women to seek medical attention if the following occur:
  • Calf pain/swelling
  • Loss of motor or sensory function
  • Sudden chest pain/breathlessness/coughing up blood
  • New breast lump/nipple changes
  • New migraines/new auras before migraines
  • Persistent unscheduled vaginal bleeding
Advise women that CHC may not be appropriate and to discuss with Health care provider if the following occur:
  • New auras before migraines
  • High Blood Pressure
  • High BMI (>35)
  • Migraines
  • VTE
  • Blood clotting abnormality/Antiphospholipid syndrome
  • Heart disease, stroke or peripheral vascular disease
  • Atrial fibrillation/cardiomyopathy
  • Breast cancer /BRAC gene mutation
  • Liver tumour/symptomatic gallstones

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