What is considered a relative contraindication for combined oral contraceptive pills?

Relative contraindications for combined oral contraceptive (COC) pills are conditions that may pose a risk to patients but are not absolute prohibitions against use. They require careful consideration of the risks and benefits when deciding whether to prescribe COCs.

In this context, depression is recognized as a relative contraindication. While many women with depression are able to safely use COCs, the use can be complicated if symptoms worsen or if certain types of antidepressants may interact with the hormonal components of the pills. Therefore, an assessment of the individual's mental health history and current status is important, and ongoing monitoring should be part of the management plan.

Undiagnosed vaginal bleeding and hepatoma of the liver are generally considered absolute contraindications for the use of COCs. Undiagnosed vaginal bleeding should be evaluated to rule out more serious conditions, and liver cancer poses significant risks due to the metabolism of hormones through the liver. Suspected history of transient ischemic attacks (TIAs) is also regarded as an absolute contraindication, as estrogen can increase the risk of thrombotic events.

When evaluating the safety and suitability of prescribing COCs, it is essential to consider all risk factors, especially with conditions such as depression that may require personalized care and treatment plans.