A 25-year-old woman requests contraception. She is a smoker (15 cigarettes/day) and is 35 years old. She had a prior deep vein thrombosis. Which contraceptive method is ABSOLUTELY contraindicated?
- A Combined oral contraceptive pill (COCP) ✓
- B Levonorgestrel-releasing intrauterine system (LNG-IUS)
- C Progestogen-only pill (POP)
- D Copper intrauterine device (Cu-IUD)
Correct answer: A. Combined oral contraceptive pill (COCP)
Explanation
Prior deep vein thrombosis is a WHO Medical Eligibility Criteria (WHO-MEC) Category 4 condition for combined oral contraceptives—an absolute contraindication. Estrogen in COCPs increases coagulation factor synthesis, raising VTE risk significantly; a prior DVT history multiplies this risk. Progestogen-only methods (POP, LNG-IUS, implant, DMPA) and non-hormonal methods (Cu-IUD) are safe options in women with prior VTE (WHO-MEC Category 2 or lower).
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.