Which oral contraceptive pill is ABSOLUTELY contraindicated in a 38-year-old woman who is a smoker (>15 cigarettes/day)?
- A Combined oral contraceptive pill (COCP) ✓
- B Progestin-only pill (mini-pill)
- C Emergency levonorgestrel-only pill
- D Desogestrel-containing progestin-only pill
Correct answer: A. Combined oral contraceptive pill (COCP)
Explanation
Combined oral contraceptive pills (COCPs, oestrogen + progestin) are WHO Category 4 (absolute contraindication) in women ≥35 years who smoke ≥15 cigarettes/day due to synergistic markedly elevated risk of arterial thrombosis, stroke, and myocardial infarction. Progestin-only pills do not contain oestrogen and are safe in smokers of all ages (WHO Category 1). Emergency levonorgestrel is also safe.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.