Surgery and the combined oral contraceptive pill.

One of the potential complications following an operation is a blood clot in one of the veins in the legs or pelvis (surgery risks) and we surgeons try to reduce the risk as far as possible. As the combined pill is also associated with a tiny risk of blood clot problems (Q15.14) we need to consider whether the combined oral contraceptive pill should be stopped before we operate. Ideally, the combined oral contraceptive pill should be discontinued four weeks before major surgery or any operation on the legs. The pill can be recommenced on the first day of the next period provided that this occurs at least 14 days after the operation. If there is need for a major operation when the combined oral contraceptive pill has not been discontinued, your surgeon may recommend injections of heparin for a few days to thin the blood a little. There is no reason to discontinue the combined oral contraceptive pill for minor operations or intermediate operations such as laparoscopy (laparoscopy). There is no recommendation to stop progestogen-only pills or other progestogen contraception for surgery.

Please click on the required question.

Q16. 1 What are the different types of combined oral contraceptive pills?

Q16. 1a What is the new Evra Patch?

Q16. 2 What are the benefits and problems of the phasic pills?

Q16. 3 How will my doctor help me to decide which is likely to be the best pill for me?

Q16. 4 Whilst I am taking the combined oral contraceptive pill, what monitoring should I receive?

Q16. 5 A member of my family has a history of a deep venous thrombosis (DVT) or pulmonary embolism (thromboembolism). Should I have a screening blood test?

Q16. 6 Does an aeroplane journey increase the risks of taking the combined oral contraceptive pill?

Q16. 7 Are there times when the combined oral contraceptive pill should be prescribed only with special caution?

Q16. 8 Are there any contraindications to taking the combined oral contraceptive pill?

Q16. 9 On which day of my menstrual cycle should I start my first course of the combined oral contraceptive pill?

Q16. 10 Can I start the combined oral contraceptive pill whilst I am breast-feeding?

Q16. 11 Can I take the combined oral contraceptive pill if I have had episodes when I did not see my periods (amenorrhoea)

Q16. 12 Can I start the combined oral contraceptive pill if I am not currently seeing my periods?

Q16. 13 Does it matter if I do not see a period whilst taking the combined oral contraceptive pill?

Q16. 14 What is the advice when my changing pill preparation?

Q16. 15 What should be done if breakthrough bleeding occurs whilst I am taking the combined oral contraceptive pill?

Q16. 16 Can my pill withdrawal bleed be planned to avoid weekends?

Q16. 17 Can I take the combined oral contraceptive pill without a seven-day pill-free gap?

Q16. 18 What should be done if a pill is missed?

Q16. 19 Could I conceive whilst I am taking the combined oral contraceptive pill?

Q16. 20 Can combined oral contraceptive pills interact with other medication?

Q16. 21 I am taking the combined oral contraceptive pill. Will this reduce my future fertility?

Q16. 22 I have been on the combined oral contraceptive pill for sometime. Is there any need to take a break from it?

Q16. 23 I am due to have an operation. Should I stop taking my pill?

Q16. 24 What is the advice with regard to third generation combined oral contraceptive pills?

Q16. 25 Until what age can I take the combined oral contraceptive pill?

Q16. 26 I have taken the combined oral contraceptive pill. Will this change the time when I will go through the menopause?

Q16. 27 I am taking the combined oral contraceptive pill. How will I know if I have reached my menopause?

Q16. 28 In what circumstances should the combined oral contraceptive pill be stopped immediately?

Q16. 29 What symptoms are commonly associated with taking the oral contraceptive pill?

Q16. 30 Should the combined oral contraceptive pill be discontinued if I develop headaches?

Q16. 31 If I have varicose veins can I take the combined oral contraceptive pill?

Q16. 32 I have developed vomiting and diarrhoea. How does this affect my pill taking?

Q16. 33 How long before starting a pregnancy should I stop taking the combined oral contraceptive pill?

Q16. 34 Family Planning Support Groups.

Q16. 35 Support Groups.

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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London.

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