The doctor should be alert to these, carefully monitor the patient and exercise medical judgement to continue or discontinue therapy as appropriate. Pre-existing uterine fibromyomata may increase in size. Hypertension may occur in association with the use of oral contraceptives. Regular blood-pressure checks, including a pretreatment level, are advisable. Prolonged amenorrhoea following the use of oral contraceptives may occur.
Caution is advised where oligomenorrhoea or amenorrhoea have occurred in the past.
Women with a past history of oligomenorrhoea or secondary amenorrhoea or women with irregular cycles may be more likely to remain anovulatory or to become amenorrhoeic post oral contraceptive therapy. Mood changes, weight gain, skin pigmentation, vaginal candidiasis, gastro-intestinal irritation and fluid retention may occur. A decrease in glucose tolerance in a significant number of women may occur. An increased risk of surgically confirmed gall-bladder disease associated with the use of oral contraceptives has been reported in a retrospective case control study. With vomiting or diarrhoea the absorption of oral contraceptives may be diminished and women should be advised to use additional methods of contraception at the time of such disorders.