The effects of DMPA and NET-EN may persist for some time after discontinuation. Some POCs may increase the risk of arterial thrombosis, although this increase is substantially less than with COCs. The effects of DMPA and NET-EN may persist for some time after discontinuation. Some types of hyperlipidaemias are risk factors for vascular disease. Any new headaches or marked changes in headaches should be evaluated.
Classification is for women without any other risk factors for stroke.
Risk of stroke increases with age. In the case of headaches with focal neurologic symptoms, it may be prudent to attempt to improve the headache by discontinuing the progestogen. Certain anti-epileptic drugs lower POC efficacy. Irregular menstrual bleeding patterns are common among healthy women, in particular among adolescents. Also, unusually heavy bleeding should raise the suspicion of serious underlying condition.