Among women with underlying vascular disease, the increased risk associated with COC use should be avoided. Among women with underlying vascular disease, the increased risk associated with COC use should be avoided. Routine screening is not appropriate because of the rarity of the conditions and the high cost of screening. While some types of hyperlipidaemias are risk factors for vascular disease, the category should be assessed according to the type, its severity, and the presence of other cardiovascular risk factors. 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, hypertension and smoking. In addition, among women with migraines, those who use COCs have a 2 to 4-fold increased risk of stroke compared with women who do not use COCs. Certain anti-epileptic drugs lower COC efficacy. Changes in menstrual bleeding patterns are common among healthy women. There are no conditions that cause vaginal bleeding that will be worsened in the short term by use of COCs.