Thrombophlebitis and the combined oral contraceptive pill

Patient

Q: I have been using birth control pills for approximately 16 years. Recently, I switched to the generic brand of the pill I usually take. Soon after switching I was diagnosed with a case of thrombophlebitis in my underarm. I believe this is the result of switching to the generic brand of my pill since I had never had any issues prior to switching. My doctor insists that I should never take birth control pills again because I will most likely have a reoccurance. Do you agree with her assessment? It feels a bit drastic to say that I should never use birth control pills again. What do you think?

Doctor

A:   In general thrombophlebitis is not an absolute contraindication for combined oral contraceptive pill (OCP) administration; however the occurrence of thrombophlebitis places you at increased risk for developing a thrombus (clot), which is an absolute contraindication for all combined OCP administration. Certain types of OCP have specified a history of thrombophlebitis or current thrombophlebitis as a contraindication, such as those pills containing cyproterone and ethinyl estradiol. You have not mentioned which OCP you are taking, therefore I would advise discussing this with your family doctor, whether the specific brand of OCP you were taking, lists thrombophlebitis as an absolute contraindication.

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