Circulatory disorders also may occur in diabetes mellitus, systemic lupus erythematosus, hemolytic uremic syndrome, chronic inflammatory bowel disease and sickle cell anemia. The increase in frequency and severity of migraine during use of combined oral contraceptives (which may be preceded by cerebrovascular disorders) can be grounds for immediate discontinuation of these drugs. Biochemical parameters which can be indicative of hereditary or acquired predisposition to venous or arterial thrombosis include resistance to activated , hyperhomocysteinemia, what is decadeficiency, protein C deficiency, protein deficiency , antiphospholipid antibodies (anticardiolipin antibodies, lupus anticoagulant).
Tumors of the increased risk of cervical cancer in long-term use of combined oral contraceptives has been reported in some epidemiological studies. His connection with the intake of combined oral contraceptives has not been proved. Contradictions persist as to the extent to which these findings relate to the characteristics of sexual behavior and other factors such as human papilloma . There is evidence of a slightly increased relative risk of developing breast cancer diagnosed in women who are at the time of the study were used combined oral contraceptives. His connection with the intake of combined oral contraceptives has not been proved. The observed increase in risk may be due to an earlier diagnosis of breast cancer in women using combined oral contraceptives. Breast cancers in women who had ever used combined oral contraceptives were clinically less severe than in women, never did not use them. In rare cases, against the background of the use of combined oral contraceptives was observed the development of liver tumors. In case of severe pain in the abdomen, liver enlargement or signs of intra-abdominal bleeding it should be considered in the differential diagnosis.
Other conditions Women with hypertriglyceridemia, or the presence of her family history, may increase the risk of developing pancreatitis while taking combined oral contraceptives. Although a slight increase in blood pressure have been reported in many women taking what is deca, clinically relevant increases were rare. However, if while taking combined oral contraceptives develops persistent, clinically significant increase in blood pressure, should be discontinued these drugs and begin treatment of hypertension. Acceptance of combined oral contraceptives may be continued if using antihypertensive treatment achieved normal blood pressure values. The following conditions have been reported to develop or worsen both during pregnancy and while taking combined oral contraceptives, but their relationship with the intake of combined oral contraceptives It has not been proven: jaundice and / or pruritus related to cholestasis; the formation of gallstones; porphyria; systemic lupus erythematosus; hemolytic uremic syndrome; chorea; herpes gestationis; hearing loss associated with otosclerosis. Disease and ulcerative colitis during treatment with combined oral contraceptives have also been described. Acute or chronic disturbances of liver function may require the elimination of the use of combined oral contraceptives, as long as liver function tests have not returned to normal. Recurrent cholestatic jaundice, which develops for the first time during pregnancy or previous use of sex hormones, requires discontinuation of combined oral contraceptives. Although combined oral contraceptives may have an effect on insulin resistance and glucose tolerance, there is no need to change the therapeutic regimen in diabetics using. However, women with diabetes should be carefully observed while taking combined oral contraceptives. Women with a tendency to chloasma while taking combined oral contraceptives should avoid prolonged exposure to sunlight and ultraviolet radiation.
using combined oral contraceptives can affect the results of certain lab tests, including liver function, kidney, thyroid, adrenal, levels of transport proteins in the plasma, carbohydrate metabolism, coagulation and fibrinolysis parameters. Changes do not usually go beyond the normal range.
The effect on the menstrual cycle
While taking combined oral contraceptives may experience irregular bleeding (spotting or breakthrough bleeding), especially during the first months of use.
Therefore, the evaluation of any irregular bleeding should be done only after a period of adaptation of approximately three cycles.
If the irregular repeated bleeding or develop after previous regular cycles, you should conduct a thorough examination to exclude malignancy or pregnancy.
some women during the tablet-free interval may not develop withdrawal bleeding if combined oral contraceptives are taken according to directions, it is unlikely that the woman is pregnant. Nevertheless, if before that combined oral contraceptives are taken irregularly or if there are no two consecutive withdrawal bleeding, to continue receiving the drug should be excluded pregnancy.
recommended to undergo a thorough general medical and gynecological examination before the beginning of the application trikvilar woman (including the study of mammary glands and cytological examination of cervical mucus), exclude pregnancy. Furthermore, it should exclude blood coagulation disorders.
In the case of long-term use of the drug is necessary every 6 months to conduct follow-up examinations. It should warn the woman that type trikvilar drugs do not
protect against what is deca and other sexually transmitted diseases through!