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Can a woman with Factor V Leiden mutation use birth control pills? #201/8

Can a 16 year-old with Factor V Leiden mutation, ovarian cysts and possible endometriosis take birth control pills containing estrogen or progestin-only birth control pills?

Certified Nurse Midwife, Riverside, CA

NO, the 2004 World Health Organization Medical Eligibility Criteria have added a new condition.  It is: “KNOWN THROMBOGENIC MUTATIONS: Factor V Leiden, prothrombin mutation, protein S, protein C and antithrombin deficiency.”  Women with one of these mutations receive a “4” for any estrogenic hormonal contraceptive.  A “4” means the condition represents an unacceptable health risk.  Do NOT use.

On the other hand, the answer to your second question is “YES”.  Progestin-only pills and Depo-Provera receive a “2” in the WHO Medical Eligibility Criteria, meaning that the advantages of these contraceptive methods usually outweigh the disadvantages.

To my knowledge, at this time no one is recommending that women routinely be screened for thrombogenic mutations.

Key Words:  birth control pills, allergy, World Health Organization Medical Eligibility Criteria, menstruation, prostaglandin inhibitors, blood clots, Factor V Leiden mutation



WHO Medical Eligibility Criteria for Starting Contraceptive Methods; World Health Organization; 2004:

Robert A. Hatcher MD, MPH
Emeritus Professor of Gynecology and Obstetrics
Emory University School of Medicine
Atlanta, GA

The directors and owners of this website and any publications and information concerning health matters offered here advise a person with a particular problem to consult a primary-care clinician or a specialist in obstetrics, gynecology, or urology (depending on the problem or the contraceptive) as well as the product package insert and other references before diagnosing, managing, or treating the problem.
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