The use of birth control pills in women with medical disorders

Since little absolute data exist in the form of large prospective studies in patients with specific illnesses who are on oral contraceptives, the clinician must rely on well-founded empiric decisions in prescribing the pill for these patients. The decision should be based on a firm understanding of the pathophysiology and laboratory effects of the oral contraceptives. This must be juxtaposed with an understanding of the efficacy and effects of the estrogen and progestational components of the birth control pill and their interactions with maintenance medications. In the final analysis, though, the clinician must rely on a trial and error method in treating these patients. It must be stressed, however, that these women require careful monitoring, both clinically and biochemically. It is comforting to note that in all diseases studied to date, the use of birth control pills has not precipitated a catastrophic change.