[Contraceptions in women with contra-indication to estrogen-progestins]

Estrogen-progestin pill contra-indications can be related to a metabolic or vascular risk or to an estrogen-dependent disease. In the first case, a pregnane progestin (chlormadinone acetate or cyproterone acetate) can be used as a first choice, because of its good tolerance and absence of deleterious effects on these diseases. IUD use is limited due to the risk of infection and a decreased efficiency with corticosteroids. Diaphragm plus spermicides or condoms can be used in any case and are the only possibilities during the course or just after a deep vein thrombosis. In case of estrogen-dependent diseases, high-dose progestin is the treatment of the diseases in most of the cases and normethyl-testosterone derivatives or other progestin can be used.