Contraception for women with health problems

Investigational data collected during FDA-monitored clinical trial stem from populations that are sharply defined so as to exclude commonly encountered clinical pathology. This is certainly the case with testing of new contraceptive agents in which patients with obesity, hypertension, altered glucose metabolism, and various endocrine disorders are screened out. What happens in the real world of clinical practice when these patients seek contraceptive counseling? This article examines some of these everyday occurrences.