– liver tumors or liver disease
– increased clotting or stroke risk
– if currently pregnant
Smoking increases the risk of serious heart side effects when using a combined estrogen and progestin birth control, including the ring or the patch. This risk increases with heavy smoking (more than15 cigarettes per day). Combination estrogen and progestin birth control should NOT be used in women over 35 years of age who smoke due to an increased risk of rare but serious side effects, such as heart attack, blood clots, and stroke.
Women of any age should avoid combination hormonal birth control if they have a history of:
– uncontrolled high blood pressure
– chest pain
– diabetes
– severe headaches
– heart or liver disease
– blood clots or stroke
Cardiovascular risks increase with age, weight, family history of heart disease, and number of cigarettes smoked per day.