The nurse is asked to assist with a 38-year-old woman who desires oral birth control pills. The patient decides on an estrogen-progesterone formulation because she still desires to get her monthly periods. The patient states she is a heavy smoker. Which of the following is the most accurate statement about the smoking and this medication?

Question

The nurse is asked to assist with a 38-year-old woman who desires oral birth control pills.  The patient decides on an estrogen-progesterone formulation because she still desires to get her monthly periods.  The patient states she is a heavy smoker.  Which of the following is the most accurate statement about the smoking and this medication?

Accepted Answer

Patient is strongly encouraged to quit smoking before starting the medication. One of the side effects of estrogen-containing birth control pills is hypercoagulability.  This is magnified greatly if the patient is also a smoker.  Patients who smoke while on estrogen-containing birth control pills are at an increased risk for thromboembolism.  Therefore, smoking cessation is recommended before commencing this medication.  Women over the age of 35 who smoke should not take oral contraceptives. Any smoking while on this medication will increase the risk of a thromboembolic event, though it is particularly bad if the person smokes 15 cigarettes a day or more.  Smoking does not interfere with the drug itself.  There is no link between estrogen birth control pills and osteoporosis in pre-menopausal women.

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