First, what are the types of birth control pills? 

1. Combined oral contraceptive pills (Estrogen + Progestin) 

2. Progestin-only pills 

Most contraindications are related to "estrogen." 

Important contraindications for combined oral contraceptive pills 

According to guidelines from the 
World Health Organization and the American College of Obstetricians and Gynecologists 

1️⃣ History of blood clots (DVT / PE)

2️⃣ History of stroke or heart disease 

3️⃣ Migraine with aura 

4️⃣ Heavy smoking and over 35 years of age 

5️⃣ Uncontrolled high blood pressure 

6️⃣ Severe liver disease / liver tumors 

7️⃣ Active breast cancer 

⚠️ Conditions that require "caution" but are not absolute contraindications 

• Diabetes with vascular complications 

• Very high cholesterol 

• Severe obesity (high BMI) 

• Breastfeeding during the early postpartum period 

🧠 What doctors commonly encounter 

Buying birth control pills over-the-counter without a prior risk assessment 
is the starting point of issues found in many patients. 

Especially for migraine with aura, 
which many people do not realize they have. 

Taking a detailed medical history before starting the medication 
is therefore much more important than you might think. 

Femily Wellness Clinic Ari 
Located about 200 meters from BTS Ari. 
You are welcome to visit us for a consultation before choosing your birth control method. 

Written by 

Dr. Witchadet Witchulada 
Obstetrician and Gynecologist, Subspecialty in Maternal-Fetal Medicine, King Chulalongkorn Memorial Hospital 

Research published in the International Journal of Transgender Health 

References 

1. World Health Organization. Medical Eligibility Criteria for Contraceptive Use, 5th ed. Geneva: WHO. 

2. CDC. U.S. Medical Eligibility Criteria for Contraceptive Use, 2024. 

3. ACOG Practice Bulletin No. 206. Use of Hormonal Contraception in Women with Coexisting Medical Conditions.