How many types of birth control pills are there? 

1. Combined hormonal type (estrogen + progestin) 

2. Progestin-only type 

Most contraindications are related to “estrogen” 

Important contraindications for combined hormonal contraceptives 

According to the guidelines of 
World Health Organization and 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 age over 35 

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 in the early postpartum period 

🧠 What doctors often see 

Buying birth control pills and taking them without a risk assessment first 
is the starting point of many problems seen in patients 

This is especially true for migraine with aura 
which many people do not realize applies to them 

A thorough medical history before starting the medication 
is therefore more important than many people think 

Femily Wellness Clinic, Ari 
About 200 meters from BTS Ari 
You can come in for a consultation before choosing a contraceptive method 

Written by 

Dr. Vichadet Vichulda 
Specialist in Obstetrics and Gynecology 
Pursuing subspecialty training in Maternal-Fetal Medicine at 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.