Family Nurse Practitioner Exam

What is considered a relative contraindication for combined oral contraceptive pills?

1. Undiagnosed vaginal bleeding

2. A hepatoma of the liver

3. Suspected history of TIAs

4. Depression

The correct answer is: Depression

Understanding relative contraindications for combined oral contraceptive pills (COCs) is essential in clinical practice. While not an absolute barrier to the use of COCs, depression can pose significant concerns when prescribing these contraceptives. Hormonal contraceptives, including COCs, can have various effects on mood and mental health, with some studies suggesting a potential link between hormone fluctuations and the exacerbation of depressive symptoms in susceptible individuals. Thus, while many women with depression can safely use COCs, healthcare providers typically weigh the risks and benefits carefully, considering the patient's mental health history and any current psychiatric treatment. If a patient has a history of severe depression or is currently experiencing significant depressive symptoms, this could lead to a recommendation against the use of COCs. In contrast, options such as undiagnosed vaginal bleeding, hepatoma of the liver, and suspected history of transient ischemic attacks (TIAs) represent stronger contraindications. Undiagnosed vaginal bleeding requires investigation to rule out serious conditions, while a hepatitis tumor and history of TIAs are well-documented factors that significantly increase the risk of serious side effects from hormonal contraceptives, such as thromboembolic events. By identifying depression as a relative contraindication, healthcare providers convey the importance