Who Can and Cannot Use Combined Oral Contraceptives

Safe and Suitable for Nearly All Women

Nearly all women can use COCs safely and effectively, including women who:

• Have or have not had children
• Are not married
• Are of any age, including adolescents and women over 40 years old
• Have just had an abortion or miscarriage
• Smoke cigarettes—if under 35 years old
• Have anemia now or had in the past
• Have varicose veins
• Are infected with HIV, whether or not on antiretroviral therapy, unless that therapy includes ritonavir (see Combined Oral Contraceptives for Women With HIV, p. 9)

Women can begin using COCs:

• Without a pelvic examination
• Without any blood tests or other routine laboratory tests
• Without cervical cancer screening
• Without a breast examination
• Even when a woman is not having monthly bleeding at the time, if it is reasonably certain she is not pregnant (see Pregnancy Checklist)

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