Abstract
This is a response to 2 previous articles in the Journal which confirmed the association between the risk of myocardial infarction and the taking of combined oral contraceptive pills. An alternative method of contraception should be recommended for women over age 34 years if they have predisposing risk factors, such as diabetes, obesity, hypertension, or Type 2 hyperlipidemia. The effect of the combined estrogen-progestogen pill may be synergistic. With other methods of contraception there may be a greater risk of pregnancy. However, after age 34 the fecundity is less. In case of failure, early abortion, if acceptable, should be offered. Sterilization might be best. Vasectomy for the husband offers a good alternative.
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