What is a significant contraindication to the use of combined oral contraceptives?

• A. A history of severe migraines
• B. History of thromboembolic events
• C. Smoking
• D. Hypertension

Answer: (B)

The use of combined oral contraceptives is contraindicated in individuals with a history of thromboembolic events due to the increased risk of clot formation. Combined oral contraceptives, which contain both estrogen and progestin, can elevate the likelihood of venous thromboembolism (VTE) because estrogen affects clotting factors in the blood and can lead to a hypercoagulable state. Patients with a prior history of thrombosis have already demonstrated a propensity for clotting issues, significantly raising their risk if they were to use these contraceptives.

While other factors, such as severe migraines, smoking, and hypertension, can also increase risks associated with oral contraceptive use, the presence of a thromboembolic history directly indicates a prior serious adverse event related to clotting, thus making it a significant contraindication. In the context of treatment safety, ensuring that patients with such a history do not use combined oral contraceptives is crucial to prevent potential life-threatening complications.