What are the contraindications for prescribing combined hormonal contraception in women with a history of thromboembolic events?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Contraindications for prescribing combined hormonal contraception (CHC) in women with a history of thromboembolic events include:

  • History of venous thromboembolism (VTE) is an absolute contraindication to CHC use due to unacceptable health risk (UKMEC Category 4).
  • Current VTE, including women on anticoagulants, should not be prescribed CHC (UKMEC Category 4).
  • Major surgery with prolonged immobilization also contraindicates CHC use because of increased VTE risk (UKMEC Category 4).

In these cases, alternative contraceptive methods that do not increase VTE risk should be considered.

The risk of VTE is increased with CHC use, and this risk is influenced by the type of progestogen in the preparation.

Therefore, combined hormonal contraception is contraindicated in women with a history of thromboembolic events to avoid unacceptable health risks.

References:

Educational content only. Always verify information and use clinical judgement.