A 36-year-old woman who smokes and has high blood pressure who is looking for short-term contraception for the next two months. Which option is appropriate?

A 36-year-old woman who smokes and has high blood pressure who is looking for short-term contraception for the next two months. Which option is appropriate?

• A. Ethinylestradiol-containing pill
• B. Copper IUD
• C. Desogestrel
• D. Levonorgestrel intrauterine system

Answer: (C)

In a smoker over 35 with hypertension, avoiding estrogen-containing contraception is key because estrogen raises cardiovascular and thromboembolic risks. For a short two‑month window, a progestin-only option is preferred because it provides effective contraception without estrogen. Desogestrel is a progestin-only pill, so it delivers contraception without estrogen exposure. It’s suitable for short-term use and can be stopped after two months with fertility returning quickly. The other options either expose the patient to estrogen (which isn’t advisable here) or are long-acting methods that extend well beyond a two-month timeframe (like copper or levonorgestrel intrauterine systems), making them less ideal for a brief interval.

In a smoker over 35 with hypertension, avoiding estrogen-containing contraception is key because estrogen raises cardiovascular and thromboembolic risks. For a short two‑month window, a progestin-only option is preferred because it provides effective contraception without estrogen.

Desogestrel is a progestin-only pill, so it delivers contraception without estrogen exposure. It’s suitable for short-term use and can be stopped after two months with fertility returning quickly. The other options either expose the patient to estrogen (which isn’t advisable here) or are long-acting methods that extend well beyond a two-month timeframe (like copper or levonorgestrel intrauterine systems), making them less ideal for a brief interval.