Monthly Injectables.................................................................... 81

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: y Have or have not had children y Are not married y Are of any age, including adolescents and women over 40 years old y Have just had an abortion or miscarriage y Smoke cigarettes—if under 35 years old y Have anemia now or had in the past y Have varicose veins y 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: y Without a pelvic examination y Without any blood tests or other routine laboratory tests y Without cervical cancer screening y Without a breast examination y Even when a woman is not having monthly bleeding at the time, if it is reasonably certain she is not pregnant (see Pregnancy Checklist, p. 372)