Use of combination OCs is contraindicated by the following: < 21 days postpartum or < 42 days postpartum if risk of venous thromboembolism is high Smoking > 15 cigarettes / day in women > 35 Current or past breast cancer Severe decompensated cirrhosis, hepatocellular adenoma, or liver cancer Venous thromboembolism (deep venous thrombosis or pulmonary embolism), thrombogenic mutation, or systemic lupus erythematosus (SLE) with unknown or positive antiphospholipid antibody status Migraine with aura or migraine of any type in women > 35 Hypertension Ischemic heart disease Peripartum cardiomyopathy Diabetes for > 20 years or with vascular disease (eg, neuropathy, nephropathy, retinopathy) Valvular heart disorders with complications Solid-organ transplantation with complications Current or medically treated gallbladder disease or a history of contraceptive-related cholestasis Hypertriglyceridemia Acute viral hepatitis Progestin-only oral contraceptives To be effective, progestin-only OCs must be taken at the same time of day, every day.