What is a contraindication for the use of combined oral contraceptives (COC)?

The use of combined oral contraceptives (COCs) carries specific contraindications due to their effects on cardiovascular health and the risk of thromboembolic events. One significant contraindication is a history of migraine with aura. Women who experience migraines with aura are at an increased risk of stroke, particularly when taking estrogen-containing medications like COCs. The presence of aura indicates a higher risk; thus, healthcare providers typically advise against using COCs in these patients to mitigate the potential dangers.

In contrast, a history of asthma does not specifically contraindicate COC use, as asthma can be managed independently of hormonal contraception. Similarly, recent flu vaccination does not interfere with the efficacy of COCs. Lastly, while a family history of diabetes may warrant closer monitoring for diabetic complications, it does not constitute a direct contraindication for the use of COCs in the absence of other risk factors.