Combined oral contraceptives are generally accepted to be contraindicated in women with pre-existing cardiovascular disease, in women who have a familial tendency to form blood clots (such as familial factor V Leiden), women with severe obesity and/or hypercholesterolemia (high cholesterol level), and in smokers over age 35.
COC are also contraindicated for women with liver tumors, hepatic adenoma or severe cirrhosis of the liver, those who have migraine with aura and for those with known or suspected breast cancer. (WHO category 4).