Side effects that have been reported in users of COCs but for which the association has been neither confirmed nor refuted are*: (see table).
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The following serious adverse events have been reported in women using COCs, which are discussed in Precautions: Venous thromboembolic disorders; Arterial thromboembolic disorders; Cerebrovascular accidents; Hypertension; Hypertriglyceridemia; Changes in glucose tolerance or effect on peripheral insulin resistance; Liver tumours (benign and malignant); Liver function disturbances; Chloasma; In women with hereditary angioedema exogenous estrogens may induce or exacerbate symptoms of angioedema; Occurrence or deterioration of conditions for which association with COC use is not conclusive: jaundice and/or pruritus related to cholestasis; gallstone formation; porphyria; systemic lupus erythematosus; hemolytic uremic syndrome; Sydenham's chorea; herpes gestationis; otosclerosis-related hearing loss, Crohn's disease, ulcerative colitis, cervical cancer.
The frequency of diagnosis of breast cancer is very slightly increased among OC users. As breast cancer is rare in women under 40 years of age the excess number is small in relation to the overall risk of breast cancer. Causation with COC use is unknown. For further information, see "Contraindications" and "Precautions".