What oral contraceptive pill would you recommend for a woman with a family history of breast cancer? Is medroxyprogesterone (Depo-Provera) considered safe? — Mary James, CNP, Andover, Ohio

A family history of breast cancer is not a contraindication to using the combined oral contraceptive pill (nor is such a family history a contraindication to using a progesterone-only contraceptive, such as medroxyprogesterone).

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Perhaps the confusion stems from the findings of the Women’s Health Initiative that showed an increased risk of breast cancer in postmenopausal women taking estrogen and progesterone; this result cannot be extrapolated to premenopausal women. A woman with a personal history of breast cancer or suspected breast cancer should not be on any hormones whatsoever. — Mary Newberry, CNM, MSN (161-3)

These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a question, submit it here.