The use of combined OCP’s is associated with an increased incidence of:
**Core Concept**
The use of combined oral contraceptive pills (OCPs) is associated with an increased risk of thromboembolic events due to the estrogen and progestin components. This is primarily due to the procoagulant effects of estrogen, which enhances the production of clotting factors and platelet aggregation.
**Why the Correct Answer is Right**
Combined OCPs contain both estrogen and progestin, which work together to prevent ovulation and thicken cervical mucus. However, estrogen also has a procoagulant effect, increasing the levels of clotting factors and platelet aggregation, thereby increasing the risk of thromboembolic events. This effect is more pronounced with the second-generation progestins, which are more androgenic and have a higher risk of thrombosis.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is not directly related to the use of combined OCPs. While hypertension is a risk factor for thromboembolic events, it is not a direct consequence of using combined OCPs.
**Option B:** While mood changes and depression can be associated with the use of OCPs, they are not the primary increased incidence associated with combined OCPs.
**Option C:** This option is incorrect as the primary increased incidence associated with combined OCPs is thromboembolic events, not ectopic pregnancy.
**Clinical Pearl / High-Yield Fact**
It's essential to note that the risk of thromboembolic events associated with combined OCPs is higher in women with a history of smoking, hypertension, or hyperlipidemia.
**Correct Answer:** C.