Question of the Week
For January 24, 2017
A 29-year-old woman with a history of obesity, hypothyroidism, and gestational diabetes requests a prescription for contraceptives. She had gestational hypertension during her only pregnancy 3 years ago, but since then, her blood pressure and glycated hemoglobin level have remained normal.
Her only current medication is levothyroxine 125 μg daily by mouth. She has no family history of pulmonary embolism, deep-vein thrombosis, or stroke. Her father has a history of type 2 diabetes, and her mother and maternal aunt have had hypothyroidism and pancreatitis attributed to severe hypertriglyceridemia.
Laboratory testing yields the following results:
Total cholesterol (mg/dL)
LDL cholesterol (mg/dL)
HDL cholesterol (mg/dL)
Glycated hemoglobin (%)
Thyroid-stimulating hormone (μU/mL)
Which one of the following hormonal contraceptives is most appropriate for this patient?