Which of the following is a contraindication to prescribing oral hormonal contraceptives?

Oral hormonal contraceptives are commonly used for various purposes, including contraception and managing menstrual-related disorders. However, certain medical conditions and lifestyle factors can contraindicate their use due to increased risks of complications, especially thromboembolic events.

In the case of a patient who is older than age 35 and has a history of smoking, the risk for cardiovascular issues, including blood clots, significantly increases. Smoking has a well-established relationship with cardiovascular disease and can enhance the thrombotic effects of hormonal contraceptives, creating a heightened risk of serious complications such as deep vein thrombosis (DVT) and pulmonary embolism. Therefore, this specific scenario represents a contraindication for prescribing oral hormonal contraceptives, as the potential risks outweigh the benefits.

Other options listed, such as a history of iron deficiency anemia, dysmenorrhea, or a positive family history of ovarian cancer, do not generally pose the same level of risk regarding the use of oral contraceptives. Iron deficiency anemia, while it requires medical management, does not prevent the safe use of hormonal contraception. Similarly, a history of dysmenorrhea or a family history of ovarian cancer would not contraindicate the use of hormonal contraceptives, as these conditions are not