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According to my gynecologist, active liver disease is more of a concern but with an oral contraceptive you do get a first pass through the liver. What about an IUD which releases low levels of estrogen locally or a copper IUD which doesn't release any? The estrogen still gets into the bloodstream but at low levels. According to my gyn this is a better option and my gastro seems perfectly fine with it.
That doesn't prevent me from wondering if its *really* okay but then, I have trust issues :)