PIP: Women with high cholesterol, who are successfully controlling it by diet, exercise, medication, or a combination of these treatments, may be able to safely use oral contraceptives (OCs). OCs change the lipid profile but keep it within the normal range. They do not increase the risk of the types of heart disease linked to high cholesterol. Women who use the higher dose OCs do not have an increased risk of heart attack, stroke, or other cardiovascular disease. Animal studies show that the OC protects against development of atherosclerosis. The estrogen component may provide this protection. It may protect against the development of coronary heart disease. Women with a rare genetic form of high cholesterol or severely high cholesterol that does not respond to medication may need to use another contraceptive method than OCs. Other risk factors for cardiovascular disease in women are sedentary lifestyle, cigarette smoking, diabetes mellitus, obesity (30% above ideal weight), high blood pressure, and a family history of heart disease. Older OC users should not smoke. If so, they should use another method. The first steps to lower cholesterol are exercise and modifying the diet, especially reducing the amount of saturated fat. Foods high in saturated fat are meat, dairy products, and eggs. If these fail, persons with high cholesterol need medication.