The truth about oral contraceptives and venous thromboembolism

J Reprod Med. 2003 Nov;48(11 Suppl):930-8.

Abstract

In the last decade, the contribution of the progestin component of oral contraceptives (OCs) to the risk of venous thromboembolism (VTE) has come under scrutiny. The publication of 4 papers in late 1995 and early 1996 led to many women discontinuing OCs containing desogestrel and gastodene, the so-called third-generation OCs. This "pill scare" was the result of study findings that the third-generation OCs were associated with a higher risk of VTE than were OCs containing older progestins, primarily levonorgestrel. Subsequent studies and reanalysis of the original studies have not provided a definitive answer to this continuing debate. More recently, a question was raised about a possible increase in the risk of VTE associated with the use of an OC containing the novel progestin drospirenone. However, the information to date does not support any increase in the risk of VTE with use of the drospirenone-containing OC as compared with any other combination OC.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Androstenes / adverse effects
  • Bias
  • Confounding Factors, Epidemiologic
  • Contraceptives, Oral, Combined / adverse effects*
  • Contraceptives, Oral, Synthetic / adverse effects*
  • Desogestrel / adverse effects
  • Female
  • Humans
  • Risk Factors
  • Thromboembolism / chemically induced*
  • Thromboembolism / prevention & control
  • Time Factors
  • Venous Thrombosis / chemically induced*
  • Venous Thrombosis / prevention & control
  • Women's Health

Substances

  • Androstenes
  • Contraceptives, Oral, Combined
  • Contraceptives, Oral, Synthetic
  • Desogestrel
  • drospirenone