The use of estrogens and progestogens in oral contraceptives has caused increased awareness of the metabolic effects of gonadal steroids. The interpretation of the accumulating number of scientific reports is, however, difficult. In particular, the overall picture of metabolic changes and their relation to the risk of cardiovascular diseases is confusing. Multiple risk factors may influence the development of cardiovascular diseases, which might have their origins in both the arterial and venous systems. Oral contraceptives may influence various of these risk factors, including changes in lipid, carbohydrate and hemostasis variables, and these risk factors in turn show clear inter-relationships. The First European Conference on Sex Steroids and Metabolism took place in May 1989. The Conference provided a platform for the Consensus Development Meeting which followed it. Based on questions formulated by the Consensus Committee which considered epidemiologic, carbohydrate, lipid and hemostasis aspects of relevance for the development of cardiovascular diseases, consensus statements were prepared in closed sessions by a panel of invited experts. The Consensus Report provides pertinent clinical guidelines for future contraceptive practice. A synopsis of the discussion and the concluding remarks will be presented regarding the influence of new low-dose oral contraceptives on hemostasis variables and on glucose and lipid metabolism.