Oral contraceptives and venous thromboembolism: a five-year national case-control study (original) (raw)
Related papers
2014
The objective of this study was to assess the influence of oral contraceptives (OCs) on the risk of venous thromboembolism (VTE) in young women. A 5-year case-control study including all Danish hospitals was conducted. All women 15–44 years old, suffering a first ever deep venous thrombosis or a first pulmonary embolism (PE) during the period January 1, 1994, to December 30, 1998, were included. Controls were selected annually, 600 per year in 1994–1995 and 1200 per year 1996–1998. Response rates for cases and controls were 87.2 % and 89.7%, respectively. After exclusion of nonvalid diagnoses, pregnant women, and women with previous thrombotic disease, 987 cases and 4054 controls were available for analysis. A multivariate, matched analysis was performed. Controls were matched to cases within 1-year age bands. Adjustment was made for confounding influence (if any) from the following variables: age, year, body mass index, length of OC use, family history of VTE, cerebral thrombosis o...
Epidemiology of the contraceptive pill and venous thromboembolism
Thrombosis Research, 2011
Current users of combined oral contraceptives have an increased risk of venous thromboembolism. The risk appears to be higher during the first year of use and disappears rapidly once oral contraception is stopped. There is a strong interaction between hereditary defects of coagulation, combined oral contraceptive use and venous thromboembolism. Nevertheless, the routine screening of women before they use combined oral contraception is not recommended. Venous thromboembolism seems to be higher in overweight users, and after air, and possibly other forms of, travel. Both the oestrogen and progestogen content of combined oral contraceptives have been implicated in differences in venous thrombotic risk between products. Even if real, the absolute difference in risk between products is small, because the background incidence of venous thromboembolism in young women is low. All currently available combined oral contraceptives are safe. Progestogen-only oral contraceptives are not associated with an increased risk of venous thromboembolism.
2010
Correspondence to: Professor Robert L Reid, Department of Obstetrics and Gynecology, Faculty of Health Sciences, Queen’s University, Kingston, Ontario, Canada ON K7L 4V7. E-mail: robert.reid@queensu.ca Background and purpose of the workshop Concern about the venous thromboembolism (VTE) risk of new hormonal contraceptive options shortly after their entry into the market has triggered a number of ‘pill scares’, each of which resulted in panic stopping of the formulations in question and a spike in unplanned pregnancies, yet with no subsequent reduction in VTE rates among women of reproductive age. Perhaps the best example of a recent pill scare that resulted in enormous harm from a public health perspective was the ‘third-generation pill scare’ that occurred in many countries in Europe and around the world in 1995. At that time the new third-generation pills were promoted as being less androgenic and as possibly having fewer adverse effects on cardiovascular and metabolic parameters ...
Oral contraceptives and thrombotic diseases: impact of new epidemiological studies [editorial]
Contraception, 1996
Four epidemiological studies have examined the effect of various types of oral contraceptives (OCs) on the risk of developing deep venous thrombosis and pulmonary embolism collectively referred to as venous thromboembolism (VTE). They suggest that women using OCs containing the third generation progestins desogestrel or gestodene face a greater risk of non-fatal VTE than women using OCs with less than 50 mcg ethinyl estradiol and a second generation progestin (generally levonorgestrel). The countries involved in the studies were the Netherlands England Europe and in one study 17 countries worldwide. The odds ratio (OR) of developing VTE among users of OCs with the third generation progestins ranged from 4.8 to 8.7 when compared with nonusers. It ranged from 3.2 to 3.8 for users of second generation OCs. In the study comparing the third generation OCs with the second generation OCs the OR for third generation OCs was 2.2. All the studies controlled for age and previous thrombosis. No...
Epidemiology of hormonal contraceptives-related venous thromboembolism
European journal of endocrinology / European Federation of Endocrine Societies, 2014
For many years, it has been well documented that combined hormonal contraceptives increase the risk of venous thromboembolism (VTE). The third-generation pill use (desogestrel or gestodene (GSD)) is associated with an increased VTE risk as compared with second-generation (levonorgestrel) pill use. Other progestins such as drospirenone or cyproterone acetate combined with ethinyl-estradiol (EE) have been investigated. Most studies have reported a significant increased VTE risk among users of these combined oral contraceptives (COCs) when compared with users of second-generation pills. Non-oral combined hormonal contraception, such as the transdermal patch and the vaginal ring, is also available. Current data support that these routes of administration are more thrombogenic than second-generation pills. These results are consistent with the biological evidence of coagulation activation. Overall, the estrogenic potency of each hormonal contraceptive depending on both EE doses and proge...