The truth about oral contraceptives and venous thromboembolism

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 reanalyses 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 drospirenonecontaining OC as compared with any other combination OC.