Oral Contraceptives and the Risk of Cardiovascular Disease

Over the years, the estrogen dose in combined oral contraceptives has been progressively reduced to decrease the risk of thrombosis; however, the cardiovascular safety of widely used oral contraceptives is still a concern. Low-dose oral contraceptives, especially those containing certain third-generation progestins, have been found to increase the risk of venous thrombosis. Low-dose oral contraceptive use has not been clearly shown to increase the risk of arterial vascular disease. The risk of arterial and venous thrombosis in young healthy women taking low-dose oral contraceptives is outweighed by the risks of unintended pregnancy. Women with cardiovascular risk factors, particularly smoking, must weigh the risk of thrombotic events against the convenience and efficacy of alternative methods for preventing pregnancy. As oral contraceptives are increasingly used in the later reproductive years, further research is needed to define the risks in older women, for whom the prevalence of risk factors and the incidence of cardiovascular disease are higher. © 2010 Springer Science+Business Media, LLC.