[Contraception using a progestagen-only minipill in cardiac patients]

The choice of method of contraception in cardiac patients is often peremptory, as combined oestrogen-progesterone preparations and intra uterine devices are often contraindicated. A pure progesterone mini-pill, lynoestrenol (500 microgram) has been used in our department for several years, and would appear to be a possible solution. Its daily, uninterrupted administration for 6 to 30 months in 40 cardiac patients, many considered to be high risk cases (28 cases), has confirmed its contraceptive action: totally effective, excellent reversibility and satisfactory acceptability despite definite menstrual changes. Above all, it was almost totally innocuous, an essential factor in cardiac patients. No haemodynamic, hypersensitive or thromboembolic side effects were observed in any pateint. No changes were observed in glucose or lipid metabolism, hepatic function or blood coagulation after 3 to 6 months, in 6 to 14 patients at high risk. Platelet aggregation, factors II, V, VII and X, fibrinogen and anti thrombin II were normal. Although this is a small series of patients, the use of microdosage lynoestrenol seems an acceptable method of oral contraception for cardiac patients, providing they collaborate and are closely followed up from the cardiac point of view.