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Oral contraceptives: an update.

R T Burkman1

  • 1Department of Obstetrics and Gynecology, Baystate Medical Center, Springfield, Massachusetts 01199, USA.

Drugs of Today (Barcelona, Spain : 1998)
|September 16, 2003
PubMed
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Oral contraceptives carry a persistent risk of venous thromboembolism, especially with factor V Leiden. While serious cardiovascular risks are rare, smoking and hypertension increase stroke and myocardial infarction risk in users.

Area of Science:

  • Reproductive Health
  • Cardiovascular Risk Assessment
  • Pharmacovigilance

Background:

  • Oral contraceptives (OCs) are widely used by reproductive-aged women globally.
  • Cardiovascular risks associated with OCs require ongoing evaluation.
  • Understanding OC side effects and compliance is crucial for effective use.

Purpose of the Study:

  • To review the cardiovascular risks associated with oral contraceptive use.
  • To examine the influence of specific progestins (gestodene, desogestrel) on venous thromboembolism risk.
  • To identify factors affecting OC compliance and successful use.

Main Methods:

  • Review of recent data on cardiovascular risk in oral contraceptive users.
  • Analysis of risk factors for venous thromboembolism, ischemic stroke, hemorrhagic stroke, myocardial infarction, and breast cancer.

Related Experiment Videos

  • Evaluation of factors influencing oral contraceptive adherence and effectiveness.

    • Main Results:

    • A persistent risk of venous thromboembolism exists for all oral contraceptive users, amplified by hemostatic disorders like factor V Leiden.
    • The impact of gestodene and desogestrel on venous thromboembolism risk remains controversial.
    • Ischemic stroke and myocardial infarction risks increase significantly with smoking and hypertension, particularly in older users.
    • Hemorrhagic stroke risk is not elevated in users without hypertension or smoking.
    • A slight increase in breast cancer risk is observed, diminishing approximately 10 years post-cessation.
    • Side effects, understanding of instructions, and timing of pill intake significantly impact successful oral contraceptive use.

    Conclusions:

    • While serious cardiovascular sequelae are uncommon, improved compliance is essential for enhancing oral contraceptive efficacy.
    • Risk stratification considering factors like smoking, hypertension, and genetic predisposition is vital for safe oral contraceptive prescribing.
    • Further research may clarify the role of specific progestins in venous thromboembolism risk.