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Updated: May 21, 2026

Ferric Chloride-induced Murine Thrombosis Models
Published on: September 5, 2016
Thrombotic risks of oral contraceptives
1Coagulation Center, Duisburg, Germany. hannelore.rott@gzrr.de
Purpose Of Review:
To inform about the risk of venous thromboembolism (VTE) of different hormonal contraceptives in different patient groups.
Recent Findings:
Combined oral contraceptives (COCs) differ significantly regarding VTE risk depending on amount of estrogen and type of progestogen: COCs containing desogestrol, gestoden or drospirenone in combination with ethinylestradiol (so called third-generation or fourth-generation COCs) are associated with a higher VTE risk than COCs with ethinylestradiol and levonorgestrel or norethisterone (so called second-generation COCs). The VTE risk for transdermal COCs like vaginal ring (NuvaRing) or patch (Evra) is as high as for COCs of third or fourth generation. Progestogen-only contraceptive methods do not increase VTE risk significantly. New kinds of COC without ethinylestradiol but with estradiol valerat or estradiol showed a much lower degree of coagulation activation than 'classical' COC containing ethinylestradiol.
Summary:
Second-generation COCs should be the first choice when prescribing hormonal contraception.In patients with a history of VTE and/or a known thrombophilic defect, COCs are contraindicated, but progestogen-only contraceptives can be safely used in this patient group. Whether newer COCs with estradiol valerate or estradiol have a lower VTE risk remains to be elucidated.
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