[Reflexions on a new generation of oral contraceptives]

Recent epidemiologic studies have demonstrated that the risk of vascular disease in those who have ever used oral contraceptives is lower if their oestrogen and progestogen content is reduced. They have also spelled out the importance of additional risk factors (age, smoking...) which act synergistically with the contraceptive risk. New generation low-dose combined oral contraceptives (OCs) are not only characterized by the low content of their steroid components, but also by an adaptation of the chemical nature of the progestogen used and a carefully chosen oestrogen/progestogen ratio. These new OCs effectively inhibit gonadal function and ovulation, and exhibit much fewer untoward metabolic effects than higher dose contraceptive preparations. Pertinent recent data on the lessened metabolic effects of new combined OCs are reviewed, with an emphasis on the effects of low-dose combinations currently available in France and Belgium.