[P-pills and thrombosis]

This review provides an account of the present situation as reflected by findings in recent studies, which illustrate epidemiological, clinical and metabolic aspects of thrombosis associated with oral contraceptive (OC) usage. With the reduction of the oestrogen content of OCs, the relative risk for acute myocardial or cerebral thrombosis is now 1.5-3. Low-dose OCs containing third generation gestagens seem to be associated with less risk of infarction, and possibly of cerebral thrombosis, than are OCs containing second generation gestagens. The risk of venous thrombosis is increased 2-4-fold in conjunction with the usage of low-dose OCs with second generation gestagens, and possibly slightly more (3-5-fold) in conjunction with OCs containing third generation gestagens, though this is of small clinical significance. When prescribing OCs for women at an increased risk of venous thrombosis, a low-dose pill with a second generation progestagen seems to be preferable. If OCs are prescribed to women at an increased risk of arterial thrombosis, OCs with third generation progestagens seem to be a reasonable first choice. Women with no thrombotic predisposion can safely use any type of low-dose OCs [corrected].