Title: Epidemiology of venous thromboembolic disease and OC use.

POPLINE Document Number: 120225

Author(s):

Ory HW

Source citation:

DIALOGUES IN CONTRACEPTION, 1996 Fall;5(1):4-7, 10.

Abstract:

A review of recent epidemiologic studies that have detected an association between the use of oral contraceptives (OCs) containing the progestins gestodene and desogestrel and venous thromboembolism (VTE) risk suggests evidence of bias. Reviewed are five major case-control and cohort studies: World Health Organization Collaborative Study, Boston Collaborative Drug Surveillance Program Study, European Transnational Study, and the Leiden Study. Three major sources of bias could account for the increased VTE risk among users of third-generation compared to second-generation OCs: 1) selective prescription of newer formulations to higher-risk women; 2) the increased tendency for women with suspected VTE to be more likely to be referred for diagnostic testing and hospitalization if they are taking the newer OCs rather than older formulations; and 3) attrition of susceptibles. The lack of any proposed biological basis for the observed association between VTE and the new progestins, compared with previous knowledge about the responsibility of estrogen for increased VTE risk, raises additional doubts about the findings. Any evaluation should balance the effects of OCs on overall risk of cardiovascular disease against protection from pregnancy and noncontraceptive health benefits such as a reduced risk of certain cancers.

Keywords:

Oral Contraceptives, Side Effects
Gestodene
Desogestrel
Thromboembolism
Risk Factors
Epidemiology
Bias
Side Effects
Contraceptive Methods
Contraceptive Agents, Side Effects
Women
Contraceptive Safety
Safety
Public Health
Health
Contraceptive Agents, Progestin
Contraceptive Agents, Female
Contraceptive Agents
Contraception
Family Planning
Embolism
Vascular Diseases
Diseases
Biology
Error Sources
Measurement
Research Methodology
Treatment
Demographic Factors
Population