The debate over increased risk of venous thromboembolism due to the pill often ignores the very low absolute risk
There has been a lot of controversy about the increased risk of clotting with the third generation progesterones in recent years.
“The first scare was in the 90s,” says Dr Paddy Moore, a paediatric and adolescent gynaecologist and head of contraceptive and abortion services at The Royal Women’s Hospital in Melbourne.
“And there has been a repeated media interest in 2014 to 2015. It has not resulted in a change to the advice we are giving.”
When considering the risk of venous thromboembolism in women taking the pill, it is important to take into account the very low baseline risk.
The combined oral contraceptive pill doubles the rate of venous thromboembolism from two to four in 10,000.
The newer, third or fourth generation progesterone combined oral contraceptive pills increase the risk three-fold – to between six and 12 events per 10,000 years.
“And, again, to put that in a bit of a context the risk of pregnancy increasing venous thromboembolism sits between five and 20 events per 10,000 women years,” says Dr Moore.
“In the six weeks or so postpartum so in that time of breastfeeding, it is 40 to 60 events.”
This video covers:
- How many women use the combined oral contraceptive pill?
- Can you tell us about the new generations of progesterones. What are they, what are their benefits?
- What are androgen side effects?
- There has been a lot of controversy about the increase risk of clotting with the third generation progesterones. What is the truth?
[media_embed]https://player.vimeo.com/video/196545422[/media_embed]
