Benefits and Risks of Third-generation Oral Contraceptives

Overview

Journal J Gen Intern Med

Publisher Springer

Specialty General Medicine

Date 1999 Nov 26

PMID 10571709

Citations 5

Authors

E S LeBlanc

A Laws

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate the risks and benefits of third-generation oral contraceptives.

Data Sources: A MEDLINE search was done for English language articles published from 1985 through 1998 relating to the side-effect profile of third-generation oral contraceptives or their association with cardiovascular or thromboembolic disease. All articles containing original data were included.

Data Synthesis: The risk of venous thromboembolism appears to be 1.5- to 2.7-fold greater in users of third-generation, compared with second-generation, oral contraceptives. Compared with nonusers, women who use third-generation oral contraceptives may have a 4.8- to 9.4-fold greater risk of venous thromboembolism. Users of third-generation oral contraceptives do not appear to have an increased risk of myocardial infarction compared with nonusers and may have risk of myocardial infarction of 0.26 to 0.7 compared with second-generation users. Whether third-generation oral contraceptives are associated with a decreased stroke risk is still not clear.

Conclusions: Although third-generation oral contraceptives most likely increase a user's risk of venous thromboembolism, their improved side-effect profile and their possible decreased association with myocardial infarction and stroke may make them a useful new class of oral contraceptives for most women except those at increased risk of venous thrombosis.

Citing Articles

Long-acting intrauterine systems: Recent advances, current challenges, and future opportunities.

Fanse S, Bao Q, Burgess D Adv Drug Deliv Rev. 2022; 191:114581.

PMID: 36270490 PMC: 10302114. DOI: 10.1016/j.addr.2022.114581.

Combined Oral Contraceptives and Venous Thromboembolism: Review and Perspective to Mitigate the Risk.

Morimont L, Haguet H, Dogne J, Gaspard U, Douxfils J Front Endocrinol (Lausanne). 2021; 12:769187.

PMID: 34956081 PMC: 8697849. DOI: 10.3389/fendo.2021.769187.

Relationship between hormonal contraceptives and sleep among women of reproductive age: a systematic review protocol.

Ma J, Cheng M, Thabane L, Ma C, Zhang N, Wang Q BMJ Open. 2021; 11(10):e045819.

PMID: 34625410 PMC: 8504351. DOI: 10.1136/bmjopen-2020-045819.

Hormonal contraceptives and cerebral venous thrombosis risk: a systematic review and meta-analysis.

Amoozegar F, Ronksley P, Sauve R, Menon B Front Neurol. 2015; 6:7.

PMID: 25699010 PMC: 4313700. DOI: 10.3389/fneur.2015.00007.

Exposure to combined oral contraceptives and risk of venous thromboembolism: a protocol for nested case-control studies using the QResearch and the CPRD databases.

Vinogradova Y, Coupland C, Hippisley-Cox J BMJ Open. 2014; 4(4):e004499.

PMID: 24713217 PMC: 3987715. DOI: 10.1136/bmjopen-2013-004499.

References

Greenlund K, Webber L, Srinivasan S, Wattigney W, JOHNSON C, Berenson G . Associations of oral contraceptive use with serum lipids and lipoproteins in young women: the Bogalusa Heart Study. Ann Epidemiol. 1997; 7(8):561-7. DOI: 10.1016/s1047-2797(97)00119-1. View

Darney P . OC practice guidelines: minimizing side effects. Int J Fertil Womens Med. 1997; Suppl 1:158-69. View

Helmerhorst F, Bloemenkamp K, Rosendaal F, Vandenbroucke J . Oral contraceptives and thrombotic disease: risk of venous thromboembolism. Thromb Haemost. 1997; 78(1):327-33. View

Lewis M, Spitzer W, Heinemann L, MacRae K, Bruppacher R . Lowered risk of dying of heart attack with third generation pill may offset risk of dying of thromboembolism. BMJ. 1997; 315(7109):679-80. PMC: 2127469. DOI: 10.1136/bmj.315.7109.679b. View

Schwartz S, Siscovick D, Longstreth Jr W, Psaty B, Beverly R, Raghunathan T . Use of low-dose oral contraceptives and stroke in young women. Ann Intern Med. 1997; 127(8 Pt 1):596-603. DOI: 10.7326/0003-4819-127-8_part_1-199710150-00003. View

Lewis M, Heinemann L, Spitzer W, MacRae K, Bruppacher R . The use of oral contraceptives and the occurrence of acute myocardial infarction in young women. Results from the Transnational Study on Oral Contraceptives and the Health of Young Women. Contraception. 1997; 56(3):129-40. DOI: 10.1016/s0010-7824(97)00118-2. View

Heinemann L, Lewis M, Thorogood M, Spitzer W, Guggenmoos-Holzmann I, Bruppacher R . Case-control study of oral contraceptives and risk of thromboembolic stroke: results from International Study on Oral Contraceptives and Health of Young Women. BMJ. 1998; 315(7121):1502-4. PMC: 2127931. DOI: 10.1136/bmj.315.7121.1502. View

Heinemann L, Lewis M, Spitzer W, Thorogood M, Guggenmoos-Holzmann I, Bruppacher R . Thromboembolic stroke in young women. A European case-control study on oral contraceptives. Transnational Research Group on Oral Contraceptives and the Health of Young Women. Contraception. 1998; 57(1):29-37. DOI: 10.1016/s0010-7824(97)00204-7. View

Lidegaard O, Edstrom B, Kreiner S . Oral contraceptives and venous thromboembolism. A case-control study. Contraception. 1998; 57(5):291-301. DOI: 10.1016/s0010-7824(98)00033-x. View

10.

Sidney S, Siscovick D, Petitti D, Schwartz S, Quesenberry C, Psaty B . Myocardial infarction and use of low-dose oral contraceptives: a pooled analysis of 2 US studies. Circulation. 1998; 98(11):1058-63. DOI: 10.1161/01.cir.98.11.1058. View

11.

Bloemenkamp K, Rosendaal F, Buller H, Helmerhorst F, Colly L, Vandenbroucke J . Risk of venous thrombosis with use of current low-dose oral contraceptives is not explained by diagnostic suspicion and referral bias. Arch Intern Med. 1999; 159(1):65-70. DOI: 10.1001/archinte.159.1.65. View

12.

Mann J, INMAN W . Oral contraceptives and death from myocardial infarction. Br Med J. 1975; 2(5965):245-8. PMC: 1673262. DOI: 10.1136/bmj.2.5965.245. View

13.

Mann J, INMAN W, Thorogood M . Oral contraceptive use in older women and fatal myocardial infarction. Br Med J. 1976; 2(6033):445-7. PMC: 1687562. DOI: 10.1136/bmj.2.6033.445. View

14.

Ory H . Association between oral contraceptives and myocardial infarction. A review. JAMA. 1977; 237(24):2619-22. View

15.

Shapiro S, Slone D, Rosenberg L, Kaufman D, STOLLEY P, Miettinen O . Oral-contraceptive use in relation to myocardial infarction. Lancet. 1979; 1(8119):743-7. DOI: 10.1016/s0140-6736(79)91205-4. View

16.

Rosenberg L, Hennekens C, Rosner B, Belanger C, Rothman K, Speizer F . Oral contraceptive use in relation to nonfatal myocardial infarction. Am J Epidemiol. 1980; 111(1):59-66. DOI: 10.1093/oxfordjournals.aje.a112874. View

17.

Slone D, Shapiro S, Kaufman D, Rosenberg L, Miettinen O, STOLLEY P . Risk of myocardial infarction in relation to current and discontinued use of oral contraceptives. N Engl J Med. 1981; 305(8):420-4. DOI: 10.1056/NEJM198108203050802. View

18.

CULLBERG G, Samsioe G, Andersen R, BREDESGAARD P, ANDERSEN N, Ernerot H . Two oral contraceptives, efficacy, serum proteins, and lipid metabolism. A comparative multicentre study on a triphasic and a fixed dose combination. Contraception. 1982; 26(3):229-43. DOI: 10.1016/0010-7824(82)90072-5. View

19.

Palatsi R, Hirvensalo E, Liukko P, Malmiharju T, Mattila L, Riihiluoma P . Serum total and unbound testosterone and sex hormone binding globulin (SHBG) in female acne patients treated with two different oral contraceptives. Acta Derm Venereol. 1984; 64(6):517-23. View

20.

Rosenberg L, Kaufman D, Helmrich S, Miller D, STOLLEY P, Shapiro S . Myocardial infarction and cigarette smoking in women younger than 50 years of age. JAMA. 1985; 253(20):2965-9. View