Oral contraceptives in risk groups: exclusion or monitoring?

Article Abstract:

Oral contraceptives have been associated with an increased risk of cardiovascular heart disease, thrombosis (blood clot formation), lipid metabolism (fats) and impaired glucose metabolism. The clinical applications of these alterations in women taking oral contraceptives are not clear. Although it is impossible to perform complex blood tests on all women desiring oral contraceptives, it may be appropriate for selected women. It is likely that the dose of the hormones is less important than the women's individual variation in the metabolic response to various oral contraceptives. Pills should be selected in their ability to prevent breakthrough bleeding, a sign that may indicate that the formula needs to be changed. A ''safe'' oral contraceptive candidate is selected by examining various risk factors, including a family history of cardiovascular disease in a first-degree relative, diabetes mellitus, high blood pressure, cigarette smoking, excess weight and a history of pregnancy-related high blood pressure (toxemia). Women who are taking oral contraceptives should stop taking the pill if they develop pain in the legs, chest and abdomen; have difficulty breathing; develop a migraine headache, numbness, weakness, difficulty taking or seeing; collapse for no apparent reason; have an increase in blood pressure greater than 160/95 millimeters of mercury; have difficulty moving after an accident or emergency surgery; or develop jaundice. Patients on oral contraceptives should have regular blood pressure checks. (Consumer Summary produced by Reliance Medical Information, Inc.)

Coronary heart disease, Dosage and administration, Migraine

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Thrombotic diseases in young women and the influence of oral contraceptives

Article Abstract:

Women who use second-generation oral contraceptives may have a higher risk of thrombotic disease than women who take third-generation oral contraceptives. Thrombotic disease is characterized by excessive blood clotting. Statistics on strokes, heart attacks and other disorders caused by excessive blood clotting in Denmark show that women under the age of 30 were more likely to have venous complications and women over 30 were more likely to have arterial complications. The mortality rate from arterial complications was higher than that for venous complications.

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Oral contraceptives and thrombosis: an overview of study methods and recent results

Article Abstract:

Studies of oral contraceptives (OCs) and excessive blood clotting in the 1990s found that the type of progestin used may increase this risk. This was surprising because estrogen was considered to be the primary culprit. Since the link was discovered in the 1970s, the dose of estrogen in OCs has been reduced. The 1990 studies confirmed that newer types of OCs still increase the risk of abnormal blood clotting, a condition called thrombosis. The risk seems to be highest in those using some of the newer progestins, including desogestrel and gestodene.

Similar abstracts:

• Abstracts: Effects of long-term gestodene-containing oral contraceptives administration on hemostasis

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