Combined oral contraceptives: the risk of myocardial infarction and ischemic stroke

Roach, Rachel E J; Helmerhorst, Frans M.; Lijfering, Willem M.; Stijnen, Theo; Algra, Ale; Dekkers, Olaf M.

doi:10.1002/14651858.cd011054.pub2

Cited by 173 publications

(162 citation statements)

References 143 publications

Supporting

Mentioning

143

Contrasting

Unclassified

Order By: Relevance

“…COC use increases the risk for venous thromboembolism (VTE) by two to four times (21) and for stroke by 1.5 to two times, compared with risk levels in nonusers (22). The risk for VTE or stroke is not statistically different between pills containing 20 mcg and 30 mcg of EE (22,23).…”

Section: Hormonal Contraceptives Thromboembolic Events and Strokementioning

confidence: 99%

Contraceptive care for Canadian youth

Meglio

Crowther

Simms

2018

Paediatrics &Amp; Child Health

View full text Add to dashboard Cite

Sexual and reproductive health is an important component of comprehensive health care for youth. This statement provides guidance for selecting and prescribing contraceptives for youth, including commonly prescribed hormonal contraceptives-the pill, patch, ring and injectable progestin-and long-acting reversible contraceptives (LARCs). LARCs, including subdermal implants (which are not available in Canada) and intrauterine contraceptives (IUCs), are substantially more effective during typical use than hormonal contraceptives. This statement endorses LARCs as the first-line option for contraception for Canadian youth, while emphasizing that providers must collaborate with youth to select a contraceptive method that is acceptable, safe, effective and practical for them. Strategies that eliminate obstacles to initiating and continuing contraception are provided.

show abstract

Section: Hormonal Contraceptives Thromboembolic Events and Strokementioning

confidence: 99%

Contraceptive care for Canadian youth

Meglio

Crowther

Simms

2018

Paediatrics &Amp; Child Health

View full text Add to dashboard Cite

show abstract

“…65 CHCs have been associated with an increased risk of arterial thrombosis but the magnitude of the risk and the effect of different hormonal contents remain unclear. 66,67 The European Medicines Agency (EMA) and the Italian Pharmaceutical Agency (Agenzia Italiana del Farmaco -AIFA) have concluded that the benefits of CHCs in preventing unwanted pregnancies continue to outweigh their risks, and that the wellknown risk of VTE with all CHCs is small. It is important that women are made aware of the risk of VTE and its signs and symptoms, and that doctors take into consideration a woman's individual risk factors when prescribing a contraceptive.…”

Section: Venous Thromboembolism and Combined Hormonal Contraceptive: mentioning

confidence: 99%

Young FADOI and gender medicine: sex gender differences in cardiovascular disease

Ciarambino

Gino

Gnerre³

et al. 2018

Ital J Med

View full text Add to dashboard Cite

IntroductionBernardine Healy, in an editorial of 1991 on the NEJ The Yentl Syndrome, 1,2 showed how cardiovascular disease in women is understudied, under diagnosed and undertreated. The adverse ischemic heart disease is leading cause of death, less common in young women, where myocardial infarction (MI) mortality is two-fold higher in women younger than 50 years compared with age-matched men. The literature suggests that when women look like men, with male-pattern obstructive cardiovascular diseases (CHD), they are more likely to be diagnosed and treated like men. Two new analyses suggest that the Yentl syndrome is alive and well 10 years later. The first event in women takes about 10-20 years later than men. Women are more likely than men to have highrisk presentations and less likely to manifest central chest pain. 1,3 Pain in the upper back, arm, neck, and jaw, as well as unusual fatigue, dyspnea, indigestion, nausea/vomiting, palpitations, weakness, and a sense of dread, occur more frequently in women compared with men. The absence of chest pain or silent heart attack is more common in women than in men (35% vs 28%). So, women often turn later to the doctor and are treated less aggressively.1 Cardiovascular disease is the most common cause of death and hospitalization in worldwide. Recognition of important gender differences plays an important role in cardiovascular disease prevention. New sensitivity about gender differences, and particularly attention among women, will be necessary for more analytic view about cardiovascular disease in both sexes. Possible causesThe Framingham study already described the risk factors for CHD in women; then the INTERHEART, conducted in 52 countries around the world, identified nine risk factors, measurable and modifiable. These factors measurable and modifiable are: i) smoking; ii) hypertension; iii) diabetes; iv) dyslipidemia; v) abdominal obesity (waist/hip ratio); vi) stress and psychosocial factors; vii) physical inactivity; viii) low intake of fruits and vegetables; ix) alcohol. More risk factors greatly multiply the probability of infarction. 4,5 These risk factors explain more than 90% of myocardial infarctions and in about 96% of CHD in women. For example, in women, it has been shown that family and marital stress increase the risk of Young FADOI and gender medicine: sex gender differences in cardiovascular disease ABSTRACTWe have evaluated gender-related differences in cardiovascular disease. In particular, in coronary heart disease, atrial fibrillation, arterial hypertension, venous thromboembolism and diabetes mellitus. ©Copyright T. Ciarambino et al., 2018 Licensee PAGEPress, Italy Italian Journal of Medicine 2018 12:23-31 doi:10.4081/itjm.2018.864 Italian Journal of Medicine 2018; volume 12:23-31 N o n -c o m m e r c i a l u s e o n l y ischemic heart disease. In women there is another condition that simulates the coronary heart disease. This condition is the Takotsubo syndrome. [6][7][8][9][10][11][12][13][14][15][16] Depression is one aspect of psycho...

show abstract

“…The important reason for reduction of the estrogen dose in COCs is based on the evidence that COCs are accountable for the development of a hyperclottable state. 23 A recent Cochrane review conducted that preparations containing lower doses of estrogen did not increase the arterial thrombotic risk, and the risk did not vary according to which progestogen type was used.…”

Section: Effect On Haemostasismentioning

confidence: 99%

Ultra-low-dose oral contraceptive pill: a new approach to a conventional requirement

Ahuja

Pujari

2017

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Combined oral contraceptives (COCs) offer a convenient, safe, effective, and reversible method of contraception. However, their use is limited by side effects. Several strategies have been suggested to make COC use more acceptable among women. Reduction in the dose of estrogen is a commonly accepted approach to reduce the side effects of COC. Use of newer generation of progestins, such as gestodene, reduces the androgenic side effects generally associated with progestogens. Furthermore, reduction in hormone-free interval, as a 24/4 regimen, can reduce the risk of escape ovulation (hence preventing contraceptive failure) and breakthrough bleeding. It also reduces hormonal fluctuations, thereby reducing the withdrawal symptoms. A COC with gestodene 60 µg and ethinylestradiol (EE) 15 µg offers the lowest hormonal dose in 24/4 treatment regimen. This regimen has been shown to offer good contraceptive efficacy and cycle control. With the progress of treatment cycles, the incidence of breakthrough bleeding reduces. Gestodene/EE low dose 24/4 regimen was associated with lower incidence of estrogen-related adverse events, such as headache, breast tenderness, and nausea. Furthermore, COCs containing low dose of estrogen have not been associated with any adverse effect on haemostasis in healthy women. Ultra-low-dose COCs can be considered in women who are at risk of developing estrogen-related side effects.

show abstract

Combined oral contraceptives: the risk of myocardial infarction and ischemic stroke

Cited by 173 publications

References 143 publications

Contraceptive care for Canadian youth

Contraceptive care for Canadian youth

Young FADOI and gender medicine: sex gender differences in cardiovascular disease

Ultra-low-dose oral contraceptive pill: a new approach to a conventional requirement

Contact Info

Product

Resources

About