Low‐dose combined oral contraceptives

Low-Dose Oral Contraceptive Use and the Risk of Myocardial Infarction

“…The newer OCs generally have smaller effects than earlier pills on clotting factors. The overall effect still tends to be in the direction of increased clotting, 7,8,25 yet within normal ranges. How these changes relate to clinical events is unknown.…”

“…The newer lower-dose OCs have less adverse effects on serum lipid levels than earlier preparations. 7,8,23 However, the observation in epidemiologic studies that the effect of OCs is acute, [1][2][3][4][5] coupled with clinical evidence of clots in OC users who suffered MIs, 24 suggests that a thrombotic rather than an atherogenic mecha-nism is involved in OC-related MIs. The newer OCs generally have smaller effects than earlier pills on clotting factors.…”

“…[4][5][6] Over the years, OC manufacturers have progressively lowered the doses, developed new progestins, and devised new types of formulations, such as triphasic preparations that release different doses of estrogen and progestin over the course of the menstrual cycle. [7][8][9][10] To assess whether the newer preparations are safer than earlier formulations, we carried out a large case-control study of OC use and the occurrence of first MI in young women. Table 1 gives the distributions of age, region of the hospital, interview year, and potential MI risk factors among the cases and controls.…”

Oral Contraceptives and the Risk of Myocardial Infarction

“…Oral contraceptives containing an estrogen and the progestagen desogestrel or gestodene, available since the 1980s, are associated with at least a doubling of the risk of venous thrombosis as compared with other combined oral contraceptives. [8][9][10][11][12] It has been suggested that these third-generation contraceptives protect against myocardial infarction by having a favorable effect on the lipid profile, [13][14][15] because studies showed that women who used these types had a slight increase in the level of high-density lipoprotein cholesterol. 15,16 Only a few studies of the association between oral contraceptives and myocardial infarction have included a direct comparison of third-and second-generation progestagens, and the results have been contradictory.…”

“…[8][9][10][11][12] It has been suggested that these third-generation contraceptives protect against myocardial infarction by having a favorable effect on the lipid profile, [13][14][15] because studies showed that women who used these types had a slight increase in the level of high-density lipoprotein cholesterol. 15,16 Only a few studies of the association between oral contraceptives and myocardial infarction have included a direct comparison of third-and second-generation progestagens, and the results have been contradictory. [17][18][19][20][21] We investigated whether the use of low-dose combined oral contraceptives affects the risk of myocardial infarction.…”