Newer OCPs Associated with an Increase Risk of DVTs

We've known for a while that estrogens can increase the risk of thromboembolic events in women, whether used for contraception or to treat vasomotor instability.  Recently, we've started offering lower & lower doses for both situations to mitigate this situation.

While deep venous thromobotic (DVT) risk appears to be lower for transdermal forms used to treat vasomotor instability, the only contraceptive patch actually increases thromboembolic risk compared to oral forms.  Obviously, the manufacturers have been working to develop newer versions of hormonal contraception in the hopes that risk of thromboembolic events would be lower.

However, as of last month, the Food & Drug Administration (FDA) was still trying to get a handle on drosperinone's risk for DVT.  But even after publication in the British Medical Journal (BMJ) last week of a cohort study of 1,436,130 women on contraception followed for 8 years that concluded that the newer generation of progestins increases risk for DVT, the FDA had not yet reached a conclusion.

To remove any bias, it should be noted that even the vaginal hormonal ring is associated with an increase risk of DVT, just like the transdermal patch as noted above.  However, while progestin combination hormone pills can double & even triple the (relative) risk of DVT, the overall (absolute) risk remains small.

Furthermore, don't forget that hormonal contraception has been associated with a lower risk of cancer, especially ovarian.  In the end, the decision regarding which hormonal method to use should be an individual one made in conjunction with one's family physician after reviewing one's medical, surgical, family & social history.  By the way, don't forget to use a condom to minimize risk of catching/giving STDs.

Follow @alvinblin
Tweet