The Medical Letter on Drugs and Therapeutics
Combination Oral Contraceptives and the Risk of Venous Thromboembolism
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Combination oral contraceptives increase the risk of venous thromboembolism (VTE). Their benefits, in addition to preventing pregnancy, include lowering the risk of ovarian and endometrial cancer, reducing dysfunctional uterine bleeding and increasing serum hemoglobin concentrations.1 Are these benefits worth the risk? And are some combination oral contraceptives safer than others?

DEGREE OF RISK — Users of contemporary combination oral contraceptive formulations have a risk of VTE 2-3 times the risk of nonusers, but the absolute risk is low: 8-10 events per 10,000 women-years, which is lower than the risk of VTE associated with pregnancy and especially the postpartum period.2 Other factors that increase the risk include obesity, immobility, trauma, a recent operation, thrombophlebitis and advanced maternal age.

CHOICE OF CONTRACEPTIVES — Some ... more      

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Title: Combination Oral Contraceptives and the Risk of Venous Thromboembolism
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