Oral Contraceptives and the Risk of Venous Thromboembolism

摘要: Oral Contraceptives (OC) were introduced in the 1960s and a major advance family planning technology for women. The first pills contained high doses of estrogen progestin; 4 times more 10 progestin than today’s OCs (Buttar Seward, Enovid: hormonal birth control pill, 2009; http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.DrugDetails). cases cardiovascular events OC users, including venous thromboembolism (VTE), myocardial infarction stroke observed soon after marketed (Records unit Research Advisory Service Royal College General Practitioners 1967; Inman Vessey, BMJ 2:193–199, 1968; Vessey Doll, Br Med J 2(5599):199–205, 2(5658):651–657, 1969; Sartwell et al., Am Epidemiol 90:365–380, 2:203–209, 1970). It was thought at that time hormone responsible 1967) consequently lower dose with different progestins goal to reduce CVD risk. This next generation did risk CVD, VTE particular, but recently discussions around have focused on type concerns raised newer, so called third fourth OCs, might increase compared containing older levonorgestrel (Meade 280:1157–1161, 1980; Sitruk-Ware, Maturitas 47:277–283, 2004; WHO, Lancet 346:1582–1588, 1995; Jick 346:1589–1593, Bloemenkamp 346:1593–1596, Lidegaard Contraception 57:291–301, 1998; Farmer 349:83–88, 1997; Spitzer 312:83–88, 1996; 321:1190–1195, 2000; Kemmeren 323:131–134, 2001). Studies since found risks vary according formulation (Lidegaard 343:d6423, 2011; Vasilakis-Scaramozza Jick, 358:1427–1429, 2001; Seaman Pharmocoepidemiol Drug Saf 13:427–436, Vasilakis 254:1610–1611, 1999; Rubig, Climacteric 6:49–53, 2003; Heineman Dinger, 27:1001–1018, 2004). Below, history development its relationship is described from when pill until present day, many years formulations later.