Journal of General Internal Medicine

, Volume 14, Issue 10, pp 625–632

Benefits and risks of third-generation oral contraceptives

  • Erin S. LeBlanc
  • Ami Laws
Clinical Reviews

Abstract

OBJECTIVE: To evaluate the risks and benefits of third-generation oral contraceptives.

DATA SOURCES: A medline search was done for English language articles published from 1985 through 1998 relating to the side-effect profile of third-generation oral contraceptives or their association with cardiovascular or thromboembolic disease. All articles containing original data were included.

DATA SYNTHESIS: The risk of venous thromboembolism appears to be 1.5- to 2.7-fold greater in users of third-generation, compared with second-generation, oral contraceptives. Compared with nonusers, women who use third-generation oral contraceptives may have a 4.8- to 9.4-fold greater risk of venous thromboembolism. Users of third-generation oral contraceptives do not appear to have an increased risk of myocardial infarction compared with nonusers and may have risk of myocardial infarction of 0.26 to 0.7 compared with second-generation users. Whether third-generation oral contraceptives are associated with a decreased stroke risk is still not clear.

CONCLUSIONS: Although third-generation oral contraceptives most likely increase a user’s risk of venous thromboembolism, their improved side-effect profile and their possible decreased association with myocardial infarction and stroke may make them a useful new class of oral contraceptives for most women except those at increased risk of venous thrombosis.

Key words

contraceptives, oral desogestrel thromboembolism myocardial infarction cerebrovascular disorders 

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Copyright information

© Society of General Internal Medicine 1999

Authors and Affiliations

  • Erin S. LeBlanc
    • 1
  • Ami Laws
    • 2
  1. 1.the Department of Internal MedicinePortland Veterans Affairs Medical CenterPortland
  2. 2.the Department of Internal MedicineStanford UniversityPalo Alto

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