A large-scale study from Denmark provides updated information on the risk of venous thromboembolisms (VTEs) associated with different types of hormonal contraceptives. The research reveals that combined hormonal pills, particularly those containing desogestrel, and progesterone-only injections, like medroxyprogesterone (Depo-Provera), carry a significantly higher risk of clots compared to other contraceptive methods.
A new study conducted by Dutch researchers investigated the link between different types of synthetic progesterone and estrogen found in contraceptives and the risk of developing venous thromboembolisms (VTEs). The study, led by Dr. Harman Gailan Hassan Yonis at Aalborg University Hospital in Denmark, analyzed health data from nearly 1.4 million women in Danish national registers over 8.4 million person-years.
None of the women included had a history of thrombosis, cancer, liver or kidney disease, infertility treatment, hormone therapy, polycystic ovary syndrome (PCOS), or endometriosis. \The researchers meticulously adjusted for various factors like age, education, and chronic conditions such as hypertension, diabetes, and multiple sclerosis. During the study period, 2691 VTEs were documented. The standardized VTE rates per 10,000 person-years were 2.0 (1.9-2.1) for women who had never used hormonal birth control. However, VTE rates climbed significantly for those who used hormonal contraceptives, reaching as high as 10 (9.2-10.9) for combined pills and a concerning 11.9 (4.4-25.6) for injections. Notably, the lowest rate of 2.1 (1.7-2.6) was observed among women using intrauterine devices.\Combined hormonal pills containing desogestrel had the highest adjusted incidence rate ratio (IRR), at 7.9 (6.0-10.3), followed by gestodene, another type of combined pill, at 6.7 (5.6-7.9). Medroxyprogesterone, a progesterone-only injection, demonstrated the highest adjusted IRR among progesterone-only methods, at 5.7 (3.5-9.3). Interestingly, this risk level was comparable to that posed by two types of combined pills: Cyproterone acetate and drospirenone. Dr. Alexandria Wells, a clinical assistant professor of obstetrics and gynecology at Stony Brook Medicine in New York, noted that the study's findings regarding the risk associated with progesterone-only injections are new and warrant further investigation. While the study doesn't directly change prescribing guidelines, it offers valuable insights for clinicians to personalize counseling and guide patients towards safer contraceptive options based on their individual risk factors
Hormonal Contraceptives VTE Risk Desogestrel Medroxyprogesterone Danish Study Birth Control Thrombosis
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