Personal Views

Hormones, women, and safety

BMJ 1997; 315 doi: (Published 23 August 1997) Cite this as: BMJ 1997;315:493
  1. Margaret Thomas, consultant in family planning and reproductive health care
  1. Lichfield

    Contraceptive research always hits the headlines—as long as the news is bad. In contrast, the revelation that hormone replacement therapy may increase the risk of venous thromboembolism was met by indifference.

    Two winters have passed since the “pill scare” of October 1995, yet there must be few users, prescribers, and prescriber—cum—users who are not struggling to come to terms with the impact of the action taken by the Committee on Safety of Medicines (CSM) in response to the research projects in question. These found a minimally different risk of venous thromboembolism with different brands of the combined oral contraceptive. The conclusion was that the absolute risk for a combined oral contraceptive containing desogestrel or gestodene was 30 per 100 000 women each year, 15 per 100 000 a year for a “second generation” combined oral contraceptive, and 5 per 100 000 a year for non-pregnant non-users. Before the publication of the studies in question research had suggested that the risk of venous thromboembolism and low dose combined oral contraceptives was, wait for it, 30 per 100 000 annually.

    As a …

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