Editorials

The third generation pill controversy (“continued”)

BMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7305.119 (Published 21 July 2001) Cite this as: BMJ 2001;323:119

The risks are still small compared with those of pregnancy

  1. J O Drife, professor of obstetrics
  1. General Infirmary, Leeds LS2 9NS

    Papers p 131

    The debate about the safety of third generation oral contraceptives shows no sign of fading away. Since it began in 1995 the main participants have been epidemiologists and clinical pharmacologists. There has been little input from the clinicians who prescribe oral contraceptives or from the women who use them.

    About 80% of British women use the pill at some time between the ages of 16 and 24.1 It was this age group that paid the price of the October 1995 scare, prompted by the publicity surrounding the announcement of the Committee on Safety of Medicines that third generation oral contraceptives had a higher risk of inducing venous thromboembolism. In the first quarter of 1996 in England and Wales there were 6198 more abortions than in the previous quarter (a 16% rise), and the increase continued more slowly until 1998.2 Doctors who counsel women with unplanned pregnancy are still angry about the amount of human misery caused by information mismanagement.

    The 1995 scare arose from three studies that reported that the risk of venous thromboembolism among users of pills containing levonorgestrel was half that of pills containing desogestrel or gestodene—the so called “third generation” progestogens. Over the following five years, …

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