Understanding VTE Risks Associated with Hormonal Contraceptives
Recent research highlighted in the Journal of the American Medical Association reveals that the risk of venous thromboembolism (VTE) can significantly differ depending on the type of hormonal contraceptive used. This study focused on a large population of women aged 15 to 49 years across Denmark.
Study Findings
The analysis included data from over 1.3 million women, tracking a total of 8,455,601 person-years. During this period, 2,691 cases of VTE were reported. The study found varying VTE rates per 10,000 person-years across different methods of hormonal contraception: nonuse (2.0), combined oral contraceptive pills (10.0), vaginal rings (8.0), patches (8.1), progestin-only pills (3.6), intrauterine devices (IUDs) (2.1), implants (3.4), and injections (11.9).
Comparative VTE Rate Ratios
The VTE rate ratios compared to nonuse were quite revealing: combined pills (4.6), vaginal rings (4.5), patches (5.0), progestin-only pills (1.0), IUDs (2.4), implants (1.8), and injections (5.7). Additionally, per 10,000 person-years, the additional VTE cases attributed to combined pills were 8.0, with vaginal rings showing 6.0, patches at 6.1, progestin-only pills at 1.6, IUDs at 0.1, implants at 1.4, and injections at 9.9.
Formulation Matters
Interestingly, the additional risk varied even further by the specific formulation of combined pills. Those containing 20-µg estrogen with levonorgestrel had an excess VTE rate of 3.0, while combined pills with third-generation progestins exhibited a higher excess risk of 14.2.
Importance of Personalized Counseling
The research underscores the critical need for personalized contraceptive counseling, taking into account the variations in VTE risks among different contraceptive products. Awareness of these differences can empower women to make informed choices regarding their contraceptive options and overall health.
It is worth noting that several authors of the study have disclosed connections to the biopharmaceutical industry.
