UK: BPAS responds to media coverage of contraceptive Pill research

‘This research simply adds to the medical evidence that the Pill is very safe medication, whichever brand women take,’ says Dr Patricia Lohr.

Responding to the British Medical Journal report that new research has confirmed a long-understood increased risk of venous thromboembolism (VTE) in women taking the combined oral contraceptive pill, Dr Patricia Lohr, Medical Director of BPAS, continued:

‘Media coverage of Pill risks must be kept in proportion with what the research actually says. We’d be worried if women were unnecessarily concerned by today’s coverage.

‘The absolute risk of suffering a venous thromboembolism (VTE) from any brand of the Pill is extremely low. We also know that the risk of suffering a VTE associated with pregnancy is higher than the risk while taking the Pill. So women who are very concerned about their VTE risk should not stop taking the Pill without considering the balance of risks involved. Our advice is that there’s no need for women who are happy with their current Pill brand to switch on the basis of these findings. If women are considering switching Pills they should always speak to their doctor.’

It is well established in the medical literature that combined hormonal contraceptive methods lead to an increased risk of venous thromboembolism, but that the absolute risk of VTE occurrence is extremely low. Prior studies show that the absolute risk of VTE on combined oral contraceptive pills (OCP) is extremely low even with 3rd generation progestogen formulations, which appear to have an elevated risk compared to the 2nd generation formulations. Of 100,000 women on a 3rd generation OCP, 30 will have a VTE per year. (Mills A. ‘Combined oral contraception and the risk of venous thromboembolism’. Human Reproduction. 1997;12:2595-8) Comparatively, the risk of VTE in pregnancy is greater, at about 60 in 100,000 per year.

To put VTE and other cardiovascular adverse events in context, it’s important to note that incidence is low in reproductive-age women overall, with or without any OCP use. Smoking has greater effect on cardiovascular adverse event incidence and mortality than does OCP use at all ages. (Farley TMM, Collins J, Schlesselman JJ. Hormonal contraception and risk of cardiovascular disease: an international perspective. Contraception. 1998;57;211-30).

According to the Office of National Statistics, the Pill is the most commonly used contraceptive in the UK. In 2007/08, three-quarters of women in the 16-49 age group reported using some form of contraception, with 28 per cent of women using the Pill, compared with 24 per cent who relied on the male condom.
In 1995, a non-evidence-based public health scare about the Pill in the UK was associated with a marked subsequent increase in unintended pregnancy and abortion, after some women reportedly ceased to take the Pill on the basis of concerns following misrepresented new Pill research. The adverse public health effects of this episode are discussed in Furedi A, ‘The public health implications of the 1995 ‘pill scare’’, Human Reproduction Update 1999, Vol. 5 No. 6, pp 621-626. Also in A Mills, ‘Combined oral contraception and the risk of venous Thromboembolism’, Human Reproduction vol.12 no.12 pp.2595–2598, 1997.