Table I.
Summary of information useful for clinical practice
| Preparation | Type of study, Reference No. (year) | Main message |
|---|---|---|
| COC | Review, 10 (2001) | COC users: 3–6 times higher risk of VTE than non-users |
| Historical cohort study, 36 (2012) | COC with 20 μg EE/desogestrel/gestodene vs non-users: 1.5–2 times higher risk of MI | |
| Progestogenonly pill | Systematic review, 31 (2018) | Adjusted RR for VTE, MI and stroke not statistically significant vs non-users |
| LNG-IUD | Large, retrospective study, 43 (2012) | No increased risk of VTE vs non-users |
| Estradiol valerate/dienogest | Prospective, controlled, non-interventional, 42 (2016) | VTE and serious cardiovascular events not significantly different vs EE/LNG users |
| Non-oral preparations | Retrospective study, 43 (2012) | Transdermal patches and vaginal ring vs non-users or users of COC containing LNG: ~7–8 fold higher VTE risk |
| Historical cohort study, 36 (2012) | Vaginal ring vs non-users: 2.5 higher risk of MI | |
| Hormone replacement therapy | Randomized controlled trial, 51 (2002) | VTE, coronary heart disease and stroke 7–8 fold higher in CEE/MPA Estradiol confers a lower VTE risk than CEE w/o progestins or combined preparations |
| Case-control, 54 (2019) | CEE/MPA users show 2-fold higher VTE risk than non-users; estradiol/dydrogesterone users had the lowest risk Transdermal preparations did not increase VTE risk |
COC: combined oral contraceptives; VTE: venous thromboembolism; EE: ethinylestradiol; MI: myocardial infarction; RR: relative risk; LNG: levonorgestrel; CEE: conjugated equine estrogen; MPA: medroxyprogesterone acetate.