Letters
Doctors should take warning seriously
EDITOR,--I wish to challenge John Guillebaud's editorial1 on the recent warning by the Committee on Safety of Medicines about combined oral contraceptives containing gestodene and desogestrel.2 Some family planning doctors will not agree with his views on a continued role for preparations that seem to double the risk of venous thromboembolism for current users compared with users of low dose monophasic oral contraceptives containing levonorgestrel and norethisterone. There is no evidence from epidemiological studies that preparations containing levonorgestrel and norethisterone carry a comparatively greater risk of excess deaths from myocardial infarction or stroke. It is virtually impossible to show an increased risk of myocardial infarction in current or past users of any combined oral contraceptive formulation if they have avoided higher dose preparations, provided that they do not smoke.3 It hardly seems necessary, therefore, to make premature claims for formulations that may protect women from a barely identifiable risk.
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- Advising women on which pill to take
- John Guillebaud
BMJ 1995 311: 1111-1112.[Extract] [Full Text]
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