If a woman has not had a thrombotic event in years of use she is unlikely to have one now

BMJ 1995;311:1638-1639 (16 December)

Letters

If a woman has not had a thrombotic event in years of use she is unlikely to have one now

EDITOR,--My editorial commenting on the letter from the Committeeon Safety of Medicines and the three studies that gave riseto it had to be cut because of lack of space.¹ In the originalversion I argued that, in these trials, the proportion of womenwho had been exposed in the past to ethinyloestradiol (in anycombination) might be higher among current users of the thirdgeneration pills containing desogestrel and gestodene; ethinyloestradiolis still recognised as the prime prothrombotic constituent ofcontraceptive pills. This difference would effectively meanthat a smaller proportion of women taking the longer establishedpills had hereditary disorders of coagulation (since such womenwould have stopped using the pill early because they had hada thromboembolic event). The users of products containing levonorgestreland norethisterone might then comprise, in effect, a populationof survivors who are less at risk of the condition under study.I . . . [Full text of this article]

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