Venous Thromboembolism Risk Higher for Certain Hormonal Contraceptives

THURSDAY, Feb. 13, 2025 (HealthDay News) — Venous thromboembolism (VTE) risk varies across hormonal contraceptives, according to a research letter published online Feb. 10 in the Journal of the American Medical Association.

Harman Gailan Hassan Yonis, M.D., from Aalborg University Hospital in Denmark, and colleagues examined VTE risk across contemporary hormonal contraceptives using Danish national registers including all females aged 15 to 49 years.

The researchers found 2,691 VTEs occurred among 1,397,235 females followed for 8,455,601 person-years. The researchers found that per 10,000 person-years, the standardized VTE rates were 2.0, 10.0, 8.0, 8.1, 3.6, 2.1, 3.4, and 11.9 for nonuse, combined pills, vaginal rings, patches, progestin-only pills, intrauterine devices (IUDs), implants, and injections, respectively. VTE rate ratios were 4.6, 4.5, 5.0, 1.8, 1.0, 2.4, and 5.7 for combined pills, vaginal rings, patches, progestin-only pills, IUDs, implants, and injections, respectively, compared with nonuse. Per 10,000 person-years, the corresponding additional VTEs were 8.0 for combined pills versus nonuse and 6.0, 6.1, 1.6, 0.1, 1.4, and 9.9 for vaginal rings, patches, progestin-only pills, IUDs, implants, and injections, respectively. Per 10,000 person-years, VTE excess varied by combined pill formulation from 3.0 for 20-µg estrogen pills with levonorgestrel to 14.2 for combined pills containing third-generation progestins. After adjusting for body mass index, smoking, and family history, the associations remained consistent.

“Variation in VTE risk across products underscores the importance of personalized contraceptive counseling,” the authors write.

Several authors disclosed ties to the biopharmaceutical industry.

Abstract/Full Text (subscription or payment may be required)