ArticleBMJ (Clinical research ed.)2009
Hormonal contraception and risk of venous thromboembolism: national follow-up study.
Article in BMJ (Clinical research ed.), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 157 papers, 13 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
157 citing papers in PubMed, 13 syntheses or guidelines pooled it.
- Representation of women in cardiovascular disease management: a systematic analysis of ESC guidelines.Open heart · 2025Pooled it
- U.S. Selected Practice Recommendations for Contraceptive Use, 2024.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2024Guideline
- Testosterone therapy and venous thromboembolism: A systematic review and meta-analysis.Thrombosis research · 2018Pooled it
- Association between progestin-only contraceptive use and cardiometabolic outcomes: A systematic review and meta-analysis.European journal of preventive cardiology · 2018Pooled it
- A systematic review and meta-analysis of venous thrombosis risk among users of combined oral contraception.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2018Pooled it
- A systematic review of cost-effectiveness analysis of screening interventions for assessing the risk of venous thromboembolism in women considering combined oral contraceptives.Journal of thrombosis and thrombolysis · 2017Pooled it
- Progestin-only contraception and thromboembolism: A systematic review.Contraception · 2016Pooled it
- Combined oral contraceptives: venous thrombosis.The Cochrane database of systematic reviews · 2014Pooled it
- Progestin-only pills for contraception.The Cochrane database of systematic reviews · 2013Pooled it
- Different combined oral contraceptives and the risk of venous thrombosis: systematic review and network meta-analysis.BMJ (Clinical research ed.) · 2013Pooled it
- Acute uterine bleeding unrelated to pregnancy: a Southern California Permanente Medical Group practice guideline.The Permanente journal · 2013Guideline
- Assessing the risk of venous thromboembolic events in women taking progestin-only contraception: a meta-analysis.BMJ (Clinical research ed.) · 2012Pooled it
- Oral contraceptives and venous thromboembolism: a systematic review and meta-analysis.Drug safety · 2012Pooled it
- Ethinylestradiol in combined hormonal contraceptive has a broader effect on serum proteome compared with estradiol valerate: a randomized controlled trial.Human reproduction (Oxford, England) · 2023Trial
- Trial
- Multinational, multicentre, randomised, open-label study evaluating the impact of a 91-day extended regimen combined oral contraceptive, compared with two 28-day traditional combined oral contraceptives, on haemostatic parameters in healthy women.The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception · 2014Trial
- Long-term tolerability of ethinylestradiol 20 μg/drospirenone 3 mg in a flexible extended regimen: results from a randomised, controlled, multicentre study.The journal of family planning and reproductive health care · 2012Trial
- Effects of a monophasic combined oral contraceptive containing nomegestrol acetate and 17β-oestradiol compared with one containing levonorgestrel and ethinylestradiol on haemostasis, lipids and carbohydrate metabolism.The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception · 2011Trial
- Contraceptive efficacy of oral and transdermal hormones when co-administered with protease inhibitors in HIV-1-infected women: pharmacokinetic results of ACTG trial A5188.Journal of acquired immune deficiency syndromes (1999) · 2010Trial
- Coagulation activation in anorexia nervosa: increased tissue factor and prothrombin fragment 1+2.Research and practice in thrombosis and haemostasis · 2026Article
97 more citing papers are in PubMed but not listed here.
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess the risk of venous thrombosis in current users of different types of hormonal contraception, focusing on regimen, oestrogen dose, type of progestogen, and route of administration.
designNational cohort study.
settingDenmark, 1995-2005.
participantsDanish women aged 15-49 with no history of cardiovascular or malignant disease.
main outcome measuresAdjusted rate ratios for all first time deep venous thrombosis, portal thrombosis, thrombosis of caval vein, thrombosis of renal vein, unspecified deep vein thrombosis, and pulmonary embolism during the study period.
results10.4 million woman years were recorded, 3.3 million woman years in receipt of oral contraceptives. In total, 4213 venous thrombotic events were observed, 2045 in current users of oral contraceptives. The overall absolute risk of venous thrombosis per 10 000 woman years in non-users of oral contraceptives was 3.01 and in current users was 6.29. Compared with non-users of combined oral contraceptives the rate ratio of venous thrombembolism in current users decreased with duration of use (<1 year 4.17, 95% confidence interval 3.73 to 4.66, 1-4 years 2.98, 2.73 to 3.26, and >4 years 2.76, 2.53 to 3.02; P<0.001) and with decreasing dose of oestrogen. Compared with oral contraceptives containing levonorgestrel and with the same dose of oestrogen and length of use, the rate ratio for oral contraceptives with norethisterone was 0.98 (0.71 to 1.37), with norgestimate 1.19 (0.96 to 1.47), with desogestrel 1.82 (1.49 to 2.22), with gestodene 1.86 (1.59 to 2.18), with drospirenone 1.64 (1.27 to 2.10), and with cyproterone 1.88 (1.47 to 2.42). Compared with non-users of oral contraceptives, the rate ratio for venous thromboembolism in users of progestogen only oral contraceptives with levonorgestrel or norethisterone was 0.59 (0.33 to 1.03) or with 75 mug desogestrel was 1.12 (0.36 to 3.49), and for hormone releasing intrauterine devices was 0.90 (0.64 to 1.26).
conclusionThe risk of venous thrombosis in current users of combined oral contraceptives decreases with duration of use and decreasing oestrogen dose. For the same dose of oestrogen and the same length of use, oral contraceptives with desogestrel, gestodene, or drospirenone were associated with a significantly higher risk of venous thrombosis than oral contraceptives with levonorgestrel. Progestogen only pills and hormone releasing intrauterine devices were not associated with any increased risk of venous thrombosis.
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