@entity65 have been a concern since combined oral contraceptives (OCs) were first introduced. In the past four years new, mostly reassuring information on the safety of modern, low @entity2931 dose OCs has become available. However, in 1995 the new information showed higher @entity1211 ( @entity1211 ) risk for OCs containing desogestrel and @entity2081 compared with @entity2692 - or @entity8098 -containing OCs. The controversial responses by national authorities, their scientific and public health merits were hotly debated and many considered the differences in risk small and resulted from bias and/or confounding. We discuss these arguments and conclude they lack empirical support or cannot account for the 2-fold increased risk. The risk of @entity64 and @entity583 ( @entity583 ) associated with low @entity2931 dose OCs are very small in @entity1 without cardiovascular risk factors, while increased risk of @entity548 is confined to @entity1 >35 years of age. Applying the most recent risks to models of OC-attributable events and deaths, OC-attributable mortality in @entity1 <35 years is estimated to be <3 per million users annually, rising to about 10 per million users annually among smokers. In the context of external cause mortality (about 90 per million @entity1 of reproductive age annually in the UK) such risks appear small. Over the age of 35 years, OC-attributable mortality is a more important concern, particularly among smokers. In the absence of any appreciable OC-attributable mortality in young healthy @entity1 , the additional @entity1211 risk for third compared with second generation OCs should be considered when @entity1 choose which OC to use.

XXXX and combined oral contraceptives: reviewing the evidence and balancing the risks.

@entity8098 :: ('MESH:D009640', 'Chemical') :: ['norethindrone'] @entity1 :: ('9606', 'Species') :: ['women'] @entity64 :: ('MESH:D020521', 'Disease') :: ['ischaemic stroke'] @entity2081 :: ('MESH:C033273', 'Chemical') :: ['gestodene'] @entity548 :: ('MESH:D006470', 'Disease') :: ['haemorrhagic stroke'] @entity2931 :: ('CHEBI:50114', 'Chemical') :: ['oestrogen'] @entity2692 :: ('MESH:D016912', 'Chemical') :: ['levonorgestrel'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction', 'MI'] @entity1211 :: ('MESH:D054556', 'Disease') :: ['VTE', 'venous thromboembolism'] @entity65 :: ('MESH:D002318', 'Disease') :: ['Cardiovascular risks']
@entity65 :: (MESH:D002318,Disease) :: ['Cardiovascular disease']
